Levels of Salivary Cortisol in Adults and Children With Bruxism Diagnosis: A Systematic Review and Meta-Analysis

Fritzen, Vanessa Martinello; Colonetti, Tamy; Cruz, Mateus; Ferraz, Sarah Dagostin; Ceretta, Luciane Bisognin; Tuon, Lisiane; Rosa, Maria Inês da; Ceretta, Renan Antonio

doi:10.1016/j.jebdp.2021.101634

Cited by 10 publications

(6 citation statements)

References 21 publications

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“…These results suggest that further and better designed studies are needed to clarify the link between SB and stress [35]. A recent systematic review showed that in a total of six primary studies, involving 854 participants, analysis of cortisol levels showed a significant difference in favor of the control group of 1.10 (95% CI: 0.68-1.53), showing that patients with bruxism have higher salivary cortisol levels [36].…”

Section: Discussionmentioning

confidence: 99%

Sleep bruxism and perceived stress: assessment using salivary cortisol levels, a biomarker of stress

Lecor,

Dieng,

Soumboundou

et al. 2023

Ann Med Physiol.

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Sleep bruxism (SB) corresponds to physiologically based manducatory muscle reactions, with no identifiable neuropathic cause, in relation to anxiety disorders, respiratory disorders or behavioral "tocs". The aim of this study was to assess the relationship between SB and perceived stress by measuring salivary cortisol levels. The study included 61 consenting adult participants: 31 for the study group (bruxers) and 30 for the control group (no bruxers). The diagnosis of BS was made using a standard bruxism assessment questionnaire defined by the American Academy of Sleep Medicine (AASM). The preliminary diagnosis was confirmed by clinical assessment according to AASM criteria. The BRUXi index, a tool proposed by Orthlieb, was used to determine the intensity of bruxism. Perceived stress was measured using the Perceived Stress Scale questionnaire. Unstimulated whole saliva was collected and morning salivary cortisol levels were determined by ELISA. Non-parametric statistical methods were used to analyze the data. The bruxers (study group) had significantly high levels of mean salivary cortisol (12.3±4.2 ng/mL or 34.5±14.6 nmol/L) than the non-bruxers (control group) (5.3±1.2 ng/mL or 14.5±4.6 nmol/L) (p<0.001). The elevated salivary cortisol level was positively associated with perceived stress and SB (p<0.0001) in the study group. These results suggest that bruxing activity is associated with higher levels of perceived psychological stress and salivary cortisol. Despite the absence of polysomnographic recording for the diagnosis of SB, a positive correlation between SB and salivary cortisol levels was observed in bruxers.

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Section: Discussionmentioning

confidence: 99%

Sleep bruxism and perceived stress: assessment using salivary cortisol levels, a biomarker of stress

Lecor,

Dieng,

Soumboundou

et al. 2023

Ann Med Physiol.

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“…This disharmony appears to be in the form of bite-raising or tooth loss (98)(99)(100). In a previous systematic review and meta-analysis by Fritzen et al (101), higher levels of salivary cortisol were observed in adult patients with bruxism, but not in children, whereas no associations were made with bruxism or stress or anxiety.…”

Section: Hpa Axis and Lateral Habenulamentioning

confidence: 95%

Neurobiology of bruxism: The impact of stress (Review)

Pavlou,

Spandidos,

Zoumpourlis

et al. 2024

Biomed Rep

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Bruxism is a non-functional involuntary muscle activity that affects more than one-third of the population at some point in their lives. A number of factors have been found to be related to the etiopathogenesis of bruxism; therefore, the condition is considered multifactorial. The most commonly accepted factor is stress. Stress has long been considered to increase muscle tone and to reduce the pain threshold. Current evidence indicates that exposure to chronic stress, distress and allostatic load ignite neurological degeneration and the attenuation of critical neuronal pathways that are highly implicated in the orofacial involuntary muscle activity. The present review discusses the negative effects that chronic stress exerts on certain parts of the central nervous system and the mechanisms through which these changes are involved in the etiopathogenesis of bruxism. The extent of these morphological and functional changes on nerves and neuronal tracts provides valuable insight into the obstacles that need to be overcome in order to achieve successful treatment. Additionally, particular emphasis is given on the effects of bruxism on the central nervous system, particularly the activation of the hypothalamic-pituitary-adrenal axis, as this subsequently induces an increase in circulating corticosterone levels, also evidenced by increased levels of salivary cortisol, thereby transforming bruxism into a self-reinforcing loop.

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“…muscle tone and reduced pain thresholds (8,9). In a systematic review and meta-analysis published in 2021, Fritzen et al (10) verified increased levels of salivary cortisol in bruxists. These increased levels correlate with strong circadian rhythms with peak levels during the activation periods (11).…”

Section: Nutrient Insufficiencies and Deficiencies Involved In The Pa...mentioning

confidence: 99%

Nutrient insufficiencies and deficiencies involved in the pathogenesis of bruxism (Review)

Pavlou,

Spandidos,

Zoumpourlis

et al. 2023

Exp Ther Med

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Stress has been well-documented to have a significant role in the etiopathogenesis of bruxism. Activation of the hypothalamic-pituitary-adrenal axis (HPA) and subsequent release of corticosteroids lead to increased muscle activity. Neurological studies have demonstrated that chronic stress exposure induces neurodegeneration of important neuronal structures and destabilization of the mesocortical dopaminergic pathway. These disruptions impair the abilities to counteract the overactivity of the HPA axis and disinhibit involuntary muscle activity, while at the same time, there is activation of the amygdala. Recent evidence shows that overactivation of the amygdala under stressful stimuli causes rhythmic jaw muscle activity by over activating the mesencephalic and motor trigeminal nuclei. The present review aimed to discuss the negative effects of certain vitamin and mineral deficiencies, such as vitamin D, magnesium, and omega-3 fatty acids, on the central nervous system. It provides evidence on how such insufficiencies may increase stress sensitivity and neuromuscular excitability and thereby reduce the ability to effectively respond to the overactivation of the sympathetic nervous system, and also how stress can in turn lead to these insufficiencies. Finally, the positive effects of individualized supplementation are discussed in the context of diminishing anxiety and oxidative stress, neuroprotection and in the reversal of neurodegeneration, and also in alleviating/reducing neuromuscular symptoms.

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Levels of Salivary Cortisol in Adults and Children With Bruxism Diagnosis: A Systematic Review and Meta-Analysis

Cited by 10 publications

References 21 publications

Sleep bruxism and perceived stress: assessment using salivary cortisol levels, a biomarker of stress

Sleep bruxism and perceived stress: assessment using salivary cortisol levels, a biomarker of stress

Neurobiology of bruxism: The impact of stress (Review)

Nutrient insufficiencies and deficiencies involved in the pathogenesis of bruxism (Review)

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