Prevalence of Temporomandibular Disorders and its Correlation with Stress and Salivary Cortisol Levels among Students

Abstract

Objective: To evaluate the prevalence of temporomandibular disorders (TMD) in students and to evaluate if any relationship existed between the stress levels, salivary cortisol levels, and TMD. Material and Methods: A total of 348 students, 187 female, and 161 male students, participated in this cross-sectional study. Students were evaluated based on the Research Diagnostic Criteria for TMD. The stress levels were evaluated using the Perceived Stress Scale. The students were divided into the control and TMD groups. Salivary cortisol levels in the salivary samples were analyzed. Results: The prevalence rate of TMDs was 30.7% in the study population. Of the female students, 61% had TMD compared with 46% of male students. Muscle disorders were the most predominant disorder in 14.2% of the students with TMD. The TMD group showed significantly higher salivary cortisol and stress levels than the control group. The TMD group also showed a moderate positive correlation between cortisol and stress levels (p=0.01). Conclusion:The study showed a strong association between salivary cortisol levels, stress, and temporomandibular disorders. Salivary cortisol could be used as a prognostic biomarker for stress while assessing the severity of TMJ problems in stressed individuals.

Salivary Biomarkers and Temporomandibular Disorders: A Systematic Review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions

“…MMP-3, 8-OHdG, 6Ckine, ANG, CXCL16, ENA-78, GM-CSF, IFN-, IL-1, IL-6, PAI-1, TGF-1, TIMP-1, VE-Cadherin and VEGF The TMD assessment methods were RDC/TMD in nine studies. [31][32][33]35,36,[38][39][40][41] TMD disorders were confirmed both clinically and radiographically in the study of B. Shukri et al 41 Hajer Jasim et al 33 ; Kobyashi FY et al 35 also tested for the diurnal variation of saliva on TMD.…”

“…Among the studies that assessed cortisol levels, Venkatesh et al 31 reported a statistically significant difference in salivary cortisol between the TMD group and the CG. They also observed TMD patients feeling more stressed.…”

“…Studies that did not meet the specific criteria or did not report on salivary biomarkers in relation to TMDs were excluded from the final selection. After applying these rigorous selection criteria, a total of 11 clinical papers [31][32][33][34][35][36][37][38][39][40][41] were found to be eligible for inclusion in the systematic review.…”

“…Table 3 represents the demographic variables of the 11 selected studies [31][32][33][34][35][36][37][38][39][40][41] that explored the relationship between salivary biomarkers and TMDs. The studies were conducted in various regions, including India, 31 Brazil, 32,35,36 Sweden, 33 Iran, 34,37,38 Turkey, 39 Canada 40 and the USA, 41 with different sample sizes ranging from 30 to 84 participants. The mean age of the participants varied across the studies, ranging from 10.63 to 49 years, with some studies not specifying the mean age.…”

“…Overall, nine studies [31][32][33][34]36,[38][39][40][41] showed some association of TMD with salivary biomarkers, while studies 35,37…”