Salivary stress biomarkers and anxiety symptoms in children with and without temporomandibular disorders

Abstract

The etiology of temporomandibular disorders (TMD), which are considered as a heterogeneous group of psychophysiological disturbances, remains a controversial issue in clinical dentistry. This study aimed to evaluate whether the salivary alpha-amylase (sAA), cortisol levels, and anxiety symptoms differ between children with and without TMD. Initially, 316 young subjects were screened in public schools (nonreferred sample); 76 subjects aged 7-14 years were selected and comprised the TMD and control groups with 38 subjects each matched by sex, age, and the presence/absence of sleep bruxism. Four saliva samples were collected: upon waking, 30 min and 1 h after awakening (fasting), and at night (at 8 PM) on 2 alternate days to examine the diurnal profiles of cortisol and sAA. Anxiety symptoms were screened using the Multidimensional Anxiety Scale for Children (MASC-Brazilian version). Shapiro-Wilk test, Student's t-test/Mann-Whitney U test, and correlation tests were used for data analysis. No significant differences were observed in the salivary cortisol area under the curve (AUC G mean ± SD = 90.22 ± 63.36 × 94.21 ± 63.13 µg/dL/min) and sAA AUC G (mean ± SD = 2544.52 ± 2142.00 × 2054.03 ± 1046.89 U/mL/min) between the TMD and control groups, respectively (p > 0.05); however, the clinical groups differed in social anxiety domain (t = 3.759; CI = 2.609, 8.496), separation/panic (t = 2.243; CI = 0.309, 5.217), physical symptoms (U = 433.500), and MASC total score (t = −3.527; CI = −23.062, −6.412), with a power of the test >80% and large effect size (d = 0.80), with no significant correlation between the MASC total score, cortisol, and sAA levels. Although children with TMD scored higher in anxiety symptoms, no difference was observed in the salivary stress biomarkers between children with and without TMD.

The association of genetic polymorphisms in serotonin transporter and catechol‐O‐methyltransferase on temporomandibular disorders and anxiety in adolescents

“…Previous studies demonstrated that stress and anxiety are strongly associated with TMD in children. [14][15][16] The influence of psychological factors on TMD development is unknown, but there is a possibility that genetic polymorphisms previously associated with stress and depression could be involved as mediating factors in the relationship between anxiety and TMD.…”

“…Modern lifestyles result in a more stressful environment for children and adolescents, with increased stimuli now beginning in early childhood through the use of applications, tablets and social media. Previous studies demonstrated that stress and anxiety are strongly associated with TMD in children …”

Characterisation of the relationships between rhythmic masticatory muscle activities and limb movements in patients with sleep bruxism

“…Although some studies suggest that genetic polymorphisms, stress, anxiety, smoking, alcohol intake, drug abuse, sleep apnoea, sleep position and gastroesophageal reflux may be associated with SB, the exact pathophysiologic mechanisms underlying SB are still largely elusive . The current treatments for SB include occlusal splints, biofeedback, kinesiotherapy, and repetitive transcranial magnetic stimulation, electrical stimulation as well as drug intake such as clonidine .…”

“…2,3 Sleep bruxism might not only cause destruction to teeth but also induce temporal and masseter muscle pain, temporomandibular disorders, and headache although SB in some conditions (eg, gastro-oesophageal reflex) might have protective effects which attribute to a decrease in the chance of a negative health outcome. 1,[4][5][6][7][8] Although some studies suggest that genetic polymorphisms, stress, anxiety, smoking, alcohol intake, drug abuse, sleep apnoea, sleep position and gastroesophageal reflux may be associated with SB, [9][10][11][12][13][14][15] the exact pathophysiologic mechanisms underlying SB are still largely elusive. [16][17][18] The current treatments for SB include occlusal splints, biofeedback, kinesiotherapy, and repetitive transcranial magnetic stimulation, electrical stimulation as well as drug intake such as clonidine.…”

Temporomandibular joint dysfunctions in the context of psychological disorders among pediatric patients

“…The greater part of scientific research is carried out without taking into account the control group or with improperly planned research work, for example by selecting the wrong research group or measuring tests. The problem under consideration in this work was presented in a tabular study - Table 1, which includes the studies: Pereira et al [9], Pizolato et al [10], Al-Khotani et al [11], Kobayashi et al [12], Sampaio et al [13], Sermet Elbay et al [14].…”