The impact of stress on psychological and physiological aspects of health of patients with TMD: A literature review from 2015–2020

Abstract

Introduction: Studies suggest that temporomandibular disorders (TMD) are a complex disorder with many causes consistent with the biopsychosocial disease model. One of the important areas of TMD etiology are psychological factors, including stress, but its role in the mechanism of TMD formation is ambiguous. Aim: The aim of this literature review was to summarize the latest study about the impact of stress in relation to temporomandibular joint disorders. Material and methods: Articles from PubMed and PEDro online databases were identified using the keywords ‘stress,’ ‘distress,’ ‘TMD.’ The review included works published in the period from October 1, 2015 to March 6, 2020. Finally, 10 articles were qualified for the review. Results and discussion: The most frequently used research tool was the questionnaire. Other methods used to evaluate a level of stress in TMD patients were measurement of cortisol level and surface electromyography of masticatory muscles. Conclusions: Stress is one of the psychological factors involved in TMD pathophysiology. Increased levels of stress in patients with TMD are associated with elevated levels of cortisol, hyperactivity of the HPA axis and increased bioelectric activity of the masticatory muscles. There is a need to extend research on the effects of stress on TMD by more objective methods.

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