Assessment of cortisol as salivary psychological stress marker in relation to temporomandibular disorders among a sample of dental students


Background: University dental students perceived a higher level of stress prior to the final exam associated with raisedsalivary cortisol levels which could be considered as a useful noninvasive biomarker for measuring acute stress. Usinga Helkimo anamnestic and clinical dysfunction scoring for temporomandibular disorders can give a better insightabout the association of this marker and temporomandibular joint disorders. The aim of this study was to evaluationlevel of salivary cortisol in stressor students with temporomandibular disorder and the relation between this marker inrelation to temporomandibular disorder severity. This might give a better understanding to the role of psychologicalstress as an etiological factor for developing temporomandibular joint problems.Materials and methods: A total eighty participants age between 20 to 24 were recruited for this study. Theparticipants were University dental students under graduate students at final examination period who wereexamined and gave saliva samples in final examination period. Salivary assay kits as cortisol was used to measurethose variables and a Helkimo anamnestic and clinical dysfunction scoring for TMD.Results: The group of participants with stress and temporomandibular disorder showed significantly higher levels ofsalivary cortisol than the control group, the salivary cortisol has statistically significant correlation with Helkimoanamnestic categories (Di-I mild, Di-II moderate and Di-III severe. Salivary cortisol levels show significant but weakassociation with two categories of clinical dysfunction criteria in Helkimo index system, which are Muscle pain andTMJ pain on palpation.Conclusion: This study demonstrated that University students perceived a high level of stress before the finalexamination. Salivary cortisol is the stress biomarker that is most often used to measure acute stress. Helkimoanamnestic and clinical dysfunction scoring criteria for still the pioneer for measuring a temporomandibular disorder