Salivary cortisol responses to acute stress in students with myofascial pain

Introduction/Objective Temporomandibular disorders (TMD) are characterized by the appearance of musculoskeletal pain and dysfunction of the masticatory system. The aims of this study were to evaluate the salivary cortisol levels in students with chronic myofascial pain (MFP) related to TMD during oral exam, as well as to analyze the correlation between salivary cortisol levels, TMD-related MFP, the level of anxiety, depression symptoms, somatization, and perceived stress. Methods The study included 60 university students, who were allocated either into the group of students with MFP (n = 30) or into the control group of healthy students (n = 30). The level of salivary cortisol was measured on the exam day and during the control day when the students had no exams. Depression symptoms, somatization, perceived stress and anxiety were evaluated according to Axis II RDC/TMD, Perceived Stress Scale and State-Trait Anxiety Inventory. Results Levels of salivary cortisol were significantly higher in the group of students with MFP in all phases of measurements compared to the control group (p < 0.01). Students with MFP also showed significantly higher depression symptoms, somatization, and trait anxiety scores than the control group. No significant group differences were found on the scales measuring state anxiety and perceived stress. The level of salivary cortisol was found to be in correlation with depression symptoms, state anxiety, and perceived stress, but not with chronic pain, somatization, and trait anxiety in students with TMD. Conclusion Salivary cortisol could be an important indicator of psychological distress in TMD.