Stress and salivary cortisol levels among temporomandibular disorders: a case-control study

TMDs patients experience significantly higher lifetime stress and cortisol levels than controls. Myalgia patients showed a complex psychological and physiological stress link, whereas the DDWoR with LO subgroup exhibited a distinct physiological stress response. Specific life stressors, particularly relationship- and partner-related stress, are key predictors of TMDs. These findings reinforce the importance of a biopsychosocial approach in understanding and managing TMDs. Future research should focus on longitudinal and interventional studies to further elucidate causal mechanisms and effective therapeutic strategies.