(1) Background: Temporomandibular disorders (TMD) signs and symptoms affect the quality of life of patients because they impose an incapacity to participate in daily life activities, causing both physical and psychological discomfort. This review aims to provide the most accurate, comprehensive, and up-to-date description of all information available regarding OHRQoL in TMD. (2) Methods: A systematic search of articles from January 2013 till August 2023 was performed on five databases to identify articles, including TMD and oral health-related quality of life. Two calibrated reviewers performed the search following inclusion and exclusion criteria. A manual search of reference articles was also performed. The data were analyzed qualitatively by combining a meta-analysis and GRADE evidence. The Newcastle–Ottawa scale for cross-sectional and case-control studies was utilized to assess the quality of the included studies. (3) Results: The initial search consisted of 738 articles without the removal of duplicates. Fifteen articles were included in this systematic review, and ten were included in the meta-analysis. Almost all the included observational studies reported poor OHRQoL among patients with different types of TMD. The results of the meta-analysis with a standard mean difference (SMD) and that included seven studies suggest high heterogeneity with I² = 99%, SMD (95% CI) = 3.18 (1.90, 4.46), p-value < 0.01. The odds ratio analyzed for three included articles in the meta-analysis reported statistical significance (p-value < 0.01) with OR = 8.21 (2.39, 28.25) and a heterogeneity of 86%. The certainty of evidence by GRADE resulted in a downgraded level of evidence, indicating that the OHRQoL of TMD patients may differ slightly from the healthy controls. (4) Conclusions: The impact of OHRQoL on the TMD was deemed to be significant. Overall, the OHRQoL is low for any type and intensity of pain among TMD patients and controls.

Background: This systematic review examines and evaluates the relationship between salivary cortisol levels and temporomandibular disorder (TMD) in young adult patients. Method: Six databases—PubMed, Scopus, Web of Science, Google Scholar, ProQuest, and Cochrane Library—were utilized to screen eligible studies. A systematic search was performed based on PECO questions and eligibility criteria. The research question for this review was “Do salivary cortisol levels correlate with TMD in individuals aged 18–40?” The risk of bias for quality assessment was determined by the Cochrane tool. PRISMA guidelines were followed while performing this review. Result: A total of fourteen studies were included in this review. Of these, eleven were observational studies (four cross-sectional and seven case–control), and three were randomized control trials. Eleven of the included studies presented a low to moderate risk in the qualitative synthesis. The total sample size of the included studies was 751 participants. The included studies suggest higher salivary cortisol levels in TMD patients than in healthy individuals. Conclusions: The findings of this review indicate higher salivary cortisol levels in adult patients with TMD than in healthy controls. Thus, supportive psychological treatment and clinical modalities should be provided to patients with TMD. Moreover, higher-quality studies with low heterogeneity are required to support this finding.

BackgroundThe etiology of temporomandibular disorders (TMD) is multifactorial, involving a complex interplay of psychological and physiological factors. While salivary biomarkers, particularly cortisol, play an important role in TMD pathophysiology, evidence in the literature is still scarce and inconsistent. Hence, this study aims to evaluate the applicability of salivary cortisol as a potential biomarker for TMD in adults.MethodsThe Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were used to accurately diagnose TMD patients. The study included adults, both male and female, aged 18-40 in the TMD group (n = 66) and non TMD participants (n = 66) matched for age and gender. Salivary samples were collected from participants at two time points: early and late morning. Cortisol levels in the samples were quantified using enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using a one-way ANOVA to evaluate the correlations between cortisol levels and the study variables. Tukey's post-hoc tests were applied to adjust for multiple comparisons.ResultsSalivary cortisol levels were significantly higher in the TMD group than in the corresponding controls (p = 0.034). In the TMD group, the mean cortisol levels early in the morning were 29.95 +/- 75.05 (0-398.64), while the late morning levels were recorded as 4.87 +/- 3.96 (0-17.13). In the control group, the mean cortisol levels early in the morning were 10.98 +/- 16.83 (2.16-92.90), and late morning mean cortisol levels were 6.15 +/- 6.13 (0-20.42). This indicates that the early morning levels of cortisol are higher in TMD patients (p = 0.046). In the subgroup analysis of the TMD, the mean salivary cortisol levels recorded were highest at 82.49 +/- 124.34 (8.32-398.64) in patients having disc displacement without reduction with limited mouth opening. Furthermore, the mean salivary cortisol levels in the early morning were statistically higher (84.83 +/- 132.80) in males compared to females (9.36 +/- 9.01) (p = 0.008) with TMD.ConclusionThe result of this study suggests that salivary cortisol could be a potential biomarker for a specific TMD subtype (disc displacement without reduction with limited mouth opening). However, further studies are needed to better understand the role of cortisol biomarker in the underlying pathogenesis of TMD.

Background/Objectives: This study aims to evaluate the impact of temporomandibular disorders (TMDs) on oral health-related quality of life (OHRQoL), determine the effects of different influencing factors, and identify the most affected dimensions among the Saudi Arabian population. Methods: A cross-sectional study was conducted among 110 individuals visiting the Department of Oral Medicine at the Dental University Hospital (DUH), King Saud University. Participants were equally categorized into two groups: TMD and controls. The diagnosis was based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMDs). OHRQoL was assessed using the OHIP-TMD scale. Statistical analyses included independent t-tests, chi-square tests, and multivariate regression models to evaluate the association between TMD and OHRQoL. Results: The study population consisted of 72.7% females, with 91.8% holding a degree and 81.8% being married. TMD patients showed significantly lower OHRQoL scores in all domains (p ≤ 0.05), with the most pronounced impairments observed in terms of physical pain and psychological discomfort (p = 0.000). Marital status was a significant predictor of OHRQoL (p = 0.02; OR = 0.277), whereas gender and education showed no significant associations. Conclusions: TMD is significantly associated with impaired OHRQoL, particularly in the domains of physical pain and psychological discomfort. Marital status emerged as a significant demographic factor influencing OHRQoL. Given the cross-sectional nature of this study, the findings highlight associations rather than causation. Future longitudinal studies are recommended to establish causal relationships and further investigate the biopsychosocial impact of TMD on quality of life.

Introduction: The current systematic review aims to explore whether there is an association between temporomandibular disorder (TMD) and psychological factors such as stress, anxiety, and/or depression in young adults.Material and methods: A systematic search was conducted on 14 March 2023 for publications from inception until February 2023, according to the PRISMA guidelines, using five major databases: the Cochrane Database of Systematic Reviews, PubMed, EMBASE, Web of Science, SCOPUS, and Google Scholar. The PECO framework formulated the focused question “Is there an association between TMD and psychological factors (stress/depression/anxiety) among young adults?” The study was previously registered with trial no. CRD42023407502. Articles were selected according to the inclusion criteria. For each study, risk of bias was applied to assess the quality of the included article using the Newcastle-Ottawa scoring system. The level of evidence was determined using GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) scoring.Results: Sixteen studies were included for final qualitative synthesis and the certainty of evidence assessment out of the 15 546 studies identified initially from different databases, with the total of 6362 participants. The included studies confirmed the association between different types of TMD and psychological factors in young adults. The risk of bias among the included studies was low, and the GRADE evidence reported was very low among included studies.Conclusions: Within the scope of this systematic review, it could be concluded that there is an association between temporomandibular disorder and psychological factors. Painful TMD in young females was associated with anxiety and stress.

Background: This study investigated how cumulative lifetime stress, as measured by the Stress and Adversity Inventory (STRAIN) scale, relates to salivary cortisol levels in temporomandibular disorders (TMD) patients compared to controls. Furthermore, to determine which specific lifetime stress domains are the strongest predictors of TMD. Methods: The study was conducted with 110 participants (55 TMDs patients, 55 controls). Lifetime stress was assessed using the STRAIN questionnaire, and salivary cortisol levels were measured at two time points (7 AM and 10 AM) using Enzyme-Linked Immunosorbent Assay (ELISA). Statistical analyses included t-tests, Analysis of variance (ANOVA) and multiple regression to identify significant stress predictors for TMD. Results: The TMDs patients had significantly higher stress scores (11.10 ± 3.26) compared to the controls (1.43 ± 0.99) (p = 0.001). Myalgia showed highest stress levels (11.69 ± 3.72), while patients with myofascial pain had the lowest (8.80± 1.14) (p = 0.043). Cortisol levels were highest in the of disc displacement without reduction with limited mouth opening (DDWoR with LO) group (82.49 ± 124.34) and lowest in myalgia patients (4.69 ± 3.90) (p = 0.001). Significant stress predictors for TMDs included relationship stress (p = 0.04), humiliation (p = 0.02), marital/partner stress (p < 0.001) and death-related stress (p = 0.01). Conclusions: 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.