Patients with temporomandibular disorders (TMD) may exhibit elevated cortisol levels, suggesting that the stress hormone may help monitor the condition. The study was recently published in the Journal of Prosthetic Dentistry.
Additionally, computer-guided occlusal adjustments using disclusion time reduction (DTR) may reduce stress levels in patients with occlusomuscular TMD, the authors wrote.
“DTR therapy significantly reduced salivary cortisol levels in patients with occlusomuscular TMD,” wrote the authors, led by Dr. Sushmitha S. Goud of the Rajarajeswari Dental College and Hospital in India (J Prosthet Dent, March 6, 2026).
The study explored stress levels in patients with occlusomuscular TMD by measuring salivary cortisol before and after DTR therapy. Participants underwent a standardized clinical evaluation, including a TMD history and an assessment of occlusomuscular function using a digital synchronization module. Thirty adult patients provided baseline salivary cortisol samples, which were analyzed using enzyme-linked immunosorbent assay, they wrote.
Furthermore, all participants were treated using a digital occlusion analyzer synchronized with surface electromyography (sEMG) to reduce disclusion times to less than 0.5 seconds during lateral movements. One month after treatment, cortisol levels and occlusal-muscular measurements were reassessed, with each patient serving as their own control for comparison.
Mean salivary cortisol levels decreased significantly with a reduction of 4.85 ng/mL (p < 0.001). Left disclusion time was reduced with a mean difference of 2.04 seconds (p < 0.001). Similarly, right disclusion time decreased with a mean reduction of 2.32 seconds (p < 0.001), the authors wrote.
While overall right-to-left occlusal force balance did not change significantly, the distribution improved slightly (p > 0.38). Additionally, the average EMG activity of the bilateral masseter and temporalis muscles showed a significant change from baseline to one month after DTR at the start of excursive movement (p < 0.001).
However, the study had limitations. Changes in muscular symptoms or emotional state following DTR therapy were not assessed. These measures could have enhanced the clinical relevance of the observed cortisol reductions, they added.
“Salivary cortisol was found to be a reliable objective biomarker for monitoring levels in patients with TMD,” Goud and colleagues concluded.
