Temporomandibular Disorders at The Crossroads: Investigating Vitamin D, Sleep, and Psychological Correlations

Canseda Avağ; Zeynep Ece Öz; Serhat Çandırlı; Dilara Kazan

doi:10.7126/cumudj.1707863

Temporomandibular Disorders at The Crossroads: Investigating Vitamin D, Sleep, and Psychological Correlations

Abstract

Objectives: Vitamin D status and circadian rhythm disturbances have been implicated in chronic pain conditions. This study investigated the relationships between vitamin D levels, sleep chronotype, and psychological factors in temporomandibular disorders (TMD) patients compared to healthy controls. Materials and Methods: This cross-sectional study assessed the relationship between vitamin D levels, sleep chronotype, and psychological distress in individuals with TMD, diagnosed according to RDC/TMD criteria. Participants were aged 18–45 and had undergone vitamin D testing within the last month. Vitamin D status was categorized as deficient (<20 ng/mL), insufficient (21–29 ng/mL), or normal (≥30 ng/mL). Chronotype was assessed using the Morningness-Eveningness Questionnaire, and psychological distress was measured using the Depression Anxiety Stress Scale-21 (DASS-21). Results: The study included 51 participants (25 TMD patients, 26 controls). Vitamin D deficiency and insufficiency were more frequent in TMD patients, while normal levels were more common in controls (p=0.302). Mean serum vitamin D levels were also lower in the TMD group (19.77±11.53 vs 23.37±11.71 ng/mL), though this difference was not statistically significant (p=0.274). Chronotype distribution differed significantly (p=0.013), with evening types more common in TMD patients and morning types more frequent in controls. DASS-21 scores were higher in TMD patients but did not differ significantly between groups (p=0.267). Conclusions: This study highlights a strong association between evening chronotype and TMD, suggesting a circadian influence in its pathogenesis. Although vitamin D levels were lower in TMD patients, no statistically significant association was found. These findings support the relevance of circadian patterns in TMD development and underscore the need for further research on the role of vitamin D in chronic pain conditions.

Keywords

Supporting Institution

2209 Program of the Scientific and Technological Research Council of Turkey (TÜBİTAK)

Project Number

1919B012221072

Ethical Statement

The study has been reviewed and approved by the Institutional Review Board of the Biruni University, Istanbul, Turkiye (approval date: 19.07.2023, IRB No. 2023/82-10). Informed written consent from each of the participants for this research was obtained.

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Details

Primary Language

English

Subjects

Oral and Maxillofacial Surgery

Journal Section

Research Article

Authors

Canseda Avağ ^*
0000-0002-6180-9159
Türkiye

Zeynep Ece Öz
0009-0001-5306-3406
Türkiye

Serhat Çandırlı
0009-0009-5780-5727
Türkiye

Dilara Kazan
0000-0002-7471-8758
Türkiye

Publication Date

December 29, 2025

Submission Date

May 29, 2025

Acceptance Date

September 26, 2025

Published in Issue

Year 2025 Volume: 28 Number: 4

DOI

https://doi.org/10.7126/cumudj.1707863

IZ

https://izlik.org/JA86SZ48MA

Cite

RIS / Bibtex

EndNote

Avağ C, Öz ZE, Çandırlı S, Kazan D (December 1, 2025) Temporomandibular Disorders at The Crossroads: Investigating Vitamin D, Sleep, and Psychological Correlations. Cumhuriyet Dental Journal 28 4 512–519.