The study evaluated the impact of treatment on cortisol levels in acute pain patients at high risk for chronic jaw-related pain. Twenty-five patients with jaw pain or facial discomfort (< 6 months) participated in the study. Patients at high risk for chronic pain received biobehavioral intervention, and those at lower risk received standard care. Cortisol levels increased over time in both conditions, F(1, 429) = 6.614, p =.010; however, cortisol variability decreased among those receiving biobehavioral treatment (p <.043), whereas variability increased among those receiving standard treatment. Together, these findings underscore the potential role of cortisol activity in that it may influence the transition from acute pain to chronic pain.