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From bite to mind: TMD--a personal and literature review
1Department of Oral and Jaw Diseases, Karolinska Hospital, Stockholm, Sweden. carl.molin@stockholm.mail.telia.com
The International Journal of Prosthodontics
|January 15, 2000
Summary
Temporomandibular disorders (TMD) understanding has evolved from mechanistic to psychosomatic concepts. Current approaches emphasize physiotherapy and cognitive behavior therapy over traditional bite-centered treatments for chronic TMD pain.
Area of Science:
- Dental Medicine
- Psychosomatic Medicine
- Pain Research
Background:
- Temporomandibular disorders (TMD) have seen significant shifts in conceptualization over the past 50 years.
- Early theories focused on mechanical explanations, such as Costen syndrome.
- Recent decades have incorporated psychological and psychosocial factors into TMD understanding.
Purpose of the Study:
- To provide a personal perspective on the evolution of TMD concepts.
- To explore the role of stress in oral parafunctions and masticatory muscle pain.
- To present hypotheses on the pathogenetic mechanisms of TMD.
Main Methods:
- Review of personal clinical and research experiences with TMD patients.
- Analysis of historical and contemporary literature on TMD.
- Inclusion of research from stress, psychosocial, and occupational medicine.
Main Results:
- TMD understanding has progressed from mechanistic to biopsychosocial models.
- Refractory TMD is increasingly viewed as a chronic pain condition.
- The development of TMD theories reflects a shift towards integrated approaches.
Conclusions:
- Bite-centered therapies for TMD are being replaced by evidence-based treatments.
- Physiotherapy and cognitive behavior therapy are becoming primary interventions for TMD.
- The study's hypotheses may offer new insights into oral parafunctions and muscle pain.