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Psychological implications in temporomandibular pain and dysfunction

J D Rugh, W K Solberg

    Oral Sciences Reviews
    |January 1, 1976
    PubMed
    Summary

    Psychological factors significantly contribute to temporomandibular joint (TMJ) disorders, necessitating a multifactorial approach to understanding and treatment. Comprehensive patient evaluation should integrate physical, emotional, and interpersonal assessments for effective management of TMJ disorders.

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    Area of Science:

    • Psychology
    • Dentistry
    • Pain Management

    Background:

    • Temporomandibular joint (TMJ) disorders are complex conditions with psychological factors playing a significant role in their etiology and perpetuation.
    • A comprehensive understanding of TMJ disorders requires a multifactorial etiological perspective, integrating emotional, behavioral, and interpersonal aspects.
    • The current symptom complex of TMJ disorders represents the musculoskeletal component of a broader pattern of dysfunction.

    Purpose of the Study:

    • To review the role of psychological factors in the etiology and management of temporomandibular joint (TMJ) disorders.
    • To advocate for a multifactorial approach to understanding and treating TMJ disorders, moving beyond unilateral etiological views.
    • To emphasize the importance of integrating psychological assessments and treatments with traditional dental approaches for TMJ disorders.

    Main Methods:

    • Review of existing literature on the psychological and multifactorial etiology of temporomandibular joint (TMJ) disorders.
    • Analysis of the interplay between emotional factors, behavioral patterns, and interpersonal relationships in the context of TMJ disorders.
    • Discussion of diagnostic challenges and the need for more explicit diagnostic criteria for TMJ disorders.

    Main Results:

    • Psychological factors, including anxiety, fear, frustration, and anger, significantly contribute to TMJ disorders by eliciting muscular tension and oral habits.
    • While not a 'necessary' factor, emotionally induced muscle activity is likely a 'sufficient' cause for TMJ disorders.
    • Chronic pain in TMJ patients is a significant prognostic indicator, comparable to physical findings.
    • The placebo effect, influenced by the doctor-patient relationship, is a powerful therapeutic tool in managing TMJ disorders.

    Conclusions:

    • A multifactorial etiology, encompassing psychological and physical components, is essential for understanding TMJ disorders.
    • Integrated treatment approaches combining dental and psychological interventions show greater promise for managing TMJ disorders.
    • Comprehensive patient evaluation must include physical, emotional, and interpersonal assessments for effective TMJ disorder management.

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