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Temporomandibular Disorders and Facial Pain: A Psychophysiological Perspective

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Abstract

This article presents a psychophysiological perspective on temporomandibular muscle and joint disorders (TMJD) and facial pain. After a brief introduction to TMJD, the article presents data, largely derived from work carried out in my laboratory, that address four questions: (1) What are the consequences of parafunctional activities? (2) Do TMJD patients engage in parafunctional activities? (3) Why are TMJD patients unaware of these activities? and (4) What are the implications of these findings for treatment? The findings suggest that low-level parafunctions increase pain in otherwise pain-free individuals and can produce symptoms sufficiently severe to meet the diagnostic criteria for TMJD diagnoses of myofascial pain and/or arthralgia. Patients with certain forms of TMJD report very high levels of parafunctional tooth contact. Their lack of awareness of these behaviors may arise from uncertain definitions of the term “clenching”, from proprioceptive deficits, or from the presence of adjunctive behaviors. Preliminary work shows that reduction in tooth contact via habit reversal techniques may be a promising mechanism for reducing pain in these patients.

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Acknowledgments

I thank my co-author colleagues for their many contributions. I also thank Asha Stevens and Chris Turner for their help. I’m grateful for the support of the National Institute of Dental and Craniofacial Research for much of the work reported in this article.

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  1. Kansas City University of Medicine and Biosciences, 1750 Independence Ave., Kansas City, MO, 64106, USA

    Alan G. Glaros

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Glaros, A.G. Temporomandibular Disorders and Facial Pain: A Psychophysiological Perspective. Appl Psychophysiol Biofeedback 33, 161–171 (2008). https://doi.org/10.1007/s10484-008-9059-9

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