Stress-Related Temporomandibular Joint Disorder
Keywords:
Dental, Pain, Temporomandibular joint, Stress, Anxiety, Myofascial pain.Abstract
Introduction:
Research has shown that stress can detrimentally affect physical health through psychosocial mechanisms. However, information on the link between emotional stress and Temporomandibular Joint Disorders (TMD) is scarce. This review is dedicated to investigating the connection between stress and the prevalence of TMD.
Methods:
This study conducted a comprehensive search of literature in the Cochrane, PubMed, Scopus, and Web of Science databases up until the year before 2022. The search utilized various keywords related to the dysfunction of the temporomandibular joint and its etiological aspects (including etiologic factors, etiology, temporomandibular joint dysfunction, disorder, disc displacement, dental occlusion, estrogen hormones, emotional stress, anxiety, depression). Only English-language articles were considered. Out of 121 abstracts initially found, 102 were dismissed due to duplication or irrelevance to the subject matter. An additional 5 studies were excluded for not being directly pertinent to the review's themes.
Results:
Out of the initial pool, 14 articles deemed most relevant were selected for detailed review. The causes of TMD are complex and involve multiple factors, categorized into three main groups. Psychological elements such as stress, mental tension, anxiety, or depression are recognized contributors to TMD. Primary factors that trigger symptom onset relate to trauma or improper loading of the chewing system. It has been verified through various research that individuals experiencing stress or myofascial pain along with joint issues like arthralgia, arthritis, or osteoarthritis show more severe stages of TMD.
Conclusions:
Stress and psychological factors such as anxiety can lead to increased muscle activity and fatigue, resulting in muscle spasms, contractures, occlusal imbalance, internal joint disruptions, and degenerative arthritis. These conditions can modify the biting cycle's occlusal pattern, suggesting these changes are more an outcome of TMD rather than its cause.
