Association between temporomandibular disorders and somatization: a narrative review

TL;DR

This paper reviews the link between temporomandibular disorders and somatization, highlighting their shared symptoms and the need for a biopsychosocial treatment approach.

Contribution

The paper provides a comprehensive narrative review of the clinical and mechanistic relationship between TMD and somatization.

Findings

TMD patients often show high somatic symptoms, leading to increased pain and psychological distress.

Central sensitization and neurobiological changes are potential mechanisms linking TMD and somatization.

Recognizing somatization in TMD is crucial for effective treatment and better outcomes.

Abstract

Temporomandibular disorders (TMD) are common orofacial pain conditions with
multifactorial etiologies. Somatization refers to the manifestation of
psychological distress as physical symptoms in the absence of clear medical
causes. A growing body of clinical research has recently shown a strong
association between TMD and somatization. A substantial proportion of TMD
patients exhibit moderate to high levels of somatic symptoms, leading to greater
pain intensity, longer disease duration, and heightened psychological distress.
The TMD-somatization relationship has been underpinned by complex
pathophysiological interactions and the underlying mechanisms involved, including
central sensitization (CS), potential biomarkers, nociplastic pain,
neurobiological changes, and so on. Clinically, recognizing somatization in TMD
patients is essential, as it can adversely affect treatment outcomes and
necessitate a biopsychosocial management approach. In this narrative review, we
summarize the clinical evidence of the TMD-somatization association, discuss the
underlying mechanisms, explore management implications, and identify directions
for future research.

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