A critical review on the importance of psychological factors in temporomandibular disorders.

Recent researches on temporomandibular disorders (TMD) have been focused on the interaction between physical and psychological factors. In this work, studies on the role of the latter have been critically reviewed and analysed. A number of works proved the existence of an association between TMD and anxiety, depression and stress, but none demonstrated causality of that relation. In consideration of that, debates are still open to discuss the possible predisposing, triggering and/or worsening role played by some psychic disorders in TMD subjects. Nevertheless, considering the usefulness of recent taxonomic proposals, it seems logical to adopt a broad therapeutic approach, directed both to the physical and psychic component of TMD symptoms. Besides, from this review it is underlined the need for controlled trials which, regardless of the causality of TMD-psychic disorders associations, definitively evaluate the efficacy of the various psychotherapy modalities proposed.