The 'temporomandibular pain dysfunction syndrome' personality: fact or fiction?

It is widely accepted that abnormal personality traits are important factors in the aetiology and maintenance of the temporomandibular pain and dysfunction syndrome (TMPDS). However, the foundation upon which this paradigm rests is largely based on clinical lore rather than evidence. The continued belief in the stress theory has onerous implications. First of all, clinicians could be lulled into a false sense of security about the efficacy of traditionally sanctioned treatments. Second, and potentially more important is the chilling effect on research that results from the premature and unsupported conclusions voiced by many, that certain issues regarding the diagnosis and treatment of TMPDS are solved. Such conclusions will lead not only to problems of patient care but may forge an unstable foundation for future research. Three theories are examined for convergent evidence in support of the putative relationship between personality and TMPDS. They are the 1) psychosomatic 2) coping and 3) psychophysiological theories. Currently evidence lacks for all three theories although there is partial support for the latter. It has not been demonstrated that TMPDS cases are characterized by a specific premorbid personality.