As we investigate further into the complex condition of temporomandibular joint disorder (TMJ or sometimes TMD), we appreciate better that the condition is caused by multiple factors and may require more complex treatment, too.
In particular, there is increasingly strong evidence that TMJ has a strong psychological component. Successful TMJ treatment may depend on wrangling those aspects of the condition as well.
Psychological Factors That Contribute to TMJ
The connection between TMJ and psychological factors has been suspected for more than 40 years. Research continues to affirm the strength of this connection and has pointed to several factors that seem to play a causal role in the development of TMJ:
- Personality type
Some personality types are more prone to developing TMJ than others. In particular, neurotic personality types and those described as “type D” are significantly more likely to develop TMJ.
Stress is a major contributor to TMJ risk. People who are highly stressed and tend to carry that stress in their jaw muscles can experience muscle pain, damage their teeth, and stress or damage the jaw joints, causing TMJ to progress.
Depression is commonly associated with TMJ and with many other chronic pain disorders. It’s hard to know whether there’s a causal link, and, if so, which is the cause.
People with anxiety disorders, such as somatization, compulsive behaviors, and parafunctional behaviors like biting fingernails and other objects can all stress the teeth and jaws, contributing to the development of TMJ.
Catastrophizing is when people tend to look at the worst possible outcomes as being also the most likely outcomes. It tends to enhance musculoskeletal pain disorders like TMJ.
Managing Psychological Factors Improves TMJ Results
Once we’ve recognized that these psychological factors contribute to the development and progression of TMJ, it’s clear that we have to manage them as part of TMJ treatment. This management can take many forms. It may include professional counseling or it may be a less formal approach such as trying yoga or meditation to help manage stress and anxiety.
There are many types of therapy that can help. Cognitive behavioral therapy (CBT) has been shown to dramatically improve TMJ for patients.
Myofunctional therapy is an approach that straddles the physical and psychological treatment regimes. It treats the physical causes and effects of TMJ, but it works partly by addressing some of the damaging and destructive habits that contribute to the condition. Myofunctional therapy can have both physical and psychological benefits for people with TMJ–if for no other reason than that it gives them power over their condition.
No Substitute for Physical Treatment
It would be a mistake to believe that your TMJ is purely psychological. Although psychological factors can contribute to the development and progression of the condition, there are still physical realities that need to be addressed. A TMJ dentist is uniquely qualified for providing that type of care for your TMJ.