Psychologic considerations in temporomandibular dysfunction. A biopsychosocial view of symptom formation.

Temporomandibular dysfunction often is conceptualized as having a significant psychologic component. After clarifying the implications that follow differentiation between acute and chronic pain, clinical features most commonly associated with the chronic or potentially chronic pain patient are presented. An attempt is made to present biopsychosocial or multifactorial models of symptom formation in a context that moves away from issues of specific etiology toward a dynamic interactional process involving predisposers, triggers, and buffering factors. The clinical presentation in temporomandibular dysfunction then reflects the final common pathway for a complicated matrix of biopsychosocial factors that varies from patient to patient.