Associação entre os subtipos de disfunção temporomandibular dolorosa e fatores psicológicos

Abstract

Temporomandibular disorder (TMD) is a multifactorial condition characterized by painful symptoms involving the temporomandibular joint (TMJ), masticatory muscles, and associated structures. Evidence suggests a strong influence of emotional factors—such as anxiety and pain catastrophizing—on the development and persistence of symptoms. This study aimed to assess the relationship between psychological factors and painful TMD subtypes in adults treated at the Orofacial Pain and TMD Clinic at the Federal University of Uberlândia (UFU). This was a quantitative, retrospective study based on the analysis of 40 clinical records of patients diagnosed with TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Psychological aspects were assessed using the Generalized Anxiety Disorder Scale (GAD-7), the Pain Catastrophizing Scale (Br-PCS), and the Graded Chronic Pain Scale version 2 (GCPS v2) to measure pain intensity. Most patients were female (85%). The most frequent diagnoses involved combinations of myofascial pain and arthralgia (70%). Severe anxiety levels were found in 42.5% of participants, and 35% showed high pain catastrophizing scores. Moderate to severe pain intensity (≥7 on GCPS v2) was reported by 45% of the sample. A significant overlap was observed among high anxiety, high pain catastrophizing, and intense pain, particularly in patients with mixed TMD subtypes. The coexistence of emotional and sensory symptoms reinforces the need to understand TMD as a multidimensional condition. Incorporating psychological assessments into clinical practice is essential for effective, personalized, and biopsychosocial grounded management.