Orofacial musculoskeletal pain: an evidence-based bio-psycho-social matrix model

Review written by Dr Sandy Hilton info

Key Points

  1. Orofacial pain disrupts the homeostatic state, interferes with goal-orientated behavior, and generates stress.
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Orofacial pain includes a variety of musculoskeletal disorders with the most common being temporomandibular disorder (TMD). Neural signals regulate the normal physiologic activities of speech, chewing, and swallowing. Relaxation of the jaw muscles results in a typical physiological “rest position” of a 3mm vertical distance between the upper and lower teeth. Dysfunction or dysregulation of the neurological state can directly influence and exacerbate TMD.

This paper explored the neurological influence of TMD as related to function and a pain response. It examined the evidence on the interaction of social, psychological and biological factors in orofacial pain, and discussed the need for updated training in order to provide the necessary interdisciplinary management for orofacial pain.

Dysregulation of the neurological state can directly influence and exacerbate temporomandibular disorder.
An interdisciplinary approach is needed to manage the individual challenges of biology, social interactions, psychological influences, and the relationship between them.


  • Emotions influence pain perception by affecting how we appraise or interpret thoughts, beliefs, expectations, and noxious stimuli (1).
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