Clinical Oral Investigations

, Volume 10, Issue 4, pp 261–268 | Cite as

How may stressful experiences contribute to the development of temporomandibular disorders?

  • Gustavo Hauber GameiroEmail author
  • Annicele da Silva Andrade
  • Darcy Flávio Nouer
  • Maria Cecília Ferraz de Arruda Veiga


Temporomandibular disorders (TMD) comprise the most common cause of chronic facial pain conditions, and they are often associated with somatic and psychological complaints including fatigue, sleep disturbances, anxiety, and depression. For many health professionals, the subjectivity of pain experience is frequently neglected even when the clinic does not find any plausible biologic explanation for the pain. This strictly biomedical vision of pain cannot be justified scientifically. The purpose of this study is to demonstrate, by original articles from the literature and recent studies conducted in our own laboratory, the biological processes by which psychological stress can be translated into the sensation of pain and contribute to the development of TMD. The role of the hypothalamic–pituitary–adrenal axis, the serotoninergic and opioid systems in the pathogenesis of facial pain is exposed, including possible future therapeutic approaches. It is hoped that knowledge from apparently disparate fields of dentistry, integrated into a multidisciplinary clinical approach to TMD, will improve diagnosis and treatment for this condition through a clinical practice supported by scientific knowledge.


Stress Pain Temporomandibular disorders Nociception Temporomandibular joint 



The authors had the following contributions in the completion of this manuscript: Gustavo Hauber Gameiro (Doctor in Physiology/Faculty of Dentistry of Piracicaba, University of Campinas)—literature review, data organization, and technical assistance; Annicele da Silva Andrade (Post-Graduation Student/Faculty of Dentistry of Piracicaba, University of Campinas)—literature review and manuscript preparation; Darcy Flávio Nouer (Doctor in Orthodontics/Faculty of Dentistry of Piracicaba, University of Campinas)—literature review and data organization; and Maria Cecília Ferraz de Arruda Veiga (Doctor in Physiology/Faculty of Dentistry of Piracicaba, University of Campinas)—literature review, data organization, and statistical analysis.


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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Gustavo Hauber Gameiro
    • 1
    Email author
  • Annicele da Silva Andrade
    • 2
  • Darcy Flávio Nouer
    • 1
  • Maria Cecília Ferraz de Arruda Veiga
    • 2
  1. 1.Department of Orthodontics, Piracicaba Dental SchoolUniversity of Campinas—UnicampPiracicabaBrazil
  2. 2.Laboratory of Orofacial Pain, Department of Physiology, Piracicaba Dental SchoolUniversity of Campinas—UnicampPiracicabaBrazil

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