The prevalence of comorbid chronic pain conditions among patients with temporomandibular disorders: A systematic review

J Am Dent Assoc. 2022 Mar;153(3):241-250.e10. doi: 10.1016/j.adaj.2021.08.008. Epub 2021 Dec 21.


Background: This systematic review was designed to evaluate the presence of comorbid conditions among patients with temporomandibular disorders (TMDs).

Types of studies reviewed: The authors reviewed studies that reported the prevalence or incidence of chronic pain conditions or psychiatric disorders (anxiety, mood, personality disorders) among patients with any type of TMD. The authors calculated sample size-weighted prevalence estimates when data were reported in 2 or more studies for the same comorbid condition.

Results: A total of 9 prevalence studies and no incidence studies were eligible for review; 8 of the studies examined chronic pain comorbidities. Weighted estimates showed high prevalence of pain comorbidities across studies, including current chronic back pain (66%), myofascial syndrome (50%), chronic stomach pain (50%), chronic migraine headache (40%), irritable bowel syndrome (19%), and fibromyalgia (14%). A single study examined psychiatric disorders and found that current depression was the most prevalent disorder identified (17.5%).

Conclusions and practical implications: There is a high prevalence of comorbid chronic pain conditions among patients with TMDs, with more than 50% of patients reporting chronic back pain, myofascial syndrome, and chronic stomach pain. Psychiatric disorders among patients with different types of TMDs were studied less commonly in this pain population. Knowledge of the distribution of these and other comorbid disease conditions among patients with different types of TMDs can help dentists and other health care providers to identify personalized treatment strategies, including the coordination of care across medical specialties.

Keywords: Central sensitization; chronic pain; comorbidities; psychiatric disorders; temporomandibular disorders.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Chronic Pain* / epidemiology
  • Comorbidity
  • Fibromyalgia* / epidemiology
  • Humans
  • Prevalence
  • Temporomandibular Joint Disorders* / complications
  • Temporomandibular Joint Disorders* / epidemiology