Association between temporomandibular disorders and somatization: a narrative review

Temporomandibular disorders (TMD) are common orofacial pain conditions with multifactorial etiologies. Somatization refers to the manifestation of psychological distress as physical symptoms in the absence of clear medical causes. A growing body of clinical research has recently shown a strong association between TMD and somatization. A substantial proportion of TMD patients exhibit moderate to high levels of somatic symptoms, leading to greater pain intensity, longer disease duration, and heightened psychological distress. The TMD-somatization relationship has been underpinned by complex pathophysiological interactions and the underlying mechanisms involved, including central sensitization (CS), potential biomarkers, nociplastic pain, neurobiological changes, and so on. Clinically, recognizing somatization in TMD patients is essential, as it can adversely affect treatment outcomes and necessitate a biopsychosocial management approach. In this narrative review, we summarize the clinical evidence of the TMD-somatization association, discuss the underlying mechanisms, explore management implications, and identify directions for future research.