Comorbid Psychiatric Disorders and Treatment Options in Temporomandibular Disorders and Bruxism

Abstract

Temporomandibular disorder (TMD) is a clinical condition affecting the masticatory muscles, the temporomandibular joint (TMJ) and the structures surrounding this joint.Bruxism is a parafunctional habit that occurs as a result of overloading of stomatognathic structures with tooth squeezing and grinding, which is included in the etiology of TMB.TMB is seen in approximately 10% of the population and bruxism is seen in 8-20%. Many factors are effective in the etiology of TMD and bruxism, and there are interactions between these factors. Biomechanical, neuromuscular, biopsychosocial and neurobiological factors contribute to the disease. The prevalence of psychiatric disorders is high in individuals with TMB and bruxism. Many psychiatric disorders, especially depression and anxiety disorders, accompany TMB and Bruxism. The antidepressants used in the treatment of these disorders cause bruxism. This is one of the important challenges in the treatment of TMB and bruxism.The first step in the treatment of TMB and bruxism is to address the basic prevention methods. While amitriptyline use is prominent in TMB pharmacotherapy, in bruxism, buspirone and clonazepam are two important drugs used.The study of these drugs in small samples and the fact that the available information is mostly based on case reports clearly shows the necessity of further studies. The widespread use of cognitive behavioral therapy in both disorders will be a solution and eliminate the side effects of medication.Regardless of the treatment option, both dentists and psychiatrists should be in a multidisciplinary working environment and should evaluate these diseases within the framework of the biopsychosocial model.

Keywords

• temporomandibular disorders
• bruxism
• depression
• mental disorders
• treatment