TEMPOROMANDIBULAR DISORDERS IN THE POPULATION: PREVALENCE, ASSOCIATED FACTORS, AND IMPLICATIONS FOR PUBLIC HEALTH

Abstract

Temporomandibular Disorder (TMD) represents a severe public health challenge, with a global prevalence reaching 34%, featuring alarming endemic peaks of 47% in South America and 13.4% in the adult population of Southern Brazil, predominantly affecting women in their economically active years. This integrative literature review, conducted according to PRISMA guidelines, aimed to synthesize evidence on the epidemiological magnitude, etiologic complexity, and Public Health implications of TMD to support the organization of care pathways. The critical analysis of large population-based studies, systematic reviews, and cohorts refutes the traditional biomedical model focused exclusively on dental occlusion, consolidating an inherently biopsychosocial and systemic etiology. Robust evidence indicates that psychological distress (anxiety and depression), poor sleep quality, parafunctional microtraumas, and metabolic deficiencies, notably severe vitamin D deficiency (serum levels < 20 ng/mL), act as strong predictors of risk and pain chronification. The profound negative impact on Oral Health-Related Quality of Life is frequently exacerbated by iatrogenesis and failures in the differential diagnosis between myofascial and neuropathic pain. In conclusion, addressing this silent epidemic requires overcoming fragmented uniprofessional care. The implementation of unified care pathways based on an interdisciplinary matrix—integrating Dentistry, Physiotherapy, Psychology, Nutrition, and Nursing—starting in Primary Care is imperative to promote comprehensive care, prevent unnecessary irreversible interventions, and reduce the severe socioeconomic burden imposed on healthcare systems.