Temporomandibular disorders: A century-old history of the battle between controversy and denialism

BACKGROUND: Temporomandibular disorders (TMDs) have been the subject to controversy for over a century, with early theories focusing on anatomical structures and their relationships. OBJECTIVE: The paper aims to examine the historical evolution of TMD concepts and the transition from mechanistic to biopsychosocial models, exploring the impact on diagnosis and therapy. RESULTS: Studies have either disproven or failed to support the early mechanistic models, thus leading to the establishment of the current evidence-based approach. The advent of postgraduate programs in orofacial pain and clinical practice guidelines has contributed to the standardization of TMD training on a global scale. DISCUSSION: Despite the compelling evidence supporting the modern model, some practitioners continue to resist these changes. The authors argue that this resistance can be construed as a denial of the well-established scientific findings that have emerged in this field. CONCLUSION: TMD diagnosis and management undergone significant advancements; however, ongoing research is imperative. The authors advocate for the broader acceptance of the evidence-based biopsychosocial model to ensure ongoing progress in the field.