Protocol and supplementary materials: Music-based interventions and chronic temporomandibular disorder pain: a critical review

Background: Music-based interventions have been associated with small reductions in pain in chronic pain populations, but evidence is heterogeneous and comparators rarely control for attention or expectation. Whether these findings apply to chronic temporomandibular disorder (TMD) pain remains unclear. Methods: MEDLINE/PubMed, Embase, Scopus, CENTRAL, and LILACS were searched on 16 July 2026 and updated on 29 September 2026. Direct evidence on music and TMD was critically appraised against the broader chronic pain literature, considering design, comparator, diagnosis, outcomes, and transferability. Results: No adequately controlled trial isolated the effect of music on chronic TMD pain. The only randomized TMD trial combined self-selected music with physical exercise against usual lifestyle, preventing attribution of the effect to music; a doctoral-thesis crossover study in patients with TMD found no pain effect but reported improved mood. In women with myalgic TMD, relaxing and favourite music reduced masseter activity during clenching in a single-session experiment without pain assessment; in healthy adults, music type altered masseter activity, whereas music did not change experimentally induced masseter pain. The only orofacial music trial concerned acute orthodontic pain. Evidence on singing was cross-sectional, with weak or null associations. Conclusions: Current evidence does not establish whether music listening reduces chronic TMD pain. Motor effects in single-session experiments may provide a testable mechanism but cannot be equated with clinical benefit. An attention-matched randomized trial is needed.