there is insufficient evidence to support either view at the expense of the other.
from a realistic clinical and therapeutic perspective,
the issue of etiology with regard to psychological and psychosocial factors may be largely irrelevant,
given the still limited information on the issue.
a critical aspect of the biopsychosocial approach prevalent in chronic pain management is the increased opportunity it provides for simultaneously considering therapeutic interventions aimed at both the biological (physical) dimensions of the problem as well as the psychological and psychosocial dimensions.
this is based on the fundamental observation that both factors are simultaneously contributing to the current situation,
independent of which came first.
finally, in this regard, if biobehavioral treatments are considered rational options for at least some TMD patients, them psychological and psychosocial assessment is mandotory to provide essential data around which to conduct such treatments.