Temporomandibular Disorders Beyond Orofacial Pain: A Narrative Review of Musculoskeletal, Headache, and Central Nervous System Implications.

Background: Temporomandibular disorders (TMD), bruxism, and occlusal dysfunction have traditionally been managed as localized orofacial conditions. Emerging evidence suggests, however, that the stomatognathic system may interact with broader neuromusculoskeletal and central pain-processing networks, with potential systemic and neurological implications. Methods: A structured narrative literature search was conducted using PubMed, Google Scholar, and Web of Science, with the final targeted search performed in June 2026. Original research articles, systematic reviews, meta-analyses, and relevant pilot studies were considered. No formal risk-of-bias or certainty-of-evidence assessment was performed. Results: The reviewed literature indicates that TMD and bruxism are associated with musculoskeletal pain beyond the orofacial region, cervical musculoskeletal dysfunction, and headache comorbidity, with relatively stronger evidence derived from systematic reviews and meta-analyses. Emerging neuroimaging evidence suggests alterations in central pain-modulatory networks, including the default mode network, which may be relevant to central sensitization, although this evidence remains preliminary. Clinically accessible parafunctional signs may prompt further orofacial assessment, and individualized intraoral splint therapy has been investigated for effects beyond local symptom relief, although the evidence remains heterogeneous across domains. Conclusions: TMD and occlusal dysfunction may be better understood within a broader neuromusculoskeletal framework. Multidisciplinary assessment and management may warrant consideration in selected patients. Future research should incorporate standardized TMD diagnostic criteria and, where relevant, neuroimaging and posturographic outcomes.