Hypnosis and relaxation techniques in the management of temporomandibular disorders: a scoping review

Temporomandibular disorders (TMD) are common causes of orofacial pain, influenced by psychological and behavioural factors. Non-pharmacological interventions, such as hypnosis and relaxation techniques, have been proposed to modulate pain perception, reduce muscle hyperactivity, and improve coping. However, their role in TMD management remains unclear. We conducted a scoping review to synthesize the available evidence on the use of hypnosis and relaxation interventions in adolescents and adults with TMD. A systematic search of PubMed, Embase, Web of Science, Cochrane Library, PsycINFO, and Google Scholar databases from January 1992 to January 2026 identified a limited number of eligible studies (n = 10), comprising randomized controlled trials and quasi-experimental studies, with substantial methodological heterogeneity in study design. Methodological quality was appraised using a simplified Joanna Briggs Institute tool. Interventions included medical hypnosis, hypnosis combined with cognitive-behavioural therapy, and various relaxation techniques, delivered as stand-alone or adjunctive therapies. Findings for the 661 participants were inconsistent: hypnosis-based interventions suggested potential reductions in pain intensity and psychological distress, whereas relaxation techniques showed mixed results, particularly when compared to standard treatments such as occlusal splints. Methodological appraisal revealed variability in study quality, with three studies at low risk of bias, four at moderate risk, and three at high risk. Overall, the small number of studies and their marked heterogeneity substantially limit the interpretability and comparability of findings, thereby constraining their integration into a robust evidence-based biopsychosocial model for TMD management. Consequently, current evidence remains preliminary and insufficient to support firm clinical recommendations. Nevertheless, these approaches are conceptually aligned with the biopsychosocial model of TMD, and preliminary results suggest that hypnosis and relaxation may represent low-risk adjunctive strategies within multimodal TMD management, particularly for patients with stress-sensitive or centrally sensitized pain profiles. Future well-designed, adequately powered trials with standardized interventions and multidimensional outcomes are needed to clarify their clinical utility.

Temporomandibular disorders; Hypnosis; Self-hypnosis; Relaxation training; Pain; Biopsychosocial model

[1] Manfredini D, Häggman-Henrikson B, Al Jaghsi A, Baad-Hansen L, Beecroft E, Bijelic T, et al. Temporomandibular disorders: INfORM/IADR key points for good clinical practice based on standard of care. CRANIO®. 2025; 43: 1–5.

[2] Valesan LF, Da-Cas CD, Réus JC, Denardin ACS, Garanhani RR, Bonotto D, et al. Prevalence of temporomandibular joint disorders: a systematic review and meta-analysis. Clinical Oral Investigations. 2021; 25: 441–453.

[3] Zieliński G, Pająk-Zielińska B, Ginszt M. A meta-analysis of the global prevalence of temporomandibular disorders. Journal of Clinical Medicine. 2024; 13: 1365.

[4] Fillingim RB, Slade GD, Greenspan JD, Dubner R, Maixner W, Bair E, et al. Long-term changes in biopsychosocial characteristics related to temporomandibular disorder: findings from the OPPERA study. Pain. 2018; 159: 2403–2413.

[5] Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. Journal of Oral & Facial Pain and Headache. 2014; 28: 6–27.

[6] Slade GD, Fillingim RB, Sanders AE, Bair E, Greenspan JD, Ohrbach R, et al. Summary of findings from the OPPERA prospective cohort study of incidence of first-onset temporomandibular disorder: implications and future directions. Journal of Pain. 2013; 14: T116–T124.

[7] Schiffman E, Ohrbach R. Executive summary of the diagnostic criteria for temporomandibular disorders for clinical and research applications. Journal of the American Dental Association. 2016; 147: 438–445.

[8] Fillingim RB, Ohrbach R, Greenspan JD, Knott C, Diatchenko L, Dubner R, et al. Psychological factors associated with development of TMD: the OPPERA prospective cohort study. Journal of Pain. 2013; 14: T75–T90.

[9] Canales GDLT, Guarda-Nardini L, Rizzatti-Barbosa CM, Conti PCR, Manfredini D. Distribution of depression, somatization and pain-related impairment in patients with chronic temporomandibular disorders. Journal of Applied Oral Science. 2019; 27: e20180210.

[10] Reis PHF, Laxe LAC, Lacerda-Santos R, Münchow EA. Distribution of anxiety and depression among different subtypes of temporomandibular disorder: a systematic review and meta-analysis. Journal of Oral Rehabilitation. 2022; 49: 754–767.

[11] Felin GC, Tagliari CV da C, Agostini BA, Collares K. Prevalence of psychological disorders in patients with temporomandibular disorders: a systematic review and meta-analysis. Journal of Prosthetic Dentistry. 2024; 132: 392–401.

[12] Al-Moraissi EA, Conti PCR, Alyahya A, Alkebsi K, Elsharkawy A, Christidis N. The hierarchy of different treatments for myogenous temporomandibular disorders: a systematic review and network meta-analysis of randomized clinical trials. Oral and Maxillofacial Surgery. 2022; 26: 519–533.

[13] Busse JW, Casassus R, Carrasco-Labra A, Durham J, Mock D, Zakrzewska JM, et al. Management of chronic pain associated with temporomandibular disorders: a clinical practice guideline. The BMJ. 2023; 383: e076227.

[14] Ferrillo M, Nucci L, Giudice A, Calafiore D, Marotta N, Minervini G, et al. Efficacy of conservative approaches on pain relief in patients with temporomandibular joint disorders: a systematic review with network meta-analysis. CRANIO®. 2025; 43: 258–274.

[15] Bijelic T, Michelotti A, Bucci R, Del Sorbo D, Ekberg E, Häggman-Henrikson B. Self-management therapies for temporomandibular disorders—evidence from systematic reviews. Journal of Oral Rehabilitation. 2026; 53: 265–281.

[16] Jogna F, Graenicher AA, Rey-Millet Q, Groz A, De Grasset J, Stollar F, et al. Pharmacological and non-pharmacological approaches to temporomandibular disorder chronic pain: a narrative review. Pain Management. 2025; 15: 285–296.

[17] Elkins GR, Barabasz AF, Council JR, Spiegel D. Advancing research and practice: the revised APA division 30 definition of hypnosis. American Journal of Clinical Hypnosis. 2015; 57: 378–385.

[18] Benson H, Beary JF, Carol MP. The relaxation response. Psychiatry. 1974; 37: 37–46.

[19] Zhang Y, Montoya L, Ebrahim S, Busse JW, Couban R, McCabe RE, et al. Hypnosis/Relaxation therapy for temporomandibular disorders: a systematic review and meta-analysis of randomized controlled trials. Journal of Oral & Facial Pain and Headache. 2015; 29: 115–125.

[20] Phillips W, Price J, Molyneux PD, Deeley Q. Hypnosis. Practical Neurology. 2022; 22: 42–47.

[21] Wortzel J, Spiegel D. Hypnosis in cancer care. American Journal of Clinical Hypnosis. 2017; 60: 4–17.

[22] Langlois P, Perrochon A, David R, Rainville P, Wood C, Vanhaudenhuyse A, et al. Hypnosis to manage musculoskeletal and neuropathic chronic pain: a systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews. 2022; 135: 104591.

[23] Silva FWD, Oliveira DV, Zina LG, Paula JS. Use of hypnosis in the treatment of orofacial pain: a systematic review. Journal of Integrative and Complementary Medicine. 2025; 31: 224–232.

[24] Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Annals of Internal Medicine. 2018; 169: 467–473.

[25] Descatha A, Morin E, Pitet S, Fadel M, Mayet A, Huard-Dutertre L, et al. Scoping reviews and umbrella reviews: principle, methodology, and practice in occupational health. Archives of Occupational and Environmental Diseases. 2025; 86: 102946. (In French)

[26] Ballester B. Revstack. 2025. Available at: https://revstack.gitbook.io/docs (Accessed: 24 February 2026).

[27] Barker TH, Stone JC, Sears K, Klugar M, Tufanaru C, Leonardi-Bee J, et al. The revised JBI critical appraisal tool for the assessment of risk of bias for randomized controlled trials. JBI Evidence Synthesis. 2023; 21: 494–506.

[28] Barker TH, Habibi N, Aromataris E, Stone JC, Leonardi-Bee J, Sears K, et al. The revised JBI critical appraisal tool for the assessment of risk of bias quasi-experimental studies. JBI Evidence Synthesis. 2024; 22: 378–388.

[29] Oakley ME, McCreary CP, Clark GT, Holston S, Glover D, Kashima K. A cognitive-behavioral approach to temporomandibular dysfunction treatment failures: a controlled comparison. Journal of Orofacial Pain. 1994; 8: 397–401.

[30] Simon EP, Lewis DM. Medical hypnosis for temporomandibular disorders: treatment efficacy and medical utilization outcome. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2000; 90: 54–63.

[31] Winocur E, Gavish A, Emodi-Perlman A, Halachmi M, Eli I. Hypnorelaxation as treatment for myofascial pain disorder: a comparative study. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2002; 93: 429–434.

[32] Wahlund K, List T, Larsson B. Treatment of temporomandibular disorders among adolescents: a comparison between occlusal appliance, relaxation training, and brief information. Acta Odontologica Scandinavica. 2003; 61: 203–211.

[33] Abrahamsen R, Zachariae R, Svensson P. Effect of hypnosis on oral function and psychological factors in temporomandibular disorders patients. Journal of Oral Rehabilitation. 2009; 36: 556–570.

[34] Abrahamsen R, Baad-Hansen L, Zachariae R, Svensson P. Effect of hypnosis on pain and blink reflexes in patients with painful temporomandibular disorders. Clinical Journal of Pain. 2011; 27: 344–351.

[35] Ferrando M, Galdón MJ, Durá E, Andreu Y, Jiménez Y, Poveda R. Enhancing the efficacy of treatment for temporomandibular patients with muscular diagnosis through cognitive-behavioral intervention, including hypnosis: a randomized study. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology. 2012; 113: 81–89.

[36] Wahlund K, Nilsson IM, Larsson B. Treating temporomandibular disorders in adolescents: a randomized, controlled, sequential comparison of relaxation training and occlusal appliance therapy. Journal of Oral & Facial Pain and Headache. 2015; 29: 41–50.

[37] Ferendiuk E, Biegańska JM, Kazana P, Pihut M. Progressive muscle relaxation according to Jacobson in treatment of the patients with temporomandibular joint disorders. Folia Medica Cracoviensia. 2019; 59: 113–122.

[38] Huhtela OS, Koivisto N, Hägg V, Sipilä K. Effectiveness of applied relaxation method vs. splint in treatment of temporomandibular disorders in Finnish students. Journal of Oral Rehabilitation. 2020; 47: 123–131.

[39] Ohrbach R, Dworkin SF. The evolution of TMD diagnosis: past, present, future. Journal of Dental Research. 2016; 95: 1093–1101.

[40] Ohrbach R, Dworkin SF. AAPT diagnostic criteria for chronic painful temporomandibular disorders. Journal of Pain. 2019; 20: 1276–1292.

[41] Jessri M, Sultan AS, Tavares T, Schug S. Central mechanisms of pain in orofacial pain patients: implications for management. Journal of Oral Pathology & Medicine. 2020; 49: 476–483.

[42] Ruiz-Marrara J, Antunes LG, Bataglion C, Fernandes MH, Melchior MO, Magri LV. Cognitive domain impairments in chronic painful temporomandibular disorders: associations with pain intensity, hypervigilance and catastrophising: a cross-sectional analysis. Journal of Oral Rehabilitation. 2026; 53: 76–88.

[43] Schulz-Stübner S, Krings T, Meister IG, Rex S, Thron A, Rossaint R. Clinical hypnosis modulates functional magnetic resonance imaging signal intensities and pain perception in a thermal stimulation paradigm. Regional Anesthesia & Pain Medicine. 2004; 29: 549–556.

[44] Ambron R. Toward the unknown: consciousness and pain. Neuroscience of Consciousness. 2023; 2023: niad002.

[45] Thompson T, Terhune DB, Oram C, Sharangparni J, Rouf R, Solmi M, et al. The effectiveness of hypnosis for pain relief: a systematic review and meta-analysis of 85 controlled experimental trials. Neuroscience & Biobehavioral Reviews. 2019; 99: 298–310.

[46] Wahlund K, Larsson B. Long-term treatment outcome for adolescents with temporomandibular pain. Acta Odontologica Scandinavica. 2018; 76: 153–160.

[47] Jensen MP, Patterson DR. Hypnotic approaches for chronic pain management: clinical implications of recent research findings. American Psychologist. 2014; 69: 167–177.

[48] Bicego A, Rousseaux F, Faymonville ME, Nyssen AS, Vanhaudenhuyse A. Neurophysiology of hypnosis in chronic pain: a review of recent literature. American Journal of Clinical Hypnosis. 2022; 64: 62–80.

[49] Mélou C, Sixou JL, Sinquin C, Chauvel-Lebret D. Temporomandibular disorders in children and adolescents: a review. Archives de Pédiatrie. 2023; 30: 335–342.