Answer to a still open question: temporomandibular disorders and posture

Even though research over the last two or three decades has confirmed the biopsychosocial nature of temporomandibular disorders (TMDs), their complex etiology and their generally benign prognosis, many dental practitioners still hold with the misconception that TMDs are monocausal. As a result they often continue to manage TMDs with occlusal therapies and even treat postural problems by occlusal means, assuming that there is a causal relationship between so-called “malocclusion” and problems of body posture and vice versa. This consensus paper briefly reviews the complex mechanisms regulating body posture, summarizes the most relevant literature on body posture and occlusion/TMDs and reviews the basic diagnostic knowledge required, so as to understand the need for validated diagnostic tests and determine when a relationship of causality is involved. The literature review shows that it is impossible to define an “ideal posture” in combination with an “ideal occlusion” and vice versa, that there is no biological plausibility for a pathologic interrelationship between occlusion and body posture, and that there is no evidence that stabilometric and/or posturographic tests have any diagnostic validity. Occlusal therapies cannot therefore be regarded as medically acceptable for the treatment of postural problems and conversely postural/ physical therapies cannot be used to treat occlusal problems.