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Fernades G, Franco AL et al. J Oral Rehabil 2012; 39: 538–544

Nevertheless, causation could not be established because the study design was cross-sectional and there was no control group. Additionally, the sample (n = 272) was biased in that it comprised only those who had sought treatment for TMD with 90% being women. The authors revisit the argument that there may be parallels between pain experienced by those with sleep bruxism and post-exercise muscle soreness. They also touch on the issue of 'the vulnerability of pain and the pain of vulnerability'. For example, do psychosocial disorders, including depression as revealed in this study by using RDC/TMD Axis II, 'predispose to this painful condition (TMD), or whether the pain itself causes these disorders (depression)'?