Recommendations for the standardized evaluation and classification of patients with painful temporomandibular disorders

Introduction. Due to the considerable degree of variation that exists among care providers with respect to the assessment of patients suffering from painful temporomandibular disorders (TMDs),an interdisciplinary working group for the study of orofacial pain aimed at developing recommendations for the evaluation and diagnostic classification of such patients. Methods. Following an extensive literature search (computer-based search and hand-search),several working sessions were needed to develop a standardized diagnostic protocol. It was a prerequisite that recommended measures and instruments should have acceptable reliability and validity. Three independent reviewers-well-known experts in the pain field - critically reviewed the contents of our recommendations. Results. A two-axis approach is recommended to assess the somatic and psychosocial pa ra meters of the pain experience. Our concept closely follows the Research Diagnostic Criteria for Temporomandibular Disorders. In addition, we distinguish a minimal, a standard, and an extended evaluation. Conclusions. The recommendations appear to be useful to enhance the diagnostic quality in the evaluation of patients with painful TMDs.