The patients in whom “nothing was ever found”
You see them first and you see them longest. And you are the only ones who know the whole course – which is why your assessment is the most valuable one we can receive.
You know these patients
People with a wide range of complaints and a long history of suffering. Many unremarkable work-ups, often already on painkillers or psychotropic drugs. The jaw has rarely been examined along this chain – not through negligence, but because it does not appear in any of the usual diagnostic pathways.
What has been measured
It is not a marginal finding
The pooled TMD prevalence is around 29.5 %, around 36.7 % in women and around 26.7 % in men – assessed according to DC/TMD or RDC/TMD criteria. In an average practice this is not an exceptional case but a regular one.
It can be screened in two minutes
A brief self-report screening identifies pain-related CMD with a sensitivity of around 0.85 and a specificity of around 0.80. It can be delegated and needs no equipment. Interpretation remains a medical responsibility.
There is a time criterion instead of a gut feeling
The guideline recommendation is: referral to secondary care in the case of an unclear diagnosis or persistence over three months despite conservative first-line treatment. That is a criterion that can be documented.
Where the evidence ends
Prevalence does not mean cause. The fact that someone has CMD does not automatically explain their other complaints – the aetiology is considered multifactorial and biopsychosocial. We examine whether a functional component is present, and we tell you so if there is none.
When a referral is useful
First and without exception: red flags and unclear findings belong in a specialist work-up, before any functional diagnostics. The CMD perspective is complementary, not a substitute.
Useful
- multiple unclear complaints without findings, especially with jaw, neck or sleep signs
- persistence over three months despite guideline-based first-line treatment
- an abnormal brief screening
- before escalating drug therapy
Not useful
- with unresolved red flags – the specialist work-up comes first
- as a substitute for GP-led care; that stays with you
Your patient remains yours. After the assessment, or after the regulation is complete, we always refer back to you. We take on any treatment beyond this exclusively at your express, written request.
Three routes – you choose
I want to know more
The sources in full text, our measurement protocols and the clinical explanatory model with the level of evidence disclosed.
I have a question about a case
A call back from the CMD specialist, not from reception.
I would like to refer
By phone, e-mail or letter – whichever suits you. The findings report comes back to you.