When the body has a measurable share
This page does not argue against your discipline. It argues for an order in which both run side by side rather than one after the other – and there are figures for that.
You know these patients
Persistent pain or exhaustion syndromes with a high level of suffering, often framed as “functional”. Long histories, many unremarkable findings, frequently a history of trauma.
What has been measured
The reference standard treats your axis as equal
DC/TMD has a two-axis structure: Axis I physical (sensitivity ≥ 0.86, specificity ≥ 0.98 for pain-related TMD), Axis II psychosocial – grading via the GCPS, jaw function via the JFLS, distress via the PHQ-4, oral behaviours via the OBC. A CMD finding without Axis II is half a finding.
The predictors are psychological, not occlusal
Pain catastrophising and depressive symptoms are the most consistent predictors of pain persistence in CMD. A connection between psychological trauma, awake bruxism and painful CMD has been described.
Your procedures have a proven effect here
Psychological treatments reduce pain intensity in painful TMD to a similar extent as standard dental treatment. Cognitive-behavioural procedures show small, reliable improvements in chronic pain; ACT reduces catastrophising and psychological inflexibility.
Where the evidence ends
We do not claim that emotional distress is always the consequence of a physical misregulation. The aetiology is considered multifactorial and biopsychosocial, and the documented direction also runs from the psyche to the pain. What we contribute is establishing whether a functional component is present – and how large it is.
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
- persistent pain or exhaustion syndromes with jaw or masticatory muscle findings
- awake bruxism, jaw clenching, oral behaviours in the foreground
- as a complement to ongoing care, not as an interruption of it
Not useful
- as a substitute for psychotherapeutic care
- with the expectation that a splint will resolve chronification
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.