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For psychotherapy and psychosomatics

When the body has a measurable share

This page does not argue against your field. It argues for a sequence 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 with a high level of distress, often framed as “functional”. Long histories, many unremarkable findings, frequently a history of trauma.

The connection

What has been measured

  1. 01Measured / described

    The reference standard treats your axis as equal

    DC/TMD has two axes: 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.

  2. 02Measured / described

    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.

  3. 03Measured / described

    Your methods have proven effects here

    Psychological treatments reduce pain intensity in painful TMD to a similar extent as standard dental treatment. Cognitive behavioural methods show small, reliable improvements in chronic pain; ACT reduces catastrophising and psychological inflexibility.

  4. 04Where the evidence ends

    Where the evidence ends

    We do not claim that psychological distress is always the result of a physical dysregulation. The aetiology is considered multifactorial and biopsychosocial, and the documented direction also runs from the psyche to pain. What we contribute is establishing whether a functional component is present – and how large it is.

Indication

When a referral is worthwhile

First, and without exception: red flags and unclear findings belong in specialist work-up, before any functional diagnostics. The CMD perspective complements, it does not replace.

Worthwhile

  • Persistent pain or exhaustion with jaw or masticatory muscle findings
  • Awake bruxism, jaw clenching, oral behaviours in the foreground
  • As a complement to ongoing care, not an interruption of it

Not worthwhile

  • As a replacement for psychotherapeutic care
  • With the expectation that a splint reverses chronification

Your patient remains yours.

After the assessment or after regulation is complete, we always refer back to you. We only provide further treatment at your explicit written request.

Next steps

Three routes – your choice

  • 01

    I want to know more

    The full-text sources, our measurement protocols and the clinical explanatory model with its level of evidence disclosed.

    Request documents
  • 02

    I have a question about a case

    Call-back from the CMD specialist, not from reception.

    Ask a question
  • 03

    I would like to refer

    By phone, email or letter – whatever suits you. The findings report comes back to you.

    Referral

Other specialties

To the overview