A proposed diagnostic classification of patients with temporomandibular disorders: implications for physical therapists.

SYNOPSIS: Physical therapists have an important role on the interprofessional team to provide care for people with temporomandibular disorders (TMDs). Diagnostic classification is a challenge in this population, given the complexities inherent in presentations of headache and orofacial pain, and is critical to selecting the appropriate intervention. The objectives of this paper were (1) to characterize the epidemiology and pathophysiology of the TMDs most commonly seen in the outpatient clinic, (2) to describe a systems screen to be used in the physical therapy examination to determine the need for interprofessional referral, and (3) to propose an approach for physical therapists to examine, evaluate, and classify patients with TMDs, based on previously validated methodologies. A modification of the diagnostic framework of the International Headache Society has provided the basis for the systems screen of people presenting with orofacial pain. The physical therapy examination and evaluation is based on the Diagnostic Criteria for TMD, developed and validated by a consortium of specialists from the American Academy of Orofacial Pain.

LEVEL OF EVIDENCE: Diagnosis, level 5.