A dual-diagnostic approach assesses TMD patients.

The understanding and treatment of patients with temporomandibular disorders, or TMDs, have been impeded by the lack of a consensually agreed-on classification system on which to make a differential diagnosis. A number of classification systems for these patients have been proposed. Some are based primarily on whether symptoms are myogenic or arthralgic--somatically based; some investigators have suggested that patients be differentiated on the basis of psychological characteristics. It has been suggested recently that patients be classified along two dimensions--physical and psychological. This article summarizes research describing the development of a psychosocial classification of TMD patients that can be used with the physical axis of the recently proposed research diagnostic criteria for classification of TMD patients. It also presents preliminary evidence supporting the clinical utility of the psychosocial classification.