Table 2 Comparison between orofacial pain (OFP) specialists (reference group) and newly graduated general dentists rating scores to different statements (a score of 5 indicates “Strongly agree” and 1 indicates “Strongly disagree”)

Chronic pain and pain behavior

• Chronic pain is a somatic and a behavioral and social problem.

3

4

4

A

No

3

3

4

0.1

0

• Sleep disturbances are common in patients with chronic OFP.

4

4

4.5

A

Yes

3

4

4

0.002*

−1.0*

• Depression can be an important etiologic factor in chronic OFP.

3.5

4

5

A

Yes

3

3

4

0.002*

−1.0*

Etiology

• TMJ clicking is a serious symptom which often creates a painful condition.

1.5

2

2

D

Yes

2

3

4

< 0.0001*

+ 2.0*

• Oral parafunctional habits are often significant in the development of chronic TMD.

3.5

4

4.5

A

Yes

3

4

4

0.4

−1.0

• Stress is a very important factor in the development of chronic TMD.

4

4

5

A

Yes

3

4

4

0.003*

−1.0*

• Pain is the most common reason to seek treatment of TMD.

4

4

5

A

Yes

2

4

4

< 0.0001*

−1.0*

• Patients with TMD who clench/brux do so either during the day or at night, but not both.

1.5

2

3

D

No

2

3

4

< 0.0001*

+ 1.0*

• Headache is commonly related to psychological or social factors.

2

2

4

D

No

3

4

4

0.003*

+ 1.0*

• Patients with rheumatoid arthritis should be asked for any TMJ symptoms.

4

4

5

A

Yes

3

4

4

< 0.0001*

−1.0*

• Migraine can cause or is comorbid with facial/ jaw pain

4

4

5

A

Yes

3

3

4

< 0.0001*

1.0*

Diagnosis and classification

• TMJ disorders pain is often associated with a clicking sound of the joint and/or restricted mouth opening.

2

3

4

A

No

3

4

4

0.1

+ 1.0

• Examination of neck muscles and TMJ with patients with orofacial chronic pain is important.

5

5

5

A

Yes

3

4

4

< 0.0001*

−2.0*

• TMD pain is aggravated/relieved by jaw motion.

2.5

4

4.5

A

No

3

3

4

0.2

0.0

• Reduced mouth opening capacity is almost never caused by TMJ arthritis.

1

2

2

D

Yes

2

3

4

< 0.0001*

+ 2.0*

• Palpatory tenderness in the masticatory system and/or TMJ is the most important clinical sign of TMD.

4

4

5

A

Yes

3

3

4

< 0.0001*

−1.0*

• TMD is more common amongst children with mixed dentition than amongst adult with permanent dentition.

1

2

2

D

Yes

2

3

4

< 0.0001*

+ 2.0*

• Measuring mouth opening capacity is a reliable assessment method.

4

4

4.5

A

Yes

3

4

4

0.006*

−1.0*

Treatment and prognosis

• Occlusal grinding is a useful early treatment modality for TMD.

1

1

2

D

Yes

3

3

4

< 0.0001*

−2.0*

• Orthodontic treatment can prevent the onset of TMD.

1

2

2.5

D

Yes

3

3

4

< 0.0001*

+ 2.0*

• Orthodontic treatment can treat TMD.

2

2

3

A

No

3

3

4

< 0.0001*

+ 2.0*

• Anti-inflammatory drugs are effective in the treatment of acute arthralgia.

4

4

5

A

Yes

3

4

4

< 0.0001*

−1.0*

• The use of an occlusal splint is a good therapy in patients with TMD.

4

4

5

A

Yes

3

3

4

< 0.0001*

−1.0*

• Relaxation-training is not an effective treatment for TMD.

1

1

2

D

Yes

2

3

4

< 0.0001*

+ 2.0*

• Occlusal splints eliminate bruxism.

1

2

2.5

D

Yes

3

3

4

< 0.0001*

+ 2.0*

• All individuals with TMJ clicking need treatment.

1

1

2

D

Yes

2

3

4

< 0.0001*

+ 2.0*

• Counselling and behavioral therapy are the first line of treatment in patients which chronic TMD.

3

4

4.5

A

No

3

4

4

0.5

0.0