Skip to main content

Classification of Orofacial Pain

  • Reference work entry
  • First Online:
Contemporary Oral Medicine

Abstract

Designing a classification system for any disease entity, let alone orofacial pain and more specifically for temporomandibular disorders, is quite the task. Unfortunately, this is made even more difficult due to the many conditions, both physical and psychosocial, that must be accounted for when undertaking this challenge for these aforementioned entities. In order to appreciate the utility of classification systems, it is first necessary to gain an understanding and comprehension as to their importance and how it may be optimally operationalized for both clinical and research activities. Other considerations that must be taken into account are past and present classification systems that have been espoused by various organizations. Each of these needs to be carefully evaluated within a framework of their inherent advantages while exposing their limitations. These previously established classification systems must then be integrated with newly proposed, expanded upon or modified systems as a result of recent findings from contemporary evidence-based scientific literature. Hopefully, this will lead to an “ideal classification system” whereby other factors such as genetics and neurobiological process can be reviewed for inclusion in this expanded schema. Additionally, adopting newer approaches, such as following ontological principles, will result in a more thorough and comprehensive classification system which ultimately will assist the clinician in providing improved diagnosis, the researcher in studying more homogenous groups, and the patient in receiving more directed and individualized interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 599.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 899.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • American Academy of Craniofacial Pain. Craniofacial pain: a handbook for assessment, diagnosis and management. Chattanooga: Chroma, Inc.; 2009.

    Google Scholar 

  • Apkarian AV, Baliki MN, et al. Predicting transition to chronic pain. Curr Opin Neurol. 2013;26(4):360–7.

    Article  Google Scholar 

  • Benoliel R, Birman N, et al. The International Classification of Headache Disorders: accurate diagnosis of orofacial pain? Cephalalgia. 2008;28(7):752–62.

    Article  Google Scholar 

  • Benoliel R, Eliav E, et al. Classification of chronic orofacial pain: applicability of chronic headache criteria. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110(6):729–37.

    Article  Google Scholar 

  • Benoliel R, Svensson P, et al. Persistent orofacial muscle pain. Oral Dis. 2011;17(Suppl 1):23–41.

    Article  Google Scholar 

  • Bonica JJ. The need of a taxonomy. Pain. 1979;6(3):247–8.

    Article  Google Scholar 

  • Bourne S, Machado AG, et al. Basic anatomy and physiology of pain pathways. Neurosurg Clin N Am. 2014;25(4):629–38.

    Article  Google Scholar 

  • Ceusters W, Michelotti A, et al. Perspectives on next steps in classification of oro-facial pain – part 1: role of ontology. J Oral Rehabil. 2015a;42(12):926–41.

    Article  Google Scholar 

  • Ceusters W, Nasri-Heir C, et al. Perspectives on next steps in classification of oro-facial pain – part 3: biomarkers of chronic oro-facial pain – from research to clinic. J Oral Rehabil. 2015b;42(12):956–66.

    Article  Google Scholar 

  • De Boever JA, Nilner M, et al. Recommendations by the EACD for examination, diagnosis, and management of patients with temporomandibular disorders and orofacial pain by the general dental practitioner. J Orofac Pain. 2008;22(3):268–78.

    PubMed  Google Scholar 

  • De Leeuw R. Orofacial pain: guidelines for assessment, diagnosis, and management. Chicago: Quintessence; 2008.

    Google Scholar 

  • De Leeuw R, Klasser GD. Orofacial pain: guidelines for assessment, diagnosis, and management. Chicago: Quintessence; 2013.

    Google Scholar 

  • Diatchenko L, Slade GD, et al. Genetic basis for individual variations in pain perception and the development of a chronic pain condition. Hum Mol Genet. 2005;14(1):135–43.

    Article  Google Scholar 

  • Diatchenko L, Nackley AG, et al. Idiopathic pain disorders – pathways of vulnerability. Pain. 2006;123(3):226–30.

    Article  Google Scholar 

  • Durham J, Exley C, et al. Persistent dentoalveolar pain: the patient's experience. J Orofac Pain. 2013;27(1):6–13.

    Article  Google Scholar 

  • Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992;6(4):301–55.

    PubMed  Google Scholar 

  • Dworkin SF, Sherman J, et al. Reliability, validity, and clinical utility of the research diagnostic criteria for temporomandibular disorders axis II scales: depression, non-specific physical symptoms, and graded chronic pain. J Orofac Pain. 2002;16(3):207–20.

    PubMed  Google Scholar 

  • Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196(4286):129–36.

    Article  Google Scholar 

  • Fillingim RB, Slade GD, et al. Summary of findings from the OPPERA baseline case-control study: implications and future directions. J Pain. 2011;12(11 Suppl):T102–7.

    Article  Google Scholar 

  • Fillingim RB, Bruehl S, et al. The ACTTION-American pain society pain taxonomy (AAPT): an evidence-based and multidimensional approach to classifying chronic pain conditions. J Pain. 2014;15(3):241–9.

    Article  Google Scholar 

  • Gonzalez YM, Schiffman E, et al. Development of a brief and effective temporomandibular disorder pain screening questionnaire: reliability and validity. J Am Dent Assoc. 2011;142(10):1183–91.

    Article  Google Scholar 

  • Gupta A, Silman AJ, et al. The role of psychosocial factors in predicting the onset of chronic widespread pain: results from a prospective populationbased study. Rheumatology (Oxford). 2007;46(4):666–71.

    Article  Google Scholar 

  • Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629–808.

    Article  Google Scholar 

  • Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018;38(1):1–211.

    Google Scholar 

  • International Network for Orofacial Pain and Related Disorders Methodology (INfORM). International consensus workshop: convergence on an orofacial pain taxonomy [Internet]. 2017. https://ubwp.buffalo.edu/rdc-tmdinternational/

  • Klasser GD, Greene CS. The changing field of temporomandibular disorders: what dentists need to know. J Can Dent Assoc. 2009;75(1):49–53.

    PubMed  Google Scholar 

  • Kotiranta U, Suvinen T, et al. Subtyping patients with temporomandibular disorders in a primary health care setting on the basis of the research diagnostic criteria for temporomandibular disorders axis II pain-related disability: a step toward tailored treatment planning? J Oral Facial Pain Headache. 2015;29(2):126–34.

    Article  Google Scholar 

  • Machado L, Nery MB, et al. Profiling the clinical presentation of diagnostic characteristics of a sample of symptomatic TMD patients. BMC Oral Health. 2012;12:26.

    Article  Google Scholar 

  • Maixner W, Diatchenko L, et al. Orofacial pain prospective evaluation and risk assessment study – the OPPERA study. J Pain. 2011a;12(Suppl 11):T4–11 e1–2.

    PubMed  Google Scholar 

  • Maixner W, Greenspan JD, et al. Potential autonomic risk factors for chronic TMD: descriptive data and empirically identified domains from the OPPERA case-control study. J Pain. 2011b;12(11 Suppl):T75–91.

    Article  Google Scholar 

  • Manfredini D, Chiappe G, et al. Research diagnostic criteria for temporomandibular disorders (RDC/TMD) axis I diagnoses in an Italian patient population. J Oral Rehabil. 2006;33(8):551–8.

    Article  Google Scholar 

  • Manfredini D, Basso D, et al. Association between magnetic resonance signs of temporomandibular joint effusion and disk displacement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107(2):266–71.

    Article  Google Scholar 

  • Manfredini D, Bucci MB, et al. Temporomandibular disorders assessment: medicolegal considerations in the evidence-based era. J Oral Rehabil. 2011;38(2):101–19.

    Article  Google Scholar 

  • Manfredini D, Favero L, et al. Axis II psychosocial findings predict effectiveness of TMJ hyaluronic acid injections. Int J Oral Maxillofac Surg. 2013;42(3):364–8.

    Article  Google Scholar 

  • Manfredini D, Stellini E, Gracco A, Lombardo L, Nardini LG, Siciliani G. Orthodontics is temporomandibular disorder-neutral. Angle Orthod. 2016;86(4):649–54.

    Article  Google Scholar 

  • Merriam-Webster. Definition of classification [Internet]. 2015 [cited 2016 June22]. Available from: http://www.merriam-webster.com/dictionary/classification

  • Merskey H. The taxonomy of pain. Med Clin North Am. 2007;91(1):13–20, vii.

    Article  Google Scholar 

  • Merskey H, Bogduk N. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. Seattle: IASP Press; 1994.

    Google Scholar 

  • Nixdorf D, Moana-Filho E. Persistent dento-alveolar pain disorder (PDAP): working towards a better understanding. Rev Pain. 2011;5(4):18–27.

    Article  Google Scholar 

  • Nixdorf DR, Drangsholt MT, et al. Classifying orofacial pains: a new proposal of taxonomy based on ontology. J Oral Rehabil. 2012;39(3):161–9.

    Article  Google Scholar 

  • Ohlmann B, Rammelsberg P, et al. Prediction of TMJ arthralgia according to clinical diagnosis and MRI findings. Int J Prosthodont. 2006;19(4):333–8.

    PubMed  Google Scholar 

  • Ohrbach R, List T, et al. Recommendations from the international consensus workshop: convergence on an orofacial pain taxonomy. J Oral Rehabil. 2010;37(10):807–12.

    Article  Google Scholar 

  • Okeson JP. Bell’s oral and facial pain. Chicago: Quintessence; 2014.

    Google Scholar 

  • Peck CC, Goulet JP, et al. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders. J Oral Rehabil. 2014;41(1):2–23.

    Article  Google Scholar 

  • Pertes RA, Gross SG. Clinical management of temporomandibular disorders and orofacial pain. Chicago: Quintessence Books; 1995.

    Google Scholar 

  • Price TJ, Inyang KE. Commonalities between pain and memory mechanisms and their meaning for understanding chronic pain. Prog Mol Biol Transl Sci. 2015;131:409–34.

    Article  Google Scholar 

  • Procacci P, Maresca M. Considerations on taxonomy of pain. Pain. 1991;45(3):332.

    Article  Google Scholar 

  • Raj P. Taxonomy and classification of pain. In: Kreitler S, Beltrutti D, Lamberto A, Niv D, editors. The handbook of chronic pain. New York: Nova Biomedical Books by Nova Science Publishers; 2007.

    Google Scholar 

  • Reichling DB, Levine JD. Critical role of nociceptor plasticity in chronic pain. Trends Neurosci. 2009;32(12):611–8.

    Article  Google Scholar 

  • Reid KI, Greene CS. Diagnosis and treatment of temporomandibular disorders: an ethical analysis of current practices. J Oral Rehabil. 2013;40(7):546–61.

    Article  Google Scholar 

  • Schiffman E, Ohrbach R. Executive summary of the diagnostic criteria for temporomandibular disorders for clinical and research applications. J Am Dent Assoc. 2016;147(6):438–45.

    Article  Google Scholar 

  • Schiffman EL, Ohrbach R, et al. The research diagnostic criteria for temporomandibular disorders. V: methods used to establish and validate revised axis I diagnostic algorithms. J Orofac Pain. 2010a;24(1):63–78.

    PubMed  PubMed Central  Google Scholar 

  • Schiffman EL, Truelove EL, et al. The research diagnostic criteria for temporomandibular disorders. I: overview and methodology for assessment of validity. J Orofac Pain. 2010b;24(1):7–24.

    PubMed  PubMed Central  Google Scholar 

  • Schiffman E, Ohrbach R, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD consortium network* and orofacial pain special interest Groupdagger. J Oral Facial Pain Headache. 2014;28(1):6–27.

    Article  Google Scholar 

  • Schmitter M, Kress B, et al. Validity of temporomandibular disorder examination procedures for assessment of temporomandibular joint status. Am J Orthod Dentofac Orthop. 2008;133(6):796–803.

    Article  Google Scholar 

  • Slade GD, Conrad MS, et al. Cytokine biomarkers and chronic pain: association of genes, transcription, and circulating proteins with temporomandibular disorders and widespread palpation tenderness. Pain. 2011;152(12):2802–12.

    Article  Google Scholar 

  • Slavich GM, Tartter MA, Brennan PA, Hammen C. Endogenous opioid system influences depressive reactions to socially painful targeted rejection life events. Psychoneuroendocrinology. 2014;49:141–9.

    Article  Google Scholar 

  • Smith SB, Maixner DW, et al. Potential genetic risk factors for chronic TMD: genetic associations from the OPPERA case control study. J Pain. 2011;12(11 Suppl):T92–101.

    Article  Google Scholar 

  • Steenks MH, de Wijer A. Validity of the research diagnostic criteria for temporomandibular disorders axis I in clinical and research settings. J Orofac Pain. 2009;23(1):9–16; discussion 17-27.

    Google Scholar 

  • Stegenga B. Nomenclature and classification of temporomandibular joint disorders. J Oral Rehabil. 2010;37(10):760–5.

    Article  Google Scholar 

  • Stohler CS. Taking stock: from chasing occlusal contacts to vulnerability alleles. Orthod Craniofacial Res. 2004;7(3):157–61.

    Article  Google Scholar 

  • Suvinen TI, Reade PC, et al. Review of aetiological concepts of temporomandibular pain disorders: towards a biopsychosocial model for integration of physical disorder factors with psychological and psychosocial illness impact factors. Eur J Pain. 2005;9(6):613–33.

    Article  Google Scholar 

  • Suvinen T, Kemppainen P, et al. Research diagnostic criteria axis II in screening and as a part of biopsychosocial subtyping of Finnish patients with temporomandibular disorder pain. J Orofac Pain. 2013;27(4):314–24.

    Article  Google Scholar 

  • Treede RD, Rief W, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6):1003–7.

    PubMed  PubMed Central  Google Scholar 

  • Turk DC. Customizing treatment for chronic pain patients: who, what, and why. Clin J Pain. 1990;6(4):255–70.

    Article  Google Scholar 

  • Turk DC, Rudy TE. Towards a comprehensive assessment of chronic pain patients. Behav Res Ther. 1987;25(4):237–49.

    Article  Google Scholar 

  • Turk DC, Rudy TE. The robustness of an empirically derived taxonomy of chronic pain patients. Pain. 1990;43(1):27–35.

    Article  Google Scholar 

  • Turp JC, Greene CS, et al. Dental occlusion: a critical reflection on past, present and future concepts. J Oral Rehabil. 2008;35(6):446–53.

    Article  Google Scholar 

  • Ventafridda V, Caraceni A. Cancer pain classification: a controversial issue. Pain. 1991;46(1):1–2.

    Article  Google Scholar 

  • Von Korff M, Ormel J, et al. Grading the severity of chronic pain. Pain. 1992;50(2):133–49.

    Article  Google Scholar 

  • Woda A, De Laat A. Classification of orofacial pain. In: Sessle BJ, editor. Orofacial pain: recent advances in assessment, management, and understanding of mechanisms. Seattle: IASP Press; 2014.

    Google Scholar 

  • Woda A, Tubert-Jeannin S, et al. Towards a new taxonomy of idiopathic orofacial pain. Pain. 2005;116(3):396–406.

    Article  Google Scholar 

  • Zebenholzer K, Wober C, et al. Facial pain in a neurological tertiary care centre – evaluation of the International Classification of Headache Disorders. Cephalalgia. 2005;25(9):689–99.

    Article  Google Scholar 

  • Zubieta JK, Smith YR, et al. Regional mu opioid receptor regulation of sensory and affective dimensions of pain. Science. 2001;293(5528):311–5.

    Article  Google Scholar 

  • Zubieta JK, Heitzeg MM, et al. COMT val158met genotype affects mu-opioid neurotransmitter responses to a pain stressor. Science. 2003;299(5610):1240–3.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gary D. Klasser .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Klasser, G.D., Goulet, JP., De Laat, A., Manfredini, D. (2019). Classification of Orofacial Pain. In: Farah, C., Balasubramaniam, R., McCullough, M. (eds) Contemporary Oral Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-72303-7_29

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-72303-7_29

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-72301-3

  • Online ISBN: 978-3-319-72303-7

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics