Background: Temporomandibular disorders (TMDs) represent a leading source of orofacial
pain, yet their diagnosis remains inherently challenging due to the subjective nature of
patient-reported symptoms. The translation of lay symptom descriptions into accurate clinical
diagnoses is a critical step in care, but one that is susceptible to variability among dentists.
Objective: This study aimed to explore how dentists interpret patient-reported orofacial pain
in TMDs and to identify key factors influencing diagnostic accuracy and clinical decision-
making.
Methods: A cross-sectional, scenario-based survey was conducted among 466 practicing
dentists. The instrument incorporated clinically relevant patient-reported symptom scenarios
to evaluate diagnostic interpretation, alongside measures of professional background,
diagnostic confidence, and use of standardized criteria. Statistical analysis included
descriptive methods, Chi-square testing, and multivariate logistic regression to identify
independent predictors of diagnostic accuracy.
Results: Marked variability was observed in the interpretation of patient-reported symptoms,
particularly in ambiguous and non-specific presentations. Higher diagnostic accuracy was
significantly associated with formal TMD training, greater clinical experience, and increased
diagnostic confidence (p < 0.05). Dentists employing an integrative diagnostic
approach—combining patient-reported symptoms with clinical examination—demonstrated
superior performance (p < 0.01). Furthermore, consistent application of standardized
diagnostic frameworks was strongly linked to improved interpretative accuracy (p < 0.001).

Conclusion: These findings highlight substantial heterogeneity in dentists’ interpretation of
patient-reported orofacial pain, underscoring the complexity of diagnostic decision-making in
TMDs. Enhancing clinician training and reinforcing the use of structured diagnostic criteria
are essential to improve diagnostic consistency, accuracy, and patient outcomes.