A scoping review on barriers and facilitators to the evidence-based referral pathway for temporomandibular disorders management

Objective: This scoping review is intended to identify and synthesize global evidence on barriers and facilitators influencing referral pathways for TMD management, highlighting implications for oral and maxillofacial surgeons (OMS) and interprofessional care models. Methods: Following Joanna Briggs Institute and PRISMA-ScR guidelines, comprehensive searches were performed. Eligible studies discussed factors affecting the diagnosis, management, or referral of TMD patients. Data were extracted and synthesized using inductive thematic analysis. Results: Six thematic domains emerged: educational, structural/institutional, communicational, systemic, cultural/professional, and technological. The most recurrent barriers were insufficient undergraduate training, fragmentation between dental and medical services, and lack of standardized referral criteria. Facilitators included interprofessional education, use of evidence-based clinical pathways, and digital referral systems. Conclusion: Referral systems for TMD remain fragmented worldwide. Strengthening interprofessional education, implementing structured referral criteria, and integrating digital decision-support within OMS services are crucial steps to align clinical practice with evidence and reduce surgical overtreatment.