The purpose of this paper is to review the current status of biomarkers used in orofacial pain conditions. Specifically, we critically appraise their relative strengths and weaknesses for assessing mechanisms associated with the orofacial pain conditions and interpret that information in light of their current value for use in diagnosis. In the third section, we explore biomarkers through the perspective of ontological realism. We discuss ontological problems of biomarkers as currently widely conceptualized and implemented. This leads to recommendations for research practice aimed to a better understanding of the potential contribution that biomarkers might make to orofacial pain diagnosis and thereby fulfill our goal for an expanded multi-dimensional framework for orofacial pain conditions that would include a third axis.
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