The orofacial region consists of heterogeneous tissues that make diagnosing and treating pain conditions a challenging task. Vital to these processes are well-structured classifcation systems that cover the breadth of chronic orofacial pain conditions and provide diagnostic criteria to enhance our ability to properly identify and categorize clinical events in an agreed pattern. A revision of the classifcation systems for orofacial pain disorders developed respectively by the International Association for the Study of Pain, the International Headache Society, the American Academy of Orofacial Pain, and the American Academy of Craniofacial Pain reveals a number of defciencies and inconsistencies ranging from terminology to the structure itself and the set of diagnostic criteria. To improve communication and enable effective collaborative work, we are at the crossroads for the development of a new multiaxial classifcation system using ontological principles to build a realistic and comprehensive representation of orofacial pain disorders. With research focusing on pain biomarkers, optimizing the systematization of data collection may contribute to identifying clinical phenotypes of chronic orofacial pain conditions that have the most impact on patient life.