Constructing the brief Diagnostic Criteria for Temporomandibular Disorders (bDC/TMD)

• DOI: 10.1101/2023.08.29.23294531
• Publication Date: 2023-08-30T05:55:23Z
• Authors: Justin Durham; Richard Ohrbach; Lene Baad-Hansen; Stephen Davies; Antoon De Laat; Daniela Godoi Gon...; Valeria V Gordan; Jean-Paul Goulet; Birgitta Häggman-...; Michael Horton; ; Michail Koutris; Alan Law; Thomas List; Frank Lobbezoo; Ambra Michelotti; Donald R. Nixdorf; Juan Fernando Oyarzo; Chris Peck; Chris Penlington; Karen G. Raphael; Vivian Santiago; Sonia Sharma; Peter Svensson; Corine M. Visscher; Imamura Yoshiki; Per Alstergren

AbstractBackgroundDespite advances in Temporomandibular disorders’ (TMDs) diagnosis, the diagnostic process continues to be problematic in non-specialist settings.ObjectiveTo complete a Delphi process to shorten the Diagnostic Criteria for TMD (DC/TMD) to a brief DC/TMD (bDC/TMD) for the diagnoses with the most utility in general dentistry settings.MethodsA international Delphi panel was created with 23 clinicians representing major specialities, general dentistry, and related fields. The process comprised a full day workshop, four virtual meetings, six rounds of electronic discussion, and finally an open consultation at a virtual international symposium.ResultsWithin the physical axis (Axis 1) the self-report Symptom Questionnaire of the DC/TMD did not require shortening from 14 items for the bDC/TMD. The compulsory use of the TMD pain screener was removed reducing the total number of Axis 1 items by 18%. The DC/TMD Axis 1 10-section examination protocol (25 movements, up to 12 sets of bilateral palpations) was reduced to 4 sections in the bDC/TMD protocol involving 3 movements and 3 sets of palpations. Axis I then resulted in two groups of diagnoses: painful TMD (inclusive of secondary headache), and common joint-related TMD with functional implications. The Psychosocial Axis (Axis 2) was shortened to an ultra-brief 11 item assessment.ConclusionThe bDC/TMD represents a substantially reduced and likely expedited method to establish (grouping) diagnoses in TMDs. This may provide greater utility for settings requiring less granular diagnoses for the implementation of initial treatment, for example non-specialist general dental practice.