Diagnostic accuracy of the Diagnostic Criteria for Temporomandibular Disorders for children aged 8‐12 years

Abstract

Background and Objective: Objective of this study was to determine whether the diagnostic accuracy of the Diagnostic Criteria for Temporomandibular Disorders (DC/ TMD) is sufficient for use among schoolchildren aged 8-12 years. Methods: This prospective cohort study on diagnostic accuracy with calibrated examiners was conducted among 533 children of both sexes aged 8-12 years, with and without TMD symptoms, selected randomly from the Rhein-Neckar district. Self-reporting of non-dental facial pain was used as the reference standard, against which we calculated the following for the pain-related items of the DC/TMD (index test): sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, accuracy and 95% Wilson Score confidence intervals. We also calculated the area under the receiver-operating characteristic (AUROC) curve displaying sensitivity and specificity. Results: Our final sample consisted of 282 children, half of whom reported having facial pain and 3.2% reported sounds from the temporomandibular joints (TMJs). Despite high specificity (90.78%; 95% confidence interval (CI): [84.86%; 94.53%]), sensitivity of the adapted DC/TMD for pain on maximum jaw opening was poor (37.59%; 95% CI: [30.02%; 45.81%]). For pain on palpation, more similar values were recorded for sensitivity (74.47%; 95% CI: [66.69%; 80.95%]) and specificity (70.21%; 95% CI: [62.21%; 77.14%]). The diagnostic odds ratio was >1 for both examinations. The AUROC for pain on opening was 68.39% (95% CI: [62.62%; 74.16%]), and for pain on palpation, it was 74.63% (95% CI: [69.45%; 79.81%]), whereas the combination of both resulted to an AUROC of 74.09% (95% CI: [68.96%; 79.21%]). It was not possible to measure the diagnostic accuracy of the DC/TMD regarding TMJ sounds or jawopening limitations, as they occurred too rarely in our sample. Conclusion: In this study, the diagnostic accuracy of the DC/TMD for TMD-related pain in children was lower than that recorded for adults in previous studies.

Diagnostic criteria for temporomandibular disorders in children and adolescents: An international Delphi study‐Part 2‐Development of Axis II

“…Having a standardised protocol to assess Axis I and Axis II would improve the quality of the research as well as clinicians' ability to detect children and adolescents at higher risk of developing long‐lasting pain. The need for tools to assess TMD in children has been clear since the publication of at least two previous studies 59,60 . However, both analysed only DC/TMD Axis I, without including any Axis II assessments.…”

“…The need for tools to assess TMD in children has been clear since the publication of at least two previous studies. 59,60 However, both analysed only DC/TMD Axis I, without including any Axis II assessments.…”

Knowledge about temporomandibular joint disorders among dental students in Saudi Arabia

“…NSAIDs are contraindicated in patients with gastrointestinal di sorders or NSAID-sensitive asthma. (5) Most of the studies conducted to assess prevalence of TMDs concluded common observation that females and younger age groups are the most affected categories by these disorders (6)(7)(8)(9) Also several studies founded a higher TMDs prevalence among university students, especially medical and dental undergraduates. (10 -13) Several studies investigated the incidence of TMDs and its related factors among kids, teenagers, adults and the elderly, but there is little knowledge available regarding colleges' dental students who are subject to a high psychosocial and physical manifestations of tension and anxiety.…”

Evaluation of Temporomandibular Disorders Among Dental Students of Saudi Arabia Using Diagnostic Criteria/temporomandibular Disorders (DC/TMD) and Its Association With Biographic, Academic, and Psychosocial Parameters – A Cross-sectional Study

“…The temporomandibular joint (TMJ) complex consists of bone, cartilage, muscles, ligaments, and associated neurovascular channels supplying to the structures [1]. The disorders arising from these structures are also complex in nature with varied presentations such as pain originating from bone and muscles; displacement of the cartilaginous disc, and degenerating conditions related to bony components [2]. As per the recent classi cation of TMD, the earlier mentioned conditions are known as pain related TMD and TMJ disorders respectively.…”

“…Later, the evaluating criterion was replaced with DC/TMD and studies were carried out in varied populations across different countries [13,14,17]. A common observation made in the past studies was the preponderance of TMD among females and in the younger age groups [2,8,9,15]. Previous studies have also pointed out the higher prevalence of TMD in university students, especially medical and dental undergraduates [13,14,18,19].…”