Diagnostic criteria for temporomandibular disorders—INfORM recommendations: Comprehensive and short‐form adaptations for children

Abstract

Background:The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) are used worldwide in adults. Until now, no adaptation for use in children has been proposed. Objective:The aim of this study was to present comprehensive and short-form adaptations of Axis I and Axis II of the DC/TMD for adults that are appropriate for use with children in clinical and research settings.Methods: Global Delphi studies with experts in TMDs and in pain psychology identified ways of adapting the DC/TMD for children. Results:The proposed adaptation is suitable for children aged 6-9 years. Proposed changes in Axis I include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for children, (ii) adding a general health questionnaire for children and one for their parents, (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire and (iv) modifying the clinical examination protocol. Proposed changes in Axis II include (i) for the Graded Chronic Pain Scale, to be developmentally appropriate for children, (ii) adding anxiety and depression assessments that have been validated in children and (iii) adding three constructs (stress, catastrophising and sleep disorders) to assess psychosocial functioning in children. Conclusion: The recommended DC/TMD, including Axis I and Axis II, for children aged 6-9 years, is appropriate for use in clinical and research settings. This adapted the first version for children includes changes in Axis I and Axis II changes requiring reliability and validity testing in international settings. Official translations to different languages according to INfORM requirements will enable a worldwide dissemination and implementation.

Post‐traumatic stress, prevalence of temporomandibular disorders in war veterans: Systematic review with meta‐analysis

“…TMJ click, pain at muscle palpation and intrameatal tenderness were also more prevalent in veterans. 32 The results of the study performed in 2011 were in line with those of the study of 2006. 23 In the study by Mottaghi and Zamani, 24 120 subjects were enrolled: 30 subjects exposed to war and diagnosed with PTSD, 30 war veterans not diagnosed with PTSD, 30 subjects not exposed to war and diagnosed with PTSD and 30 not exposed to war and not diagnosed with PTSD.…”

“…Headache was the most intense pain reported in the PTSD group. TMJ click, pain at muscle palpation and intrameatal tenderness were also more prevalent in veterans 32 …”

Biological and psychological factors affecting the sensory and jaw motor responses to orthodontic tooth movement

“…A list of questionnaires and checklists is also provided in Table 1. As psychological traits can affect sensory processing at all ages and TMD is also prevalent in the paediatric population, 51 it is useful to get information about psychological traits also in children, and recommended to screen for TMD before commencing orthodontic and other dental procedures using validated instruments 52–57 …”

Does dental rehabilitation under general anaesthetic contribute to the development of temporomandibular disorders in children and adolescents? A scoping review

“…The American Academy of Pediatric Dentistry 2 state that controversy surrounds the significance of signs and symptoms in children and adolescents and the value of certain diagnostic procedures; hence, a recent Delphi study was performed to develop a standardised protocol for TMD diagnosis in children and adolescents by adapting the pre-existing DC/TMD Axis I used in adults. 73 The DC/TMD is the most widely used diagnostic criteria for TMD and as this adapted DC/TMD, alongside the psychosocial status and pain-related disability within DC/TMD Axis II, will provide a more comprehensive standardised process for the collection of clinical information in children and adolescents, 64,73 there may be scope for a question in the history questionnaire instrument of Axis I, to determine how many of those children and adolescents presenting with TMD have experience of pDGA.…”