Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jun;147(6):438-45.
doi: 10.1016/j.adaj.2016.01.007. Epub 2016 Feb 26.

Executive summary of the Diagnostic Criteria for Temporomandibular Disorders for clinical and research applications

Eric Schiffman, Richard Ohrbach

Executive summary of the Diagnostic Criteria for Temporomandibular Disorders for clinical and research applications

Eric Schiffman et al. J Am Dent Assoc. 2016 Jun.

Abstract

Background: In this executive summary, the authors describe a protocol for assessing patients with temporomandibular disorder (TMD). It is based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications.

Methods: The DC/TMD was developed using published Axis I physical diagnoses for the most common TMDs. Axis I diagnostic criteria were derived from pertinent clinical TMD signs and symptoms. Axis II consists of psychosocial and behavioral questionnaires already in the public domain. A panel of experts vetted and modified the Axis I and Axis II diagnostic protocols. Recommended changes were assessed for diagnostic accuracy by using the Validation Project's data set, which formed the basis for the development of the DC/TMD.

Results: Axis I diagnostic criteria for TMD pain-related disorders have acceptable validity and provide definitive diagnoses for pain involving the temporomandibular joint (TMJ) and masticatory muscles. Axis I diagnostic criteria for the most common TMJ intra-articular disorders are appropriate for screening purposes only. A definitive diagnosis for TMJ intra-articular disorders requires computed tomography or magnetic resonance imaging. Axis II questionnaires provide valid assessment of psychosocial and behavioral factors that can affect management of TMD.

Conclusions: The DC/TMD provides a questionnaire for the pain history in conjunction with validated clinical examination criteria for diagnosing the most common TMDs. In addition, it provides Axis II questionnaires for assessing psychosocial and behavioral factors that may contribute to the onset and perpetuation of the patient's TMD.

Practical implications: The DC/TMD is appropriate for use in clinical and research settings to allow for a comprehensive assessment of patients with TMD.

Keywords: National Institutes of Health; Temporomandibular joint disorders; clinical protocols; diagnostic challenge; facial pain; masticatory muscles; myofascial pain; orofacial pain; research; temporomandibular dysfunction.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest related to this study.

Figures

Figure 1
Figure 1
Biopsychosocial model of disease applied to TMD.
See this image and copyright information in PMC

Comment in

  • TMD Diagnostic Criteria.
    DiBenedetto D. DiBenedetto D. J Am Dent Assoc. 2016 Oct;147(10):775-6. doi: 10.1016/j.adaj.2016.08.013. J Am Dent Assoc. 2016. PMID: 27688224 No abstract available.
  • Authors' response.
    Schiffman E, Ohrbach R. Schiffman E, et al. J Am Dent Assoc. 2016 Oct;147(10):776. doi: 10.1016/j.adaj.2016.08.014. J Am Dent Assoc. 2016. PMID: 27688226 No abstract available.

References

    1. Dworkin SF, LeResche L. Research Diagnostic Criteria for Temporomandibular Disorders: Review, Criteria, Examinations and Specifications, Critique. Journal of Craniomandibular Disorders, Facial and Oral Pain. 1992;6(4):301–55. - PubMed
    1. Fillingim RB, Bruehl S, Dworkin RH, et al. The ACTTION-American Pain Society Pain Taxonomy (AAPT): An evidence-based and multidimensional approach to classifying chronic pain conditions. Journal of Pain. 2014;15(3):241–49. - PMC - PubMed
    1. Bossuyt PM, Reistsma JB, Bruns DE, et al. Standards for Reporting of Diagnostic Accuracy. Toward complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. Standards for Reporting of Diagnostic Accuracy. Clinical Chemistry. 2009;49:1–6. - PubMed
    1. Truelove E, Pan W, Look JO, et al. The Research Diagnostic Criteria for Temporomandibular Disorders. III: Validity of Axis I diagnoses. Journal of Orofacial Pain. 2010;24(1):35–47. - PMC - PubMed
    1. Schiffman EL, Ohrbach R, Truelove EL, et al. The Research Diagnostic Criteria for Temporomandibular Disorders. V: Methods used to establish and validate revised Axis I diagnostic algorithms. Journal of Orofacial Pain. 2010;24(1):63–78. - PMC - PubMed

Publication types