Diagnostic criteria for temporomandibular disorders-INfORM recommendations: Comprehensive and short-form adaptations for adolescents

EwaCarin Ekberg; Ing-Marie Nilsson; Ambrosina Michelotti; Amal Al-Khotani; Per Alstergren; Paulo Cesar Rodrigues Conti; Justin Durham; Jean-Paul Goulet; Christian Hirsch; Stanimira Kalaykova; Flavia P Kapos; Christopher D King; Osamu Komiyama; Michail Koutris; Thomas List; Frank Lobbezoo; Richard Ohrbach; Tonya M Palermo; Christopher C Peck; Chris Penlington; Claudia Restrepo; Maria Joao Rodrigues; Sonia Sharma; Peter Svensson; Corine M Visscher; Kerstin Wahlund; Roberto Rongo; International Network for Orofacial Pain and Related Disorders Methodology (INfORM)

doi:10.1111/joor.13488

Diagnostic criteria for temporomandibular disorders-INfORM recommendations: Comprehensive and short-form adaptations for adolescents

J Oral Rehabil. 2023 Nov;50(11):1167-1180. doi: 10.1111/joor.13488. Epub 2023 Jun 27.

Authors

EwaCarin Ekberg¹, Ing-Marie Nilsson^{1

2}, Ambrosina Michelotti³, Amal Al-Khotani^{4

5}, Per Alstergren^{1

5

6}, Paulo Cesar Rodrigues Conti^{7

8}, Justin Durham⁹, Jean-Paul Goulet¹⁰, Christian Hirsch¹¹, Stanimira Kalaykova¹², Flavia P Kapos^{13

14}, Christopher D King^{15

16

17}, Osamu Komiyama¹⁸, Michail Koutris¹⁹, Thomas List^{1

5}, Frank Lobbezoo¹⁹, Richard Ohrbach²⁰, Tonya M Palermo²¹, Christopher C Peck²², Chris Penlington⁹, Claudia Restrepo²³, Maria Joao Rodrigues²⁴, Sonia Sharma^{1

20}, Peter Svensson²⁵, Corine M Visscher¹⁹, Kerstin Wahlund²⁶, Roberto Rongo³; International Network for Orofacial Pain and Related Disorders Methodology (INfORM)²⁷

Affiliations

¹ Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.
² Center for Oral Rehabilitation, Norrköping, Sweden.
³ School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy.
⁴ Dental Department, East Jeddah Hospital, Ministry of Health, Jeddah, Saudi Arabia.
⁵ Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden.
⁶ Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden.
⁷ Department of Prosthodontics and Periodontology, Bauru School of Dentistry-University of São Paulo, Bauru, Sao Paulo, Brazil.
⁸ Bauru Orofacial Pain Group, University of São Paulo, Bauru, Sao Paulo, Brazil.
⁹ Newcastle School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK.
¹⁰ Faculty of Dental Medicine, Laval University, Quebec, Quebec, Canada.
¹¹ Clinic of Pediatric Dentistry, University of Leipzig, Leipzig, Germany.
¹² Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
¹³ Department of Epidemiology, University of Washington, Seattle, Washington, USA.
¹⁴ Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA.
¹⁵ Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
¹⁶ Pediatric Pain Research Center (PPRC), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
¹⁷ Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
¹⁸ Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo, Matsudo, Japan.
¹⁹ Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
²⁰ Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, New York, USA.
²¹ Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle Children's Research Institute, Seattle, Washington, USA.
²² Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
²³ CES-LPH Research Group, Universidad CES, Medellin, Colombia.
²⁴ Institute for Occlusion and Orofacial Pain, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
²⁵ Section for Orofacial Pain and Jaw Function, School of Dentistry and Oral Health, Aarhus, Denmark.
²⁶ Department of Orofacial Pain and Jaw Function, Kalmar County Hospital, Kalmar, Sweden.
²⁷ International Network for Orofacial Pain and Related Disorders Methodology (INfORM), a Network within the International Association for Dental Research (IADR).

PMID: 37144484
DOI: 10.1111/joor.13488

Abstract

Background: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for use in adults is in use worldwide. Until now, no version of this instrument for use in adolescents has been proposed.

Objective: To present comprehensive and short-form adaptations of the adult version of DC/TMD that are appropriate for use with adolescents in clinical and research settings.

Methods: International experts in TMDs and experts in pain psychology participated in a Delphi process to identify ways of adapting the DC/TMD protocol for physical and psychosocial assessment of adolescents.

Results: The proposed adaptation defines adolescence as ages 10-19 years. Changes in the physical diagnosis (Axis I) include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for adolescents, (ii) adding two general health questionnaires, one for the adolescent patient and one for their caregivers and (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire. Changes in the psychosocial assessment (Axis II) include (i) adapting the language of the Graded Chronic Pain Scale to be developmentally appropriate for adolescents, (ii) adding anxiety and depression assessment that have been validated for adolescents and (iii) adding three constructs (stress, catastrophizing and sleep disorders) to assess psychosocial functioning in adolescents.

Conclusion: The recommended DC/TMD, including Axis I and Axis II for adolescents, is appropriate to use in clinical and research settings. This adapted first version for adolescents includes changes in Axis I and Axis II requiring reliability and validity testing in international settings. Official translations of the comprehensive and short-form to different languages according to INfORM requirements will enable a worldwide dissemination and implementation.

Keywords: adolescents; diagnostic criteria; dysfunction; pain; temporomandibular disorders.

MeSH terms

Adolescent
Adult
Chronic Pain*
Facial Pain / diagnosis
Humans
Language
Pain Measurement / methods
Reproducibility of Results
Temporomandibular Joint Disorders* / diagnosis
Temporomandibular Joint Disorders* / psychology