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

Ing-Marie Nilsson; EwaCarin Ekberg; 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 Visscher; Kerstin Wahlund; Roberto Rongo; International Network for Orofacial Pain and Related Disorders (INfORM)

doi:10.1111/joor.13390

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

J Oral Rehabil. 2023 Feb;50(2):99-112. doi: 10.1111/joor.13390. Epub 2022 Dec 14.

Authors

Ing-Marie Nilsson^{1

2}, EwaCarin Ekberg¹, 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 Kapos¹³, Christopher D King^{14

15

16}, Osamu Komiyama¹⁷, Michail Koutris¹⁸, Thomas List^{1

5}, Frank Lobbezoo¹⁸, Richard Ohrbach¹⁹, Tonya M Palermo^{13

20}, Christopher C Peck²¹, Chris Penlington⁹, Claudia Restrepo²², Maria Joao Rodrigues²³, Sonia Sharma^{1

19}, Peter Svensson²⁴, Corine Visscher¹⁸, Kerstin Wahlund²⁵, Roberto Rongo³; International Network for Orofacial Pain and Related Disorders (INfORM)

Affiliations

¹ Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.
² Center for Oral Rehabilitation, FTV Östergötland, 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 Dental Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
⁷ Department of Prosthodontics and Periodontology, Bauru School of Dentistry - University of São Paulo, Bauru, Brazil.
⁸ Bauru Orofacial Pain Group, University of São Paulo, Bauru, Brazil.
⁹ Newcastle School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK.
¹⁰ Faculty of Dental Medicine, Laval University, 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 Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA.
¹⁴ Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
¹⁵ Center for Understanding Pediatric Pain (CUPP), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
¹⁶ Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
¹⁷ Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo, Japan.
¹⁸ Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
¹⁹ Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, New York, USA.
²⁰ Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
²¹ Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
²² CES-LPH Research Group, Universidad CES, Medellin, Colombia.
²³ Institute for Occlusion and Orofacial Pain, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
²⁴ Section for Orofacial Pain and Jaw Function, School of Dentistry and Oral Health, Aarhus, Denmark.
²⁵ Department of Orofacial Pain and Jaw Function, Kalmar County Hospital, Kalmar, Sweden.

PMID: 36373958
DOI: 10.1111/joor.13390

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.

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

MeSH terms

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