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Axis I diagnostic algorithms were demonstrated to be reliable but below target sensitivity of> 0.70 and specificity of> 0.95. Empirical data supported Axis I algorithm revisions that were valid. Axis II instruments were shown to be both reliable and valid. An international consensus workshop was convened to obtain recommendations and finalization of new Axis I diagnostic algorithms and new Axis II instruments.

Methods: A comprehensive search of published TMD diagnostic literature was followed by review and consensus via a formal structured process by a panel of experts for revision of the RDC/TMD. The panel’s recommendations for revision of the diagnostic algorithms were assessed for validity using available data.

Results: The recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for pain diagnoses and valid criteria (sensitivity> 0.80, specificity> 0.95) for the most common pain-related TMDs and for one intra-articular disorder. Diagnostic criteria for other common intra-articular disorders lacked adequate validity for clinical diagnoses but can be used for screening purposes. The Axis II protocol retains selected RDC/TMD screening instruments augmented with new instruments to better assess the interactions between pain and psychosocial functioning. A comprehensive classification system is also presented.

Conclusion: The recommended evidence-based DC/TMD protocol is appropriate for use in both the clinical and research settings. Simple Axis I and II screening tests augmented by validated Axis I and Axis II instruments allow for identification of simple to complex TMD patients.