Corporate Banner
Satellite Banner
Molecular & Clinical Diagnostics
Scientific Community
Become a Member | Sign in
Home>News>This Article

First Evidence-Based Diagnostic Criteria Published For TMD

Published: Monday, February 03, 2014
Last Updated: Monday, February 03, 2014
Bookmark and Share
The first evidence-based diagnostic criteria have been developed to help health professionals better diagnose temporomandibular disorders, commonly known as TMJ.

The disorder affect an estimated 10 to 15 percent of Americans.  The diagnostic criteria, developed by researchers in North America, Europe and Australia, are professional recommendations on how best to detect a disease or condition.  

The new criteria, supported in part by the National Institutes of Health, comprise an improved screening tool to help researchers and health professionals including dentists more readily differentiate the most common forms of TMD and reach accurate diagnoses that are grounded in supportive scientific evidence.  Historically, diagnostic criteria for TMD have been based on a consensus of expert opinion and often reflect a shared clinical perspective.  None have been rigorously tested by scientists. 

"We've had diagnostic criteria for years," said Eric Schiffman, D.D.S., a co-lead author on the article, who studies TMD at the University of Minnesota School of Dentistry, Minneapolis.  "What is unique here is instead of a panel of experts empirically deciding best practices, we relied on science as a methodology to test our best assumptions and see if we were actually correct."

Called DC/TMD, the latest criteria are published today in the winter issue of the Journal of Oral and Facial Pain and Headache.  They are available online at the International RDC/TMD Consortium Network website

Although TMD is commonly considered a jaw problem, researchers have determined that most people with chronic temporomandibular problems also contend with other ailments.  In 1992, the Research Diagnostic Criteria for TMD (RDC/TMD) reflected this awareness.  They were the first to integrate biological, psychological, and social factors into two distinct protocols, or axes.  Axis I was designed to evaluate the physical diagnoses, while Axis II characterized the nature of a person's pain, distress, and disability.  The criteria were translated into 18 languages and become the most widely used diagnostic system among TMD researchers.

But the RDC/TMD dual axes represented a first step with biopsychosocial diagnostic criteria.  In the early 2000s, the NIH's National Institute of Dental and Craniofacial Research (NIDCR) assembled a group of experts to lead the first comprehensive assessment of the criteria.  The group found Axis I in particular to be less valid than previously thought, leading to a mandate from the TMD clinical and research communities to create the diagnostic equivalent of RDC/TMD 2.0.

All agreed at the outset that the "R" was no longer needed.  Research criteria, while useful for scientists in the laboratory and clinic, can leave researchers and health care providers using different diagnostic terms, measures, and tools.

"A common language allows clinicians to communicate more easily to researchers about their daily diagnostic challenges," said Richard Ohrbach, D.D.S., Ph.D., a co-lead author on the publication who studies TMD at the University at Buffalo School of Dental Medicine in New York.  "Conversely, a common language allows research findings to be more easily integrated into a clinical setting and improve patient care."

The DC/TMD start with a refined version of Axis I, the physical assessment.   It begins with an easily administered patient questionnaire that is specially designed to detect pain-related TMD.  If TMD is detected, the protocol moves on to newly crafted diagnostic criteria to help practitioners differentiate among the common subtypes.  In field tests, the diagnostic criteria for painful TMD were found to have at least 86 percent sensitivity and 97 percent specificity.  Sensitivity refers to how well a test identifies a person with a given ailment, while specificity characterizes the ability to identify correctly those who are not affected.  

Axis II, the psychosocial assessment, screens patients to assess pain location, pain intensity, pain-related disability, psychological distress, degree of jaw dysfunction, and presence of oral habits (i.e.,e.g. grinding teeth) that may contribute to the dysfunction.  If more information is needed, a more comprehensive follow-up questionnaire is available to tap into additional anxiety measures and the possible presence of other pain-causing physical ailments.  Both instruments have been scientifically validated.  

"By diagnosing the person, beyond only the physical condition, a whole avenue of treatment options opens up," said Schiffman.  "Instead of prescribing mouth guards, exercises, or surgery, practitioners can consider trying bio-behavioral treatments including relaxation techniques and biofeedback to help the patient successfully manage their TMD.  In short, you can better customize the treatment to fit the whole person, not just their disorder."

Further Information
Access to this exclusive content is for Technology Networks Premium members only.

Join Technology Networks Premium for free access to:

  • Exclusive articles
  • Presentations from international conferences
  • Over 2,800+ scientific posters on ePosters
  • More than 4,000+ scientific videos on LabTube
  • 35 community eNewsletters

Sign In

Forgotten your details? Click Here
If you are not a member you can join here

*Please note: By logging into you agree to accept the use of cookies. To find out more about the cookies we use and how to delete them, see our privacy policy.

Related Content

$21M Invested in Research Hubs in Developing Countries
The National Institutes of Health and other U.S. and Canadian partners are investing $20.9 million dollars over five years to establish seven regional research and training centers in low- and middle-income countries (LMICs).
Friday, October 09, 2015
Scientists Create World’s Largest Catalog of Human Genomic Variation
An international team of scientists from the 1000 Genomes Project Consortium has created the world’s largest catalog of genomic differences among humans, providing researchers with powerful clues to help them establish why some people are susceptible to various diseases.
Thursday, October 01, 2015
NIH Framework Points The Way Forward For Developing The President’s Precision Medicine Initiative
The NIH Advisory Committee to the Director has presented to NIH Director Francis S. Collins, M.D., Ph.D., a detailed design framework for building a national research participant group, called a cohort, of 1 million or more Americans to expand our knowledge and practice of precision medicine.
Monday, September 21, 2015
Undiagnosed Diseases Network Launches Online Application Portal
UDN Gateway enables patients to apply to national network of clinical sites.
Thursday, September 17, 2015
Using Genetic Sequencing to Manage Cancer in Children
A team of scientists have investigated the feasibility of incorporating clinical sequencing information into the care of young cancer patients.
Tuesday, September 15, 2015
Hastings Center Awarded NIH Grant
Funding has been awarded for a major project on goals and practices of next-generation prenatal testing.
Monday, September 14, 2015
NIH Grants Seek Best Ways To Combine Genomic Information and EHRs
Researchers seek to better understand genomic basis of disease, provide tailored care to patients.
Friday, September 04, 2015
Tumor DNA in Blood Reveals Lymphoma Progression
Using an advanced genetic test, researchers were able to detect diffuse large B-cell lymphoma (DLBCL) in blood serum before it could be seen on CT scans.
Tuesday, April 14, 2015
NIH Funds Nine Antimicrobial Resistance Diagnostics Projects
Investigators to develop tools to detect hospital-associated pathogens.
Friday, April 10, 2015
NIH Launches Tool to Advance Down Syndrome Research
Web portal will help approved professionals to plan clinical studies.
Wednesday, January 28, 2015
Sophisticated HIV Diagnostics Adapted For Remote Areas
New tool is low-cost, with no electricity needed.
Tuesday, December 02, 2014
NIH Names New Clinical Sites in Undiagnosed Diseases Network
Four-year, $43 million initiative engages broad expertise in study of mystery conditions.
Wednesday, July 02, 2014
Genetic Disorder Causing Strokes, Vascular Inflammation in Children Discovered
NIH researchers have identified gene variants that cause a rare syndrome of sporadic fevers, skin rashes and recurring strokes, beginning early in childhood.
Thursday, February 20, 2014
NIH, Industry and Non-Profits Join Forces to Speed Validation of Disease Targets
Goal is to develop new treatments earlier, beginning with Alzheimer's, type 2 diabetes, and autoimmune disorders.
Tuesday, February 11, 2014
Speeding Validation of Disease Targets
NIH, industry and non-profits join forces to develop new treatments earlier, beginning with Alzheimer’s, type 2 diabetes, and autoimmune disorders.
Tuesday, February 04, 2014
Scientific News
Measuring microRNAs in Blood to Speed Cancer Detection
A simple, ultrasensitive microRNA sensor holds promise for the design of new diagnostic strategies and, potentially, for the prognosis and treatment of pancreatic and other cancers.
Biomedical Imaging at One-Thousandth the Cost
Mathematical modeling enables $100 depth sensor to approximate the measurements of a $100,000 piece of lab equipment.
Improving Outcomes for Lung Cancer and Diabetic Patients
Novel technologies have been developed with support from SBRI Healthcare funding.
New Way of Detecting Cancer
A new RNA test of blood platelets can be used to detect, classify and pinpoint the location of cancer by analysing a sample equivalent to one drop of blood.
Rapid, Portable Ebola Diagnostic
Scientists confirmed the efficiency of the novel Ebola detection method in field trials.
New, Better Test for Prostate Cancer
A study from Karolinska Institutet shows that a new test for prostate cancer is better at detecting aggressive cancer than PSA.
Blood Test Picks Out Prostate Cancer Drug Resistance
Scientists have developed a blood test that can identify key mutations driving resistance to a widely used prostate cancer drug, and identify in advance patients who will not respond to treatment.
Antibody Targets Key Cancer Marker
University of Wisconsin-Madison researchers have created a molecular structure that attaches to a molecule on highly aggressive brain cancer and causes tumors to light up in a scanning machine.
Key Piece of MRSA Vaccine Puzzle
New research funded by the Health Research Board and the Wellcome Trust has pinpointed immune cells that could be targeted by an MRSA vaccine.
Biomarker Finder Adjusts On the Fly
Rice University scientists build better tool to find signs of disease.
Skyscraper Banner

Skyscraper Banner
Go to LabTube
Go to eposters
Access to the latest scientific news
Exclusive articles
Upload and share your posters on ePosters
Latest presentations and webinars
View a library of 1,800+ scientific and medical posters
2,800+ scientific and medical posters
A library of 2,500+ scientific videos on LabTube
4,000+ scientific videos