Reliability and Validity of the DC/TMD Axis I

There are two main purposes for the development of diagnostic criteria: research and clinical management. The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD)1 provided an initial structure to assist in confirming that research studies were being carried out insimilar, standardized diagnostic groups, and although these diagnostic categories were only broadly defined, they did provide some consistency for studying similar diagnostic populations. However, the original RDC/TMD did not provide any assistance in management. The newer Diagnostic Criteria for TMD (DC/TMD)2 attempted to refine research and clinical criteria for the study of TMD; however, because TMD symptoms are common findings in many head and neck complaints, rigid, all-inclusive criteria are difficult to establish. Drs Steenks, Türp, and de Wijer should be commended for their efforts in their Focus Article, since they have more specifically addressed some of the shortcomings of the more recent DC/TMD. This Focus Article has critically evaluated the DC/TMD, commenting on the advantages and disadvantages of these suggested guidelines. Steenks et al state both their support and concerns regarding these new criteria. I comment below on some of their statements.

1.Dworkin SF, LeResche L. Research Diagnostic Criteria for Temporomandibular Disorders: Review, criteria, examina-tions and specifications, critique. J Craniomandib Disord 1992;6:301–355.

2.Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache 2014;28:6–27.

3.Steenks MH, Türp JC, de Wijer A. Reliability and validity of the Diagnostic Criteria for Temporomandibular Disorders Axis I in clinical and research settings: A critical appraisal. J Oral Facial Pain Headache 2018;32:7–18.

4.Simons DG, Travell JG, Simons LS. Myofascial Pain and Dysfunction: The Trigger Point Manual, ed 1. Baltimore: Williams & Wilkins, 1983.

5.Benoliel R, Svensson P, Heir GM, et al. Persistent orofacial muscle pain. Oral Dis 2011;17(suppl):s23–s41.

6.Lipton RB, Dodick D, Sadovsky R, et al. A self-administered screener for migraine in primary care: The ID Migraine valida-tion study. Neurology 2003;61:375–382.