Critical Commentary 3: Validity of the Research Diagnostic Criteria for Temporomandibular Disorders Axis I in Clinical and Research Settings

The commentary by Drs Steenks and de Wijer1 is an important appraisal of the potential shortcomings of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD).2 Nothing is perfect and everything can be improved. Clinicians and researchers need to be aware of the pros and cons for any type of diagnostic or classification scheme of orofacial pain conditions and therefore a critical dissection of the merits of the RDC/TMD is much welcomed. The authors raise a number of questions and concerns and discuss them in a timely and fair manner. Nevertheless, I would like specifically to comment on two points.

1. Steenks MH, de Wijer A. Validity of the research diagnostic criteria for temporomandibular disorders axis I in clinical and research settings. J Orofac Pain 2009;23:9–16.

2. Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: Review, criteria, examinations and specifications, critique. J Craniomandib Disord Facial Oral Pain 1992;6:301–355.

3. John MT, Dworkin SF, Mancl LA. Reliability of clinical temporomandibular disorder diagnoses. Pain 2005; 118:61–69.

4. Lobbezoo F, van Selms MK, John MT, et al. Use of the research diagnostic criteria for temporomandibular disorders for multinational research: Translation efforts and reliability assessments in the Netherlands. J Orofac Pain 2005;19:301–308.

5. Schmitter M, Kress B, Leckel M, Henschel V, Ohlmann B, Rammelsberg P. Validity of temporomandibular disorder examination procedures for assessment of temporomandibular joint status. Am J Orthod Dentofacial Orthop 2008;133:796–803.

6. Wiese M, Svensson P, Bakke M, et al. Association between temporomandibular joint symptoms, signs, and clinical diagnosis using the RDC/TMD and radiographic findings in temporomandibular joint tomograms. J Orofac Pain 2008;22:239–251.

7. Ohrbach R, Svensson P (Orgs). Validation Studies of the RDC/TMD: Progress toward Version 2. Symposium, International Association for Dental Research, Toronto, 2008.

8. Turk DC, Dworkin RH, Burke LB, et al. Developing patient-reported outcome measures for pain clinical trials: IMMPACT recommendations. Pain 2006;125:208–215.

9. Goulet J-P, Palla S. The path to diagnosis. In: Sessle BJ, Lavigne GJ, Lund JP, Dubner R (eds). Orofacial Pain: From Basic Science to Clinical Management, ed 2. Chicago: Quintessence, 2008:135–143.