Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): Polish assessment instruments

Temporomandibular disorders (TMDs) constitute a heterogeneous group of conditions characterized by the presence of signs and symptoms associated with the masticatory system, such as pain in the masticatory muscles and/or the temporomandibular joints (TMJs), limited jaw movements, and TMJ sounds (i.e., clicking and/or crepitus) during function.¹ Temporomandibular disorders pose a significant public health problem, affecting approx. 5–12% of the population, based on the United States estimates,² and likely have the same prevalence in Poland. Our understanding of the etiology, diagnosis and treatment of TMDs continues to improve. An essential part of the methodology facilitating this development is the use of standardized classification systems for ascertaining the case status, and for further investigating the disorders in terms of mechanisms and taxonomic improvement. The first evidence-based diagnostic method for TMDs emerged in 1992 as the Research Diagnostic Criteria for TMDs (RDC/TMD).³ The RDC/TMD came from the openly acknowledged need for a diagnostic system that could not only reliably distinguish cases from controls for epidemiologic and clinical research purposes, but also differentially define and diagnose the common sub-types, such as pain-related TMDs and mechanical disturbances within TMJs. The RDC/TMD consisted of 2 axes: Axis I for a physical diagnosis; and Axis II for assessing the behavioral and functional status of the patient. The RDC/TMD utilize epidemiologic data to determine at a population level the threshold distinguishing a disorder from ordinary symptoms, such as a transient pain process or TMJ clicking that exhibits no symptoms or functional consequences. In the subsequent 2 decades, the RDC/TMD evoked a significant response to these foundational principles from the international scientific community – the research built on testable evidence in the context of an iterative process, providing a basis for reliable and valid revisions that were to come next.⁴.