Diagnostic Criteria for Temporomandibular Disorders for children aged 8–12 years

Diagnostic accuracy of the Diagnostic Criteria for Temporomandibular Disorders for children aged 8–12 years:

Abstract

Background and Objective

Objective of this study was to determine whether the diagnostic accuracy of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) is sufficient for use among school children aged 8–12 years.

Methods

This prospective cohort study on diagnostic accuracy with calibrated examiners was conducted among 533 children of both sexes aged 8–12 years, with and without TMD symptoms, selected randomly from the Rhein‐Neckar district. Self‐reporting of non‐dental facial pain was used as the reference standard, against which we calculated the following for the pain‐related items of the DC/TMD (index test): sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, accuracy, and 95% Wilson Score confidence intervals. We also calculated the area under the receiver‐operating characteristic (AUROC) curve displaying sensitivity and specificity.

Results

Our final sample consisted of 282 children, half of whom reported having facial pain and 3.2% reported sounds from the temporomandibular joints (TMJs).
Despite high specificity (90.78%; 95% confidence interval(CI): [84.86%; 94.53%]), sensitivity of the adapted DC/TMD for pain on maximum jaw opening was poor (37.59%; 95%CI: [30.02%; 45.81%]). For pain on palpation, more similar values were recorded for sensitivity (74.47%; 95%CI: [66.69%; 80.95%]) and specificity (70.21%; 95%CI: [62.21%; 77.14%]). The diagnostic odds ratio was > 1 for both examinations. The AUROC for pain on opening was 68.39% (95%CI: [62.62%; 74.16%]) and for pain on palpation it was 74.63% (95%CI: [69.45%; 79.81%]), whereas the combination of both resulted to an AUROC of 74.09% (95% CI: [68.96%; 79.21%]). It was not possible to measure the diagnostic accuracy of the DC/TMD regarding TMJ sounds or jaw opening limitations, as they occurred too rarely in our sample.

Conclusion

In this study, the diagnostic accuracy of the DC/TMD for TMD‐related pain in children was lower than that recorded for adults in previous studies.