The Evolution of TMD Diagnosis: Past, Present, Future.
This review explores the principles and process associated with the diagnosis of temporomandibular disorders (TMDs). TMD diagnosis has evolved substantially over the past 25 y. Previously, diagnosis focused solely on aberrations in oral structures, largely without empirical evidence. The Research Diagnostic Criteria for TMD (RDC/TMD) were developed on core principles of 1) a dual-axis system reflecting the biopsychosocial model, 2) a clear operationalization for reliability, and 3) the allowance of multiple diagnoses. These principles were retained in the subsequent validation research of the RDC/TMD, and the current diagnostic system-the Diagnostic Criteria for TMD (DC/TMD)-has improved on those principles as well as on diagnostic validity and protocols for assessing the psychosocial domain. Further investigations into etiology and its potential contribution to taxonomy revision are described, particularly within the context of complex disease. The review concludes with an outline of major research areas already underway that will support future revisions of the DC/TMD.
Department of Oral Diagnostic Sciences, School of Dental Medicine, University at Buffalo, NY, USA ohrbach@buffalo.edu.
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Ohrbach
Schools of Medicine and Dentistry, University of Washington, Seattle, WA, USA.
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Dworkin
D018771:Arthralgia / Q000175:diagnosis; D032921:Consensus; D003937:Diagnosis, Differential; D055094:Evidence-Based Dentistry; D005157:Facial Pain / Q000175:diagnosis; D005544:Forecasting; D006801:Humans; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis*
decision making; diagnostic systems; informatics; pain; psychosocial factors; temporomandibular disorders