Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) - presentation of Axis II, and the concept of screening

The main breakthrough characteristic of the new Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), besides the standardized examination, is its dual diagnostic axis protocol. The purpose of this article is to present Axis II of the new DC/TMD in Germany, and to emphasize the importance of screening in cases of TMD. Axis II of the established Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD) has not yet found wide acceptance among dentists and orofacial pain specialists in Germany, presumably because of its complexity. The most recent DC/TMD has a totally new approach to Axis II, which could make its use more feasible, even in general practice. It consists of a core of short and easyto- apply screening questions that should be used initially. It also provides several instruments covering a variety of clinical symptoms. The main parts of the DC/TMD Axis II core are: 1. A short anamnestic questionnaire consisting of 14 questions, some of which are integrated into the diagnostic algorithm, in combination with the clinical findings from Axis I, from which a three-question screening for temporomandibular disorder (TMD) pain was developed. 2. Graded chronic pain status (GCPS, version 2.0), consisting of eight questions. 3. Screening for depression and anxiety by use of four questions. 4. A drawing showing the location of pain (face, mouth, and body). 5. The short form of the jaw functional limitation scale (JFLS-8). 6. An oral behavior checklist, comprising 21 questions, for global assessment of parafunctions. As the last two instruments are not yet established, screening for TMD can be adequately achieved by use of a few questions and a pain drawing. If a little time is taken to complete all these instruments and assess the results, the process is compatible with regular routine in dental practice. The regular use of these screening instruments can enable dentists to achieve a better diagnosis of TMD, resulting in timely intervention. Keywords: Diagnostic Criteria for Temporomandibular Disorders, screening, temporomandibular dysfunction, myoarthropathy