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Diagnostic criteria for temporomandibular disorders (DC/TMD) in children and adolescents: an international Delphi study-Part 2-Development of Axis II
School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy.
Malmö University, Faculty of Odontology (OD).ORCID iD: 0000-0001-5635-1887
Malmö University, Faculty of Odontology (OD).ORCID iD: 0000-0002-0550-8925
Scandinavian Center for Orofacial Neurosciences, Sweden.
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2022 (English)In: Journal of Oral Rehabilitation, E-ISSN 1365-2842, Vol. 49, no 5, p. 541-552Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Unlike the psychosocial assessment established for adults in the diagnostic criteria for temporomandibular disorders (DC/TMD), a standardized psychosocial assessment for children and adolescents with TMD complaints has not yet been established.

OBJECTIVES: To develop a new standardized instrument set to assess the psychosocial functioning in children and adolescents by adapting the psychosocial status and pain-related disability (Axis II) of the adult DC/TMD and by including new instruments.

METHODS: A modified Delphi method was used to survey 23 international TMD experts and four international experts in pain-related psychological factors for consensus regarding assessment tools for psychosocial functioning and pain-related disability in children and adolescents. The TMD experts reviewed 29 Axis II statements at round 1, 13 at round 2, and 2 at round 3. Agreement was set at 80% for first-round consensus level and 70% for each of the second and third rounds. The psychological experts completed a complementary Delphi survey to reach a consensus on tools to use to assess more complex psychological domains in children and adolescents. For the psychological experts, the first round included 10 open-ended questions on preferred screening tools for depression, anxiety, catastrophizing, sleep problems, and stress in children (ages 6-9 years old) and adolescents (ages 10-19 years old) as well as on other domains suggested for investigation. In the second round, the psychological experts received a 9-item questionnaire to prioritize the suggested instruments from most to least recommended.

RESULTS: The TMD experts, after three Delphi rounds, reached consensus on the changes of DC/TMD to create a form to evaluate Axis II in children and adolescents with TMD complaints. The psychological experts added tools to assess depression and anxiety, sleep disorders, catastrophizing, stress, and resilience.

CONCLUSION: Through international expert consensus, this study adapted Axis II of the adult DC/TMD to assess psychosocial functioning and pain-related disability in children and adolescents. The adapted Axis II protocols will be validated in the target populations.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2022. Vol. 49, no 5, p. 541-552
National Category
Dentistry
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URN: urn:nbn:se:mau:diva-49274DOI: 10.1111/joor.13301ISI: 000759532100001PubMedID: 34951729Scopus ID: 2-s2.0-85125070022OAI: oai:DiVA.org:mau-49274DiVA, id: diva2:1626175
Available from: 2022-01-10 Created: 2022-01-10 Last updated: 2024-01-17Bibliographically approved

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Ekberg, EwaCarinNilsson, Ing-MarieAlstergren, PerList, ThomasSharma, SoniaSvensson, Peter

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