Diagnostic criteria for temporomandibular disorders in children and adolescents: An international Delphi study-Part 2-Development of Axis II

Roberto Rongo; Ewa Carin Ekberg; Ing Marie Nilsson; Amal Al-Khotani; Per Alstergren; Paulo Cesar Rodrigues Conti; Justin Durham; Jean Paul Goulet; Christian Hirsch; Stanimira I. Kalaykova; Flavia P. Kapos; Christopher D. King; Osamu Komiyama; Michail Koutris; Thomas List; Frank Lobbezoo; Richard Ohrbach; Tonya M. Palermo; Christopher C. Peck; Chris Penlington; Claudia Restrepo; Maria Joao Rodrigues; Sonia Sharma; Peter Svensson; Corine M. Visscher; Kerstin Wahlund; Ambrosina Michelotti

doi:10.1111/joor.13301

Diagnostic criteria for temporomandibular disorders in children and adolescents: An international Delphi study-Part 2-Development of Axis II

Roberto Rongo^*, Ewa Carin Ekberg, Ing Marie Nilsson, Amal Al-Khotani, Per Alstergren, Paulo Cesar Rodrigues Conti, Justin Durham, Jean Paul Goulet, Christian Hirsch, Stanimira I. Kalaykova, Flavia P. Kapos, Christopher D. King, Osamu Komiyama, Michail Koutris, Thomas List, Frank Lobbezoo, Richard Ohrbach, Tonya M. Palermo, Christopher C. Peck, Chris PenlingtonClaudia Restrepo, Maria Joao Rodrigues, Sonia Sharma, Peter Svensson, Corine M. Visscher, Kerstin Wahlund, Ambrosina Michelotti

^*Corresponding author for this work

Orofacial Pain and Dysfunction

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Background: Unlike the psychosocial assessment established for adults in the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), a standardised psychosocial assessment for children and adolescents with TMD complaints has not yet been established. Objectives: To develop a new standardised 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, catastrophising, 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 prioritise 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, catastrophising, 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.

Original language	English
Pages (from-to)	541-552
Number of pages	12
Journal	Journal of Oral Rehabilitation
Volume	49
Issue number	5
Early online date	24 Dec 2021
DOIs	https://doi.org/10.1111/joor.13301
Publication status	Published - May 2022

Bibliographical note

Funding Information:
Our Delphi study was supported by the International Network for Orofacial pain and Related disorders Methodology (INfORM) Group of the International Association for Dental Research (IADR). We thank Dr. Caroline Bryant for the suggestions given to this study.

Publisher Copyright:
© 2021 John Wiley & Sons Ltd.

Funding

Our Delphi study was supported by the International Network for Orofacial pain and Related disorders Methodology (INfORM) Group of the International Association for Dental Research (IADR). We thank Dr. Caroline Bryant for the suggestions given to this study.

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Rongo, R., Ekberg, E. C., Nilsson, I. M., Al-Khotani, A., Alstergren, P., Rodrigues Conti, P. C., Durham, J., Goulet, J. P., Hirsch, C., Kalaykova, S. I., Kapos, F. P., King, C. D., Komiyama, O., Koutris, M., List, T., Lobbezoo, F., Ohrbach, R., Palermo, T. M., Peck, C. C., ... Michelotti, A. (2022). Diagnostic criteria for temporomandibular disorders in children and adolescents: An international Delphi study-Part 2-Development of Axis II. Journal of Oral Rehabilitation, 49(5), 541-552. https://doi.org/10.1111/joor.13301

@article{063f1da4b27d434680dbce4b81ae1449,

title = "Diagnostic criteria for temporomandibular disorders in children and adolescents: An international Delphi study-Part 2-Development of Axis II",

abstract = "Background: Unlike the psychosocial assessment established for adults in the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), a standardised psychosocial assessment for children and adolescents with TMD complaints has not yet been established. Objectives: To develop a new standardised 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, catastrophising, 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 prioritise 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, catastrophising, 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.",

author = "Roberto Rongo and Ekberg, {Ewa Carin} and Nilsson, {Ing Marie} and Amal Al-Khotani and Per Alstergren and {Rodrigues Conti}, {Paulo Cesar} and Justin Durham and Goulet, {Jean Paul} and Christian Hirsch and Kalaykova, {Stanimira I.} and Kapos, {Flavia P.} and King, {Christopher D.} and Osamu Komiyama and Michail Koutris and Thomas List and Frank Lobbezoo and Richard Ohrbach and Palermo, {Tonya M.} and Peck, {Christopher C.} and Chris Penlington and Claudia Restrepo and Rodrigues, {Maria Joao} and Sonia Sharma and Peter Svensson and Visscher, {Corine M.} and Kerstin Wahlund and Ambrosina Michelotti",

note = "Funding Information: Our Delphi study was supported by the International Network for Orofacial pain and Related disorders Methodology (INfORM) Group of the International Association for Dental Research (IADR). We thank Dr. Caroline Bryant for the suggestions given to this study. Publisher Copyright: {\textcopyright} 2021 John Wiley & Sons Ltd.",

year = "2022",

month = may,

doi = "10.1111/joor.13301",

language = "English",

volume = "49",

pages = "541--552",

journal = "Journal of Oral Rehabilitation",

issn = "0305-182X",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "5",

}

Rongo, R, Ekberg, EC, Nilsson, IM, Al-Khotani, A, Alstergren, P, Rodrigues Conti, PC, Durham, J, Goulet, JP, Hirsch, C, Kalaykova, SI, Kapos, FP, King, CD, Komiyama, O, Koutris, M, List, T, Lobbezoo, F, Ohrbach, R, Palermo, TM, Peck, CC, Penlington, C, Restrepo, C, Rodrigues, MJ, Sharma, S, Svensson, P, Visscher, CM, Wahlund, K & Michelotti, A 2022, 'Diagnostic criteria for temporomandibular disorders in children and adolescents: An international Delphi study-Part 2-Development of Axis II', Journal of Oral Rehabilitation, vol. 49, no. 5, pp. 541-552. https://doi.org/10.1111/joor.13301

TY - JOUR

T1 - Diagnostic criteria for temporomandibular disorders in children and adolescents

T2 - An international Delphi study-Part 2-Development of Axis II

AU - Rongo, Roberto

AU - Ekberg, Ewa Carin

AU - Nilsson, Ing Marie

AU - Al-Khotani, Amal

AU - Alstergren, Per

AU - Rodrigues Conti, Paulo Cesar

AU - Durham, Justin

AU - Goulet, Jean Paul

AU - Hirsch, Christian

AU - Kalaykova, Stanimira I.

AU - Kapos, Flavia P.

AU - King, Christopher D.

AU - Komiyama, Osamu

AU - Koutris, Michail

AU - List, Thomas

AU - Lobbezoo, Frank

AU - Ohrbach, Richard

AU - Palermo, Tonya M.

AU - Peck, Christopher C.

AU - Penlington, Chris

AU - Restrepo, Claudia

AU - Rodrigues, Maria Joao

AU - Sharma, Sonia

AU - Svensson, Peter

AU - Visscher, Corine M.

AU - Wahlund, Kerstin

AU - Michelotti, Ambrosina

N1 - Funding Information: Our Delphi study was supported by the International Network for Orofacial pain and Related disorders Methodology (INfORM) Group of the International Association for Dental Research (IADR). We thank Dr. Caroline Bryant for the suggestions given to this study. Publisher Copyright: © 2021 John Wiley & Sons Ltd.

PY - 2022/5

Y1 - 2022/5

N2 - Background: Unlike the psychosocial assessment established for adults in the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), a standardised psychosocial assessment for children and adolescents with TMD complaints has not yet been established. Objectives: To develop a new standardised 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, catastrophising, 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 prioritise 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, catastrophising, 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.

AB - Background: Unlike the psychosocial assessment established for adults in the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), a standardised psychosocial assessment for children and adolescents with TMD complaints has not yet been established. Objectives: To develop a new standardised 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, catastrophising, 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 prioritise 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, catastrophising, 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.

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Diagnostic criteria for temporomandibular disorders in children and adolescents: An international Delphi study-Part 2-Development of Axis II

Abstract

Bibliographical note

Funding

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