Diagnostic criteria for temporomandibular disorders ( DC / TMD ): interexaminer reliability of the Finnish version of Axis I clinical diagnoses

Summary Recently, updated diagnostic criteria for temporomandibular disorders ( DC / TMD ) were published to assess TMD in a standardised way in clinical and research settings. The DC / TMD protocol has been translated into Finnish using specific cultural equivalency procedures. To assess the interexaminer reliability using the Finnish translations of the DC / TMD ‐ FIN Axis I clinical diagnostic assessment instruments. Reliability assessment data were collected during a 1‐day DC / TMD Examiner Training Course at the University of Turku, Finland, in collaboration with the International DC / TMD Training and Calibration Center in Malmö University. Clinical TMD examinations according to the Finnish pre‐final version of the DC / TMD Axis I assessment protocol were performed by four experienced TMD specialists on altogether 16 models. Kappa coefficient, overall percentage agreement (%A) as well as positive ( PA ) and negative ( NA ) agreements were used to define the reliability. Myofascial pain with referral, headache attributed to TMD and disc displacement ( DD ) without reduction without limited opening showed excellent kappa values (range 0·87–1·00). Fair‐to‐good reliability was observed for diagnoses of myalgia (k = 0·67), arthralgia (k = 0·71) and DD with reduction (k = 0·64). The PA was high for all pain‐related diagnoses and DD without reduction without limited opening (medians ≥83%), and acceptable for DD with reduction (median 67%). The NA was high (medians ≥87%) for all DC / TMD diagnoses, except for myalgia which showed acceptable NA (median 75%). The %A was high for all assessed diagnoses (medians >85%). The findings of this study showed DC / TMD ‐ FIN Axis I to demonstrate sufficiently high reliability for pain‐related TMD diagnoses.