TMD Care - Free Online TMD test
TMD CARE is a diagnostic tool based on DC-TMD international research. It is an open source set to have discrimination on TMD symptoms for clinicians and patients. It could inform you about the prevalence of Axis I, miofacial and tmj symptoms, despite of Axis II psicological stress related symptoms. If you prefer to remain anonymus please sign it by your initials.
Remember that TMD test could NOT inform you about the Axis I clinical examination necessary for the complete TMD diagnosis, it could not replace clinical visit. You are invited to send the results to your confidence dental doctor. Repeat montly the test to monitor the clinical effect of your therapy.
Fill out your personal information to start the test.
TMD - TMJ
TMD has been described as a group of musculoskeletal and neuromuscular conditions that involve the TMJs, the masticatory muscles, and all associated tissues.TMDs are functional disorders of the anatomic regions of the TMJ and associated musculature including arthritidies and myogenous pains and headaches. When assessing the prevalence of TMD in a headache population, it was described that 56% of headache patients had TMD. This percentage increased if the study population had both migraine and tension-type headache.
To establish uniform assessment criteria, in 1992 Dworkin and LeResche introduced the Research Diagnostic Criteria for Temporomandibular Disorders (now DC/TMD). This system has 2 assessment components. Axis I, a clinical and radiographic assessment, is designed to differentiate myofascial pain, disk displacement, and arthralgia, arthritis, and arthrosis. Axis II evaluates psychologic status and pain-related disability.
The RDC ⁄TMD Axis I protocol is a standardized series of diagnostic tests based on clinical signs and symptoms. Diagnostic algorithms using different combinations of clinical and questionnaire measures are used to differentiate eight RDC ⁄TMD-deﬁned Axis I diagnoses for TMD. These diagnoses include myofascial pain (Ia), myofascial pain with limited opening (Ib), disc displacement with reduction (IIa), disc displacement without reduction with limited opening (IIb), disc displacement without reduction without limited opening (IIc), arthralgia (IIIa), osteoarthritis (IIIb), and osteoarthrosis (IIIc).
The Research Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and especially its Axis II diagnostic system were developed to be used as a screener for identifying individuals with psychosocial factors that would impact disease progression and treatment response. The Graded Chronic Pain Scale from the RDC/ TMD Axis II is a brief ordinal measure of global pain severity. It divides pain patients into four grades according to the intensity and disability caused by the pain. Correlation of the pain grade with psychosocial factors has been demonstrated; in higher grades patients have more psychosocial distress compared with patients with less disability. Graded Chronic Pain Scale has also been used to delineate unfavourable outcome and used in studies on prognostic factors in diverse pain conditions including orofacial pain. The ability to predict this through the identification of prognostic risk factors could guide the clinician in selection of treatments to target those particular factors. The depression measure has good to excellent clinical utility as a screener for psychiatric morbidity, while nonspeciﬁc physical symptoms is not useful as a screener with regard to psychiatric morbidity
The DC-TMD Axis II is comprised of measures that assess the following constructs: 1) Depression: assesses core symptoms known to affect pain modulation and coping as well as indicating potential morbidity and suicidal ideation, and measured with a depression scale adapted from the Symptom Checklist; 2) Non-speciﬁc physical symptoms: assesses symptoms currently considered to represent functional somatic syndromes, other pain conditions, or comorbid conditions, and measured with the somatization scale; 3) Pain-related disability: provides a hierarchical painrelated disability classiﬁcation based on extent of life interference because of pain, and measured with the Graded Chronic Pain Scale); Characteristic pain intensity: average of current pain; and 4) Limitation of the jaw: assesses a wide range of potential jaw functions affected by pain.
TMD CARE prediction model identified a combination of
five factors, which were associated with the outcome. The test will be positive if the patient is over 15% of the total score and you will be able to assess the degree of severity of TMD symptoms in their entirety. You can not pass the test by generating a positive score in only one section of symptoms but you need to be positive in at least two sections examined.
The patient can control each section to identify the nature of the symptoms so you will be able to choose your best treatment for TMD. Dental treatment will probably be useful if your score is positive in the Groups of Axis 1 sections, and weakly positive in Axis 2 sections, while if the symptoms reported are mainly grouped in Axis 2 sections is preferable to avoid dental treatment and prefer conservative and psychological therapies.
TMD CARE test may have direct clinical utility for
primary care clinicians in the early identification of
patients with potentially unfavourable prognosis.
According to the current view, most TMD patients
can be successfully treated in primary care by simple,
condition-specific treatments, but referral of patients
with increased risk of pain persistence to comprehensive
assessment and multidisciplinary treatment is