The clinical examination in diagnostic criteria for temporomandibular disorders (DC/TMD) is a strict procedure and comprises mandatory commands. However, learning and using these mandatory commands in general practice have proven to be difficult and their use of DC/TMD is minimal. To investigate whether reliability on a diagnostic level for DC/TMD diagnoses differs between examiners using the mandatory commands or not. Six examiners were divided into two groups: one using the mandatory commands in DC/TMD for the clinical examination and one who did not use the mandatory commands. A reliability assessment was performed twice, one occasion for each group of examiners. The assessment was performed according to the guidelines from the International Network for Orofacial Pain and Related Disorders Methodology. Each group of examiners thereby examined 16 subjects (11 TMD patients and 5 healthy individuals) each, and the diagnostic agreement (reliability) as compared to diagnoses derived by a reference standard examiner was calculated with Cohen' s kappa coefficient. The DC/TMD diagnoses myalgia, arthralgia and headache attributed to TMD were included in the reliability assessment. There was no significant difference regarding diagnostic agreement reliability between the examiners using or not using the mandatory DC/TMD commands. This study indicates that not using the mandatory commands in DC/TMD in general practice does not impair the diagnostic reliability regarding the diagnoses myalgia, arthralgia and headache attributed to TMD compared to including the commands.

Background A functional integration between the jaw and neck regions during purposive jaw movements is well described in adults, but there is a lack of knowledge of such integration during jaw function in children. Objectives To determine the movement integration between the jaw and neck during jaw motor tasks in 6‐year‐olds, whether there is a difference between children and adults. Methods Jaw and neck movements were recorded with an optoelectronic 3D system in 25 healthy 6‐year‐olds (12 girls, 13 boys) and 24 healthy adults (12 women, 12 men) during paced jaw opening‐closing and self‐paced gum chewing. Jaw and neck movement amplitudes, intra‐individual variation in movement amplitude, ratio between neck‐jaw movement amplitudes and movement cycle time were analysed. Differences between children and adults were evaluated with Mann‐Whitney U test for independent samples. Results Compared to adults, 6‐year‐old children showed larger neck movement amplitudes (P = .008) during chewing, higher intra‐individual variability in amplitudes of jaw (P = .008) and neck (P = .001) movements, higher ratio between neck‐jaw movement amplitudes for jaw opening‐closing (P = .026) and chewing (P = .003), and longer jaw movement cycle time (P ≤ .0001) during the jaw opening‐closing task. Conclusion Despite integrated jaw‐neck movements in 6‐year‐old children, the movement pattern differs from that of adults and may be interpreted as an immature programming of jaw‐neck motor behaviour. The well‐integrated movements observed in adults most likely develop over years, perhaps into adolescence, and needs further research including well‐controlled longitudinal studies to map this development in order to provide appropriate age‐related clinical treatment for functional disorders.

BackgroundThe functional integration of the jaw and neck motor systems, of great importance to everyday oral activities, is established in early childhood. Detailed characterisation of this developmental progress is largely unknown.ObjectiveTo establish developmental changes in jaw–neck motor function in children over the ages 6–13 years compared to adults.MethodsJaw and head movement kinematics during jaw opening–closing and chewing were longitudinally recorded in 20 Swedish children (8 girls) at 6 (6.3 ± 0.4), 10 (10.3 ± 0.3) and 13 (13.5 ± 0.7) years of age and 20 adults (9 women, 28.2 ± 6.7). Movement amplitudes, jaw movement cycle time (CT), coefficient of variation (CV) and head/jaw ratio for amplitudes were analysed. Linear mixed effect analysis and Welch's t‐test were used.ResultsChildren showed pronounced movement variability and longer CT at 6 and 10 years old during opening and chewing (p < .001). Compared to adults, 6‐year‐olds showed higher head/jaw ratios (p < .02) and longer CT (p < .001) during opening and chewing, and higher CV‐head (p < .001) during chewing. Whereas 10‐year‐olds showed larger jaw and head amplitudes (p < .02) and longer CT (p < .001) during opening, and longer CT (p < .001) and higher CV‐head (p < .001) during chewing. For 13‐year‐olds, longer CT (p < .001) during chewing was found.ConclusionChildren showed pronounced movement variability and longer movement cycle time at 6–10 years and developmental progress in jaw–neck integration from 6 to 13 years, with 13‐year‐olds displaying adult‐like movements. These results add new detailed understanding to the typical development of integrated jaw–neck motor function.