Aim: The purpose of this study was to assess whether recalibration of examiners would improve reliability of clinical signs and diagnoses of TMD according to Research Diagnostic Criteria for TMD (RDC/TMD).

Materials and Methods: Forty-eight symptomatic and asymptomatic subjects were examined independently according to the RDC/TMD by two clinicians on two occasions, six months apart: I. Aarhus, Denmark (n=24; 6 male, 18 female, ages 18-59); II, Malmö, Sweden (n=24; 6 male, 18 female, ages 18-86). Clinicians were calibrated in use of the RDC/TMD Axis I examination 1 day prior to each examination.

Results: Intraclass Correlation Coefficients (ICC) used to examine inter-examiner reliability for the two clinicians on each occasion (I, II) yielded the following: Vertical range of jaw motion showed little difference from I-II [ICC= 0.90 (I), 0.88 (II)]. For other examination components, ICC showed consistent improvement from I-II. For example, summary scores for pain on TMJ palpation went from ICC=0.29 (I) to 0.80 (II); for masticatory muscle palpation pains, from ICC= 0.78 (I) to 0.89 (II). Similar improvements were seen in ICC for RDC/TMD clinical diagnoses: Ia. Myofascial pain [ICC= 0.83 (I)to 1.00 (II)], Ib.Myofascial pain with limited mouth opening, [ICC= 0.76 (I) to 1.00 (II)], IIa. Disc displacement with reduction, ICC= 0.26 (I) to 0.64 (II)], and IIIa. Arthralgia, [ICC= 0.16 (I) to 0.73 (II).

Conclusion: Re-calibration considerably improved interexaminer reliability for assessing RDC/TMD clinical variables and diagnoses, especially where initial inter-examiner reliability was low. Final inter-examiner reliabilities were all associated with acceptable to excellent levels. Supported by NIDCR DE-13722.

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