The Network Psychometric Properties of the Temporomandibular Joint Disorder Questionnaire Among Australian Adults

BACKGROUND: Australian adults have at least one symptom of temporomandibular joint disorder (TMD), and those who experience TMD report lower oral health-related quality of life. While a self-administered TMD questionnaire can be a valuable screening instrument for initial identification of disease/conditions, to the best of our knowledge, there are no comprehensively validated TMD questionnaires for the Australian population. OBJECTIVE: To evaluate the psychometric properties of the TMD questionnaire using data imputation and novel network models. METHODS: This is a secondary analysis of data from the National Study of Adult Oral Health 2017-18. The sample included 2423 participants who responded to the 12-item TMD questionnaire. Descriptive statistics included demographic characteristics and the TMD distribution of adult Australians. The analytical steps include: (1) model estimation, (2) Unique Variable Analysis, (3) Exploratory Graph Analysis (EGA), (4) model fit, (5) criterion validity and (6) reliability. RESULTS: (12): 1045.91, CFI: 0.970, RMSEA: 0.077, 90% CI: 0.073-0.081, SRMR: 0.027). The reliability was good (α = 0.8; Ω = 0.8). Finding also supported known-groups validity by sex (Risk Ratios ranging from 1.44 to 4.43) and criterion validity according to quality of life (r = -0.26) and age (r = -0.21). CONCLUSIONS: This study provided evidence on the validity and reliability of the 9-item temporomandibular joint questionnaire for evaluating temporomandibular joint disorder among Australian Adults. The TMD questionnaire is readily available, which can be a practical measure of self-reported TMD symptoms for a population-based initial assessment or epidemiological research.