Comparison Between the Fonseca's Questionnaire and Clinical Evaluation in Temporomandibular Disorders Among Dental Students: A Cross-Sectional Study.

BACKGROUND: Temporomandibular disorders (TMDs) are conditions with heterogeneous clinical presentations. Screening tools like the Fonseca's Anamnestic Index (FAI) are used to self-assess TMD symptoms. Agreement with objective findings remains debated. This study aimed to compare FAI with clinical evaluation. MATERIALS AND METHODS: One hundred and twenty-five dental students completed the FAI. Subsequently, an experienced maxillofacial surgeon performed standardized clinical examinations. TMDs were clinically classified as absent, muscular, articular, or mixed. Agreement between FAI and clinical diagnosis was evaluated using Cohen's kappa. RESULTS: According to FAI, 22.4% of participants reported no TMD, 54.4% mild, 20.0% moderate, and 3.2% severe symptoms. Clinical examination identified TMD signs in 60.0% of students, with muscular dysfunction being the most prevalent. Among subjects classified as absent or mild by FAI, 35.4% showed clinical signs of TMD. Conversely, 6.9% of those with moderate/severe self-reported symptoms showed no objective dysfunction. Overall agreement between subjective and clinical assessments was moderate, with a Cohen's kappa of 0.56 (95% CI: 0.42-0.71, p < 0.001). CONCLUSIONS: FAI is a useful tool for TMDs but shows only moderate concordance with clinical evaluation and may fail to detect objective signs that are not accompanied by reported symptoms. The integration of self-reported measures with professional clinical assessment is essential for accurate diagnosis.