Development of a brief and effective temporomandibular disorder pain screening questionnaire

Abstract

Background Available screening instruments for identifying temporomandibular disorders (TMDs) exhibit methodological or logistic limitations. The authors conducted a study to develop and assess the validity of a self-report instrument in screening patients for pain-related TMDs. Methods By using psychometric methods for item selection, the authors developed short (three-item) and long (six-item) versions of the questionnaire and evaluated them for validity among 504 participants. Results Internal reliability was excellent, with coefficient α values of 0.87 and 0.93 for the short and long versions, respectively. When the authors dichotomized instrument scores at optimal thresholds, both versions had a sensitivity of 99 percent and a specificity of 97 percent for correct classification of the presence or absence of TMD. The specificity was at least 95 percent in the correct identification of people with nonpainful TMJ disorders or headahce without TMD pain. Conclusions With use of appropriate psychometric methodology, the selected items exhibited excellent content validity. The excellent levels of reliability, sensitivity and specificity demonstrate the validity and usefulness of this instrument. Clinical Implications Using this instrument will allow clinicians to identify more readily—and cost-effectively—most patients with painful TMD conditions for whom early and reliable identification would have a significant effect on diagnosis, treatment and prognosis.

A Proposed Diagnostic Classification of Patients With Temporomandibular Disorders: Implications for Physical Therapists

“…22,29 The initiating question is, "Have you had pain or stiffness in the face, jaw, temple, in front of the ear, or in the ear in the past month?" A positive response should be followed with a question about whether the symptoms are altered by any of the following jaw activities: chewing, talking, singing, yawning, kissing, moving the jaw.…”

“…A positive response should be followed with a question about whether the symptoms are altered by any of the following jaw activities: chewing, talking, singing, yawning, kissing, moving the jaw. 22,29,74,75 The other key inquiry is directed toward identifying the presence of a disc displacement 22,74 : "Have you ever had your jaw lock or catch so that it would not open all the way? If so, was this limitation in jaw opening severe enough to interfere with your ability to eat?…”

Pain detection by clinical questionnaire in patients referred for temporomandibular disorders in a Chilean hospital.

“…On the other hand, systematic reviews of the available literature suggest that only 15 articles of TMD populations and 6 in community samples were developed to collect data from clinical diagnoses in patients with the use of the RDC/ TMD 15 , so the use of the latter in large epidemiological studies may not be possible depending on the interview technique, and/or the time available for data collection 10 . Consequently it is necessary to standardize and simplify the design of validated studies on painful TMD.…”

“…A descriptive study, based on the application of a clinical questionnaire to detect painful TMD was performed. The questionnaire was the extended version containing6 questions proposed by Gonzalez et al 2011 10 .…”

“…From this questionnaire a short version that included three questions, and other extended version that included six were proposed. Both versions were compared with the extended protocol RDC/TMD, finding an internal reliability of the extended version (alpha coefficient 0.93) with high sensitivity (99%) and specificity (97%) 10 .…”