Determining The Sensitivity and Specificity of two Questionnaires when comparing Odontogenic Pain with Temporomandibular Disorders-related Pain

Abstract

Objectives: Two common types of orofacial pains that are clinically important to distinguish are odontogenic pain and temporomandibular disorders (TMD) pain. The aim of this study was to determine the sensitivity and specificity of two screening instruments in distinguishing patients with odontogenic pain from patients with TMD pain. Methods: A convenience sample of patients seeking care at an Endodontist’s office and at an Orofacial Pain Clinic was recruited. The 14-item Dental Pain Questionnaire (DePaQ) (Pau et al., 2005) was used to screen for odontogenic pain and the 6-item TMD-screener (Gonzalez et al., 2011) was used to screen for TMD pain. Sensitivity and specificity calculations, with 95% confidence intervals, were performed for both instruments. Results: Thirty-four patients with odontogenic pain and 37 patients with TMD pain were enrolled. Both groups had comparable age distribution (49±12 vs. 45±18 years) and gender composition (53% vs. 86% females). Results of the sensitivity and specificity are provided in the table below with determination of diagnostic accuracy of these measures evaluated using published guidelines. Odontogenic Pain versus TMD Pain (95% confidence interval) DePaQ Sensitivity 85% (69% to 95%) Specificity 11% (3% to 25%) TMD-screener Sensitivity 92% (78% to 98%) Specificity 59% (41% to 75%) Conclusion: The point estimates for both the DePaQ and TMD screener were “acceptable” in identifying patients who had the pain condition in question (i.e., sensitivity), although the point estimate for appropriately identifying patients who did not have the pain condition when they did not have it (i.e., specificity) was “non-acceptable” neither for the DePaQ nor for the TMD screener. The potential for high amounts of false positive responses with the DePaQ limits its use as a screening instrument when patients are suspected as having TMD pain.