Jens Christoph Türp1, Hans Jürgen Schindler2. 1. Abteilung Myoarthropathien/Orofazialer Schmerz, Klinik für Oral Health & Medicine, Universitäres Zentrum für Zahnmedizin Basel, Mattenstrasse 40, 4058, Basel, Schweiz. jens.tuerp@unibas.ch. 2. Poliklinik für Zahnärztliche Prothetik, Universitätsklinikum Würzburg, Würzburg, Deutschland.
Abstract
BACKGROUND: Temporomandibular disorders (TMDs) are typically characterized by pain in the masticatory muscles and temporomandibular joints (TMJs) and by limitation of mandibular mobility. In June 2019, the German Society of Craniomandibular Function and Disorders presented a screening tool to identify individuals with TMDs. The assessment tool consists of patient history (three questions related to jaw pain, one question related to impaired mandibular mobility) and a clinical examination (palpation of masticatory muscles and TMJs; evaluation of maximum jaw opening; assessment of the presence of occlusal disturbances; documentation of TMJ noises). OBJECTIVES: The present article focusses on two questions: (1) Which of the nine parts of the tool are appropriate, and which are not? (2) In general, can screening for TMDs be recommended? CONCLUSION: While the anamnestic questions, as well as the assessment of maximum mandibular opening, reflect the clinically relevant symptoms and signs of TMD patients, the remaining four clinical measures do not. Furthermore, TMD screening for painful TMDs appears unnecessary because patients suffering from orofacial pain and/or restricted mandibular mobility are likely to consult a therapist by themselves. Therefore, the use of this screening tool may lead to overdiagnosis, possibly resulting in nonindicated diagnostic and therapeutic measures.
BACKGROUND:Temporomandibular disorders (TMDs) are typically characterized by pain in the masticatory muscles and temporomandibular joints (TMJs) and by limitation of mandibular mobility. In June 2019, the German Society of Craniomandibular Function and Disorders presented a screening tool to identify individuals with TMDs. The assessment tool consists of patient history (three questions related to jaw pain, one question related to impaired mandibular mobility) and a clinical examination (palpation of masticatory muscles and TMJs; evaluation of maximum jaw opening; assessment of the presence of occlusal disturbances; documentation of TMJ noises). OBJECTIVES: The present article focusses on two questions: (1) Which of the nine parts of the tool are appropriate, and which are not? (2) In general, can screening for TMDs be recommended? CONCLUSION: While the anamnestic questions, as well as the assessment of maximum mandibular opening, reflect the clinically relevant symptoms and signs of TMDpatients, the remaining four clinical measures do not. Furthermore, TMD screening for painful TMDs appears unnecessary because patients suffering from orofacial pain and/or restricted mandibular mobility are likely to consult a therapist by themselves. Therefore, the use of this screening tool may lead to overdiagnosis, possibly resulting in nonindicated diagnostic and therapeutic measures.
Entities:
Keywords:
Clinical decision-making; Facial pain; Mass screening; Surveys and questionnaires; Temporomandibular joint dysfunction syndrome
Authors: Gary D Slade; Eric Bair; Joel D Greenspan; Ronald Dubner; Roger B Fillingim; Luda Diatchenko; William Maixner; Charles Knott; Richard Ohrbach Journal: J Pain Date: 2013-12 Impact factor: 5.820
Authors: Eric Bair; Richard Ohrbach; Roger B Fillingim; Joel D Greenspan; Ronald Dubner; Luda Diatchenko; Erika Helgeson; Charles Knott; William Maixner; Gary D Slade Journal: J Pain Date: 2013-12 Impact factor: 5.820