J Orofac Pain
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To analyze the reliability, validity, and clinical utility of the depression, non-specific physical symptoms, and graded chronic pain scales comprising the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis II. ⋯ The major RDC/TMD Axis II measures demonstrate psychometric properties suitable for comprehensive assessment and management of TMD patients.
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The operational definitions for the Craniomandibular Index (CMI) were redesigned to conform precisely to those of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), resulting in a single examination protocol, the Temporomandibular Index (TMI). The objectives were to evaluate interexaminer reliability of the TMI as well as its criteria and construct validity for measurement of TMD severity. ⋯ This study has provided statistical evidence for the clinical reliability and validity of the TMI, which indicates that the RDC examination protocol is appropriate for determining TMD severity by the TMI algorithm, and diagnosis of TMD subtypes by the RDC algorithm.
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Burning mouth syndrome (BMS) primarily affects postmenopausal women and is often difficult to treat successfully. Treatment outcomes have been problematic because of failure to distinguish between patients with BMS and patients presenting with oral burning (OB) resulting from other clinical abnormalities. The purpose of this study was to determine characteristics that might uniquely identify BMS patients from patients with OB and to determine whether proper classification influences treatment outcome. ⋯ These data indicate that while BMS and OB groups may initially present with similar clinical and psychosocial features, they are distinguishable with careful diagnosis that often enables successful management of symptoms for each group.
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This paper addresses questions 2 to 6 posed in the charge to the conference to discuss the study of temporomandibular disorders (TMD) and orofacial pain from the perspective of the predoctoral dental curriculum. This paper lends itself to an additional query: how much diagnostic and therapeutic skill relative to TMD and orofacial pain should a new graduate possess and demonstrate to be deemed competent in accordance with the definition of competence of the American Dental Association's Commission on Dental Accreditation? Although much of the content of this and the accompanying articles from the conference pertain to the TMD and orofacial pain curricula of dental schools in North America, most of what is presented here is universal to the teaching of the subject matter; therefore, it could be applied to educational institutions in other parts of the world. Indeed, an international survey relative to the teaching of TMD and orofacial pain would be of interest and value to dental schools worldwide.
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Randomized Controlled Trial Comparative Study Clinical Trial
Diffusion model of pain language and quality of life in orofacial pain patients.
To address the following questions: (1) Which words are preferred by different groups of orofacial pain patients to describe their pain experience? (2) Is it possible, based on such descriptions, to obtain a clinical differential diagnosis in these patients? (3) Is there any relationship between the verbal description of pain and self-rated quality of life (QOL)? (4) Can a pattern of modulation of pain language by affective variables (diffusion model) be recognized in orofacial pain patients, as it has in other chronic pain patients? and (5) If so, what might be the clinical usefulness of assessing pain language in these patients? ⋯ Although trends in patients' choice of descriptors were evident, differential diagnosis based on only a pain questionnaire was not possible in the different groups of orofacial pain patients examined in this study. The present study suggests the presence of a phenomenon of diffusion in the language of those patients who were experiencing a worsening of their QOL as a result of pain and consequent psychologic distress. This observation can be of clinical usefulness by enhancing the sensitivity of the clinician to the suffering and affective distress experienced by the patient, and it also can be helpful in refining the therapeutic approach for each individual patient.