People with temporomandibular joint disorder (often called TMJ or TMD), can have a hard time getting a true diagnosis of their condition. Misdiagnosis is common. This can prevent people from getting successful treatment. There are many reasons why it’s hard to get an accurate diagnosis. Part of it is that primary care doctors often don’t know much about the condition. Part of it is that the symptoms can be numerous and varied.
Researchers at the University College of London hoped that a questionnaire used to distinguish musculoskeletal back pain from neuropathic back pain could also help distinguish TMJ, but they found to their dismay that the tool had limited usefulness.
This highlights again that the training, skill, and expertise of your TMJ dentist is of critical importance in getting an accurate diagnosis.
Testing PainDETECT
There are many potential sources of pain in the face and mouth. Distinguishing between neuropathic pain like trigeminal neuralgia and musculoskeletal pain like TMJ could help doctors target treatments for their patients. Since the PainDetect questionnaire, developed in 2006 (sometimes called the PD-Q), had been used successfully to distinguish between these two types of pain for people with lower back pain, they hoped the questionnaire could help with TMJ screening.
To test whether the PD-Q would distinguish different types of facial pain, researchers enrolled 254 patients from their pain clinic in the study. All patients were given the PD-Q, then interviewed by experienced specialist dentists, who developed a clinical diagnosis. The results from the PD-Q were compared against the eventual diagnosis.
Researchers determined that the questionnaire was not very good at distinguishing the two types of pain. They tested the accuracy using a measure called the area under a receiver operating characteristic curve (AUROC), which for this test was 0.63. A score of 0.6 or less is generally considered a worthless test, so you can tell that the PD-Q doesn’t offer much help in distinguishing between these two types of pain.
The test was better at detecting neuropathic pain when it was the only type of pain, but mixed pain couldn’t be distinguished very well.
Better Screening Tools Needed
After seeing how poorly the PD-Q performed in these tests, researchers put out a call for a new screening tool that could help these patients. Currently, people with TMJ can take years to find an accurate diagnosis and in the meantime may waste a lot of time and money on treatments based on poor diagnosis. A more accurate screening tool would help these people get better treatment.
Our own TMJ screening tool is good at telling people when they need to seek professional care, but it can’t distinguish between different types of care.
An Experienced Clinician Can Help
However, since we don’t currently have an easy screening tool that anyone could use, you have to be smart in selecting your TMJ dentist. Choose a dentist with outstanding training, great skill, and extensive experience.
Dr. Kevin Berry has long been known as a leading TMJ dentist in Denver. Since receiving his DDS in 1999. He has continued to study at many of the best schools for TMJ diagnosis and treatment, including LVI, the Las Vegas Institute for Advanced Dental Studies. With 20 years’ experience, Dr. Berry has continued to hone his ability to identify and distinguish different sources of facial pain so that he could successfully treat patients or refer them to someone who could.
If you are having difficulty getting a good diagnosis and treatment for your facial pain in the Denver area, we can help. Please call (303) 691-0267 today for an appointment with Dr. Kevin Berry at the TMJ Therapy & Sleep Center of Colorado.
