Development and preliminary evaluation of a new screening instrument for atypical odontalgia and persistent dentoalveolar pain disorder

J. Durham, S. J. Stone, L. J. Robinson, R. Ohrbach, D. R. Nixdorf

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Aim: To develop and preliminarily evaluate a new screening instrument for atypical odontalgia (AO) or persistent dentoalveolar pain disorder (PDAP). To evaluate the instrument's performance in detecting AO/PDAP amongst a heterogeneous group of orofacial pain conditions and pain-free controls and empirically compare its performance with an established neuropathic screening instrument (S-LANSS), which is the best available standard. Methods: The study design was cross-sectional; subjects recruited included a convenience sample of pain-free controls (n = 21) and four groups of orofacial pain conditions: AO/PDAP (n = 22); trigeminal neuralgia (n = 21); temporomandibular disorder (n = 41); and acute dental pain (n = 41). The instrument's internal reliability and factor structure were examined alongside its sensitivity and specificity and ROC-determined threshold score. Results: The 9 AO/PDAP-specific items were found to moderately correlate with the S-LANSS (r = 0.58; P < 0.01). The 14-items of the full instrument were examined using exploratory factor analysis and reduced to ten items in a two-factor structure that explained 96% of the variance. This 10-item final instrument had a ROC area of 0.77 (95% CI: 0.67; 0.88), sensitivity of 77% (95% CI: 55; 92%), and specificity of 69% (95% CI: 60; 77%) with an intentionally higher false-positive rate than false-negative rate. In contrast, the S-LANSS exhibited sensitivity of 32% (95% CI: 14;55%) and specificity of 78% (95% CI: 70;85%) with less optimal false-positive versus false-negative rates. Conclusion: This preliminary study confirms the new screening instrument for AO/PDAP merits progression to field testing.

Original languageEnglish (US)
Pages (from-to)279-287
Number of pages9
JournalInternational Endodontic Journal
Issue number3
StatePublished - Mar 2019


  • atypical odontalgia
  • facial pain
  • orofacial pain
  • painful peripheral traumatic trigeminal neuropathy
  • persistent dentoalveolar pain
  • screening instrument

PubMed: MeSH publication types

  • Comparative Study
  • Journal Article

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