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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Abstract

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
Volume52
Issue number3
DOIs
StatePublished - Mar 2019

Bibliographical note

Funding Information:
This study was funded by a research grant from the American Academy of Orofacial Pain, a University of Minnesota Lasby Visiting Fellowship, and Newcastle University internal funds. The authors thank Drs. Barbara Fonseca Alonso and Sarah Shueb for their contributions to this study during data collection. JD was funded by a NIHR Clinician Scientist award (NIHR-CS-011-003). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health in the United Kingdom. We would like to thank the patients who participated in this study and made it possible.

Publisher Copyright:
© 2018 International Endodontic Journal. Published by John Wiley & Sons Ltd

Keywords

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

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