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OR05 - TMD and Endodontic Odontalgia: Screening and Comorbidity Assessment (TOSCA)

Thursday, April 28, 2022

3:35 PM – 3:45 PM PST

Location: 225

Presenter(s)

Iryna H. Daline, D.M.D., M.S.

Endodontics Resident
University of North Carolina
University of North Carolina
Chapel Hill, North Carolina

Disclosure: AAE Foundation (Grant/Research Support)American Academy of Orofacial Pain (Grant/Research Support)Dental Foundation of North Carolina (Grant/Research Support, Dr. Shizuko Yamauchi Endodontics Graduate Student Award)IADR INfORM (Grant/Research Support)

Co-Author(s)

IT

Inna E. Tchivileva, M.S.

Assistant professor
University of North Carolina
Chapel Hill, North Carolina

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
GS

Gary Slade, B.D.S., Ph.D.

Professor
University of North Carolina
Chapel Hill, North Carolina

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Ashraf F. Fouad, D.D.S., M.S.

Professor and Chair of Endodontics
University of Alabama of Dentistry at UAB
Birmingham, Alabama

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Don Nixdorf, D.D.S., M.S.

Professor
University of Minnesota
Minneapolis, Minnesota

Disclosure: MinnScan LLC (Individual(s) Involved: Self): Patent holder, Patent holder, Stockholder/Ownership Interest (excluding diversified mutual funds), Stockholder/Ownership Interest (excluding diversified mutual funds); NIH (Individual(s) Involved: Self): Grant/Research Support; University od Minnesota (Individual(s) Involved: Self): Other Financial or Material Support, Salary

Abstract: While temporomandibular myalgia and arthralgia (TMD) are known to mimic endodontic pain, it is not feasible to apply the full Diagnostic Criteria for TMD (DC/TMD) in routine endodontic practice. This prospective study aimed to determine prevalence of painful TMD and assess the accuracy of a 6-item TMD screening questionnaire (Gonzalez et al, JADA 2011;142(10):1183–91) in patients with endodontic pain. Ninety consecutive patients referred for non-surgical root canal treatment with a history of tooth pain in the preceding 30 days were enrolled at the University of North Carolina. Before treatment, patients completed the TMD screening questionnaire, after which a board-certified orofacial pain specialist/endodontic resident conducted both DC/TMD and endodontic examinations. Contingency tables were analyzed to compute screening sensitivity and specificity against the DC/TMD gold standard and logistic regression was used to calculate area under the receiver operator characteristic curve (AUROC). The 90 patients were aged 18-74 years, 60% were female, 16% were Hispanic, and 54% were non-White. Pulp necrosis (36%) and symptomatic apical periodontitis (62%) were the most common endodontic diagnoses. 57% of patients had examiner-verified painful TMD. The screening questionnaire's AUROC was 0.78 (95%CL=0.69, 0.87) while at the screening-positivity threshold of ≥3, sensitivity was 0.84 (95%CL=0.74, 0.94) and specificity was 0.54 (95%CL=0.38, 0.69). A majority of patients presenting for endodontic treatment of a painful tooth had painful TMD. The TMD screening questionnaire was highly sensitive with useful overall accuracy in detecting painful TMD.