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Development and preliminary evaluation of a new screening instrument for atypical odontalgia and persistent dentoalveolar pain disorder
Author(s) -
Durham J.,
Stone S. J.,
Robinson L. J.,
Ohrbach R.,
Nixdorf D. R.
Publication year - 2019
Publication title -
international endodontic journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.988
H-Index - 119
eISSN - 1365-2591
pISSN - 0143-2885
DOI - 10.1111/iej.13017
Subject(s) - medicine , dentistry , orofacial pain , physical therapy
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.