TMD Is Hard to Distinguish from Other Facial Pain

One of the greatest challenges facing people with temporomandibular joint disorders (TMD or sometimes TMJ) is just getting an accurate diagnosis. Many people spend years dealing with their primary care doctors and various specialists trying to get relief, but are unable to get relief because they can’t get a positive diagnosis.

Researchers at the University College of London hoped to utilize a questionnaire originally developed for lower back pain to try to distinguish TMD from neuropathic orofacial pain. However, their study showed the questionnaire wasn’t very effective. This reminds us that experienced and insightful TMD dentists remain your best option for getting an accurate diagnosis.

Young experiencing musculoskeletal & orofacial pain due to TMJ/TMD

Applying PainDETECT

Researchers recognize that in order to better serve people with orofacial pain (pain in the mouth and face), we need to be able to determine the source of their pain. TMD is an umbrella term that can refer to many different types of pain, but in order to treat them successfully, we have to know which one we’re dealing with. Pain that comes from a musculoskeletal source, like TMD, should be treated very differently than pain from a neuropathic source, like trigeminal neuralgia.

A similar challenge faced doctors treating lower back pain. Pinched nerve problems like sciatica had to be treated very differently from back strain. To distinguish the two types of pain, they developed the painDETECT questionnaire in 2006. Since then, it has been judged to be a useful screening tool to separate patients experiencing these two different types of pain.

To test its effectiveness for orofacial pain, researchers enrolled 254 patients referred to their clinic for treatment of orofacial pain. These patients were all given the painDETECT questionnaire, and the results were analyzed against patients’ eventual diagnoses.

Researchers found that the questionnaire had a poor ability to distinguish neuropathic pain from musculoskeletal orofacial pain. It worked reasonably well to identify people with straight neuropathic pain, but it wasn’t good at identifying musculoskeletal pain, and it was practically worthless in cases where the pain was of mixed origin.

We Need a New Screening Tool

Researchers concluded that the painDETECT questionnaire was not a useful tool for clinical settings. Instead, they recommended that professionals should strive to adapt the questionnaire into a tool specifically focused on distinguishing different types of orofacial pain.

An Experienced Clinician Can Help

In the absence of a good screening tool, the skill, training, and, overall, the experience of your dentist becomes critical to getting a good diagnosis for your TMD.

If you are looking for treatment of your orofacial pain in San Jose, Dr. Nancy Nehawandian is a highly trained neuromuscular dentist with decades of experience. She has helped many people overcome their discomfort to experience dramatically less pain. Sometimes people can become completely pain-free, seeing relief from jaw pain, headaches, neck pain, and more.

If you are having difficulty getting successful treatment for your chronic headaches and other pain in the head or neck, we can help. Please call (408) 354-5600 today for an appointment with Dr. Nehawandian at Top Down Dental in Los Gatos.

By |January 10th, 2019|TMJ|