Validity of three screening questions (3Q/TMD) in relation to the DC/TMD

• Published in: Journal of oral rehabilitation 2016-10, Vol.43 (10), p.729-736
• Main Authors: Lövgren, A., Visscher, C. M., Häggman-Henrikson, B., Lobbezoo, F., Marklund, S., Wänman, A.
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Bruxism - diagnosis; Bruxism - epidemiology; Bruxism - physiopathology; Cost-Benefit Analysis; Dental Care; Dentistry; diagnostic test; epidemiology; Facial Pain - diagnosis; Facial Pain - epidemiology; Facial Pain - physiopathology; Female; health services research; Humans; Male; Mass Screening - economics; Mass Screening - methods; oro-facial pain/TMD; Pain Measurement; practice guidelines as topic; Practice Patterns, Dentists' - statistics & numerical data; Prevalence; Public Health Dentistry - economics; routine; Sweden - epidemiology; temporomandibular disorders; Temporomandibular Joint Disorders - diagnosis; Temporomandibular Joint Disorders - economics; Temporomandibular Joint Disorders - epidemiology; Temporomandibular Joint Disorders - physiopathology
• ISSN: 0305-182X; 1365-2842; 1365-2842
• DOI: 10.1111/joor.12428

Summary Temporomandibular disorders (TMD) are common but seem to be largely undetected within general dental care. To improve dentists’ awareness of these symptoms, three screening questions (3Q/TMD) have been introduced. Our aim was to validate 3Q/TMD in relation to the diagnostic criteria for TMD (DC/TMD), while taking into account the severity level of the symptoms. The study population consisted of 7831 individuals 20–69 years old, who had their routine dental check‐up at the Public Dental Health Service in Västerbotten, Sweden. All patients answered a health declaration, including the 3Q/TMD regarding frequent temporomandibular pain, pain on movement and catching/locking of the jaw. All 3Q‐positives (at least one affirmative) were invited for examination in randomised order. For each 3Q‐positive, a matched 3Q‐negative was invited. In total, 152 3Q‐positives and 148 3Q‐negatives participated. At examination, participants answered 3Q/TMD a second time, before they were examined and diagnosed according to DC/TMD. To determine symptom's severity, the Graded Chronic Pain Scale and Jaw Functional Limitation Scale‐20 (JFLS‐20) were used. In total, 74% of 3Q‐positives and 16% of 3Q‐negatives met the criteria for DC/TMD pain or dysfunction (disc displacements with reduction and degenerative joint disorder were excluded). Fifty‐five per cent of 3Q‐positives had a TMD diagnosis and CPI score ≥3 or a JFLS‐20 score ≥5, compared to 4% of 3Q‐negatives. The results show that the 3Q/TMD is an applicable, cost‐effective and valid tool for screening a general adult population to recognise patients in need of further TMD examination and management.