Abstract
ObjectivePain in the orofacial region may originate from different structures, and one challenge for the clinician is to determine the primary origin of pain reported by the patient. In clinical practice, it is important to discriminate between a temporomandibular joint (TMJ) pain disorder and jaw muscle pain; therefore, tests that are proposed for such purposes warrant evaluation. The aim of the present study was to evaluate the outcome of a TMJ compression test in relation to a Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) arthralgia diagnosis.MethodsA study population (n = 300), randomly selected from the adult population in Västerbotten, Sweden, was examined according to the DC/TMD criteria and with a TMJ compression test. This test is comprised of forceful unilateral biting for 20 s on a wooden spatula in the first molar region. Familiar pain on the contralateral side to the clenching side was considered a positive test outcome.ResultsPositive contralateral outcome of the TMJ compression test was associated with an arthralgia diagnosis (B = 1.737; OR 5.7, 95% CI 3.3–9.9). This association was confounded by concurrent myalgia (B = 1.737 → B = 0.996, 42.7%).ConclusionIn a general population, a negative TMJ compression test was strongly associated with the absence of a contralateral TMJ arthralgia diagnosis according to DC/TMD. The association between a positive TMJ compression test and a DC/TMD arthralgia diagnosis was confounded by the presence of myalgia.Clinical relevanceConcurrent myalgia renders the usefulness of the TMJ compression test for predicting an arthralgia diagnosis questionable.
Highlights
Temporomandibular disorders (TMD) are considered musculoskeletal disorders that embrace pain or dysfunction of the temporomandibular joint (TMJ) and masticatory muscles [1, 2]
A Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) arthralgia diagnosis was established in 66 individuals (Table 1), representing 22% of the study population (13 men and 53 women, mean age 38.1 years; SD 15.0)
This indicates that a negative TMJ compression test is strongly associated with the absence of a contralateral TMJ arthralgia diagnosis according to DC/TMD
Summary
Temporomandibular disorders (TMD) are considered musculoskeletal disorders that embrace pain or dysfunction of the temporomandibular joint (TMJ) and masticatory muscles [1, 2]. TMD is the most common reason for chronic pain in the orofacial region [3] and is commonly associated with interference in daily life [4, 5]. The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) is a valid process to diagnose the most common TMD conditions. In the DC/TMD, both TMJ pain (arthralgia) and myalgia diagnoses are based on self-reported pain modified by function, in combination with familiar pain elicited during jaw movements or palpation [6]. Both these diagnoses have a high diagnostic sensitivity and specificity.
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