The Reliability and Validity of Self-reported Temporomandibular Disorder Pain in Adolescents

Aims: To evaluate the reliability and validity of self-reported pain associated with temporomandibular disorders (TMD) in adoles-cents and to determine how this validity may change over time. The authors’ hypothesis was that self-reported pain can be used to reliably and accurately detect adolescents with TMD pain. Methods: One hundred twenty adolescents, 60 with self-reported TMD pain and 60 age- and gender-matched controls without TMD pain, were examined twice. At the first examination at a Public Dental Service clinic, self-reported TMD pain was recorded for each patient. At the second examination, a clinical examina-tion was completed, blind to the patients’ self-report of pain symp-toms, after which self-reported TMD pain was again recorded. The clinical examination was based upon the Research Diagnostic Criteria for TMD (RDC/TMD). Self-reported TMD pain in this investigation was based upon the subjects’ responses to 2 ques-tions: (1) Do you have pain in your temples, face, temporo-mandibular joint (TMJ), or jaws once a week or more? and (2) Do you have pain when you open your mouth wide or chew once a week or more? Results: Test-retest reliability of .83 (kappa) was found for the 2 questions. The sensitivity was .98 (95% CI, .90 to 1.0) and specificity was .90 (95% CI, .81 to .95) for comparison of assessments made on the same day. Sensitivity was .96 (95%CI, .85 to .99) and specificity .83 (95% CI, .72 to .90) for assess-ments made 2 to 4 weeks apart. Conclusion: Very good reliability and high validity were found for the self-reported pain questions. A short time interval between the screening question and examina-tion slightly increased the accuracy of the measure. In adolescent populations, the questions in this study can be used to screen for TMD pain.

adolescents; diagnosis; reliability; sensitivity; speci-ficity; temporomandibular pain

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