Benefits of implementing pain-related disability and psychological assessment in dental practice for patients with temporomandibular pain and other oral health conditions

Corine M. Visscher, Lene Baad-Hansen, Justin Durham, Jean Paul Goulet, Ambra Michelotti, Carolina Roldán Barraza, Birgitta Häggman-Henrikson, Ewa Carin Ekberg, Karen Raphael

Research output: Contribution to journalArticle

Abstract

Background: Evidence in the field of dentistry has demonstrated the importance of pain-related disability and psychological assessment in the development of chronic symptoms. The Diagnostic Criteria for Temporomandibular Disorders offer a brief assessment for the diagnostic process in patients with orofacial pain (Axis II). The authors describe relevant outcomes that may guide general oral health care practitioners toward tailored treatment decisions and improved treatment outcomes and provide recommendations for the primary care setting. Methods: The authors conducted a review of the literature to provide an overview of knowledge about Axis II assessment relevant for the general oral health care practitioner. Results: The authors propose 3 domains of the Axis II assessment to be used in general oral health care: pain location (pain drawing), pain intensity and related disability (Graded Chronic Pain Scale [GCPS]), and psychological distress (Patient Health Questionnaire-4 [PHQ-4]). In the case of localized pain, low GCPS scores (0-II), and low PHQ-4 scores (0-5), patients preferably receive treatment in primary care. In the case of widespread pain, high GCPS scores (III-IV), and high PHQ-4 scores (6-12), the authors recommend referral to a multidisciplinary team, especially for patients with temporomandibular disorder (TMD) pain. Conclusions: The authors recommend psychological assessment at first intake of a new adult patient or for patients with persistent TMD pain. The authors recommend the pain-related disability screening tools for all TMD pain symptoms and for dental pain symptoms that persist beyond the normal healing period. Practical Implications: A brief psychological and pain-related disability assessment for patients in primary care may help the general oral health care practitioner make tailored treatment decisions.

Original languageEnglish (US)
Pages (from-to)422-431
Number of pages10
JournalJournal of the American Dental Association
Volume149
Issue number6
DOIs
StatePublished - Jun 1 2018

Fingerprint

Oral Health
Tooth
Psychology
Pain
Temporomandibular Joint Disorders
Chronic Pain
Delivery of Health Care
Primary Health Care
Health
Facial Pain
Process Assessment (Health Care)
Dentistry
Therapeutics
Referral and Consultation

Keywords

  • general practice
  • Orofacial pain
  • primary health care

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Benefits of implementing pain-related disability and psychological assessment in dental practice for patients with temporomandibular pain and other oral health conditions. / Visscher, Corine M.; Baad-Hansen, Lene; Durham, Justin; Goulet, Jean Paul; Michelotti, Ambra; Roldán Barraza, Carolina; Häggman-Henrikson, Birgitta; Ekberg, Ewa Carin; Raphael, Karen.

In: Journal of the American Dental Association, Vol. 149, No. 6, 01.06.2018, p. 422-431.

Research output: Contribution to journalArticle

Visscher, Corine M. ; Baad-Hansen, Lene ; Durham, Justin ; Goulet, Jean Paul ; Michelotti, Ambra ; Roldán Barraza, Carolina ; Häggman-Henrikson, Birgitta ; Ekberg, Ewa Carin ; Raphael, Karen. / Benefits of implementing pain-related disability and psychological assessment in dental practice for patients with temporomandibular pain and other oral health conditions. In: Journal of the American Dental Association. 2018 ; Vol. 149, No. 6. pp. 422-431.
@article{57af3c76d01b4ba7989f7549ad36d590,
title = "Benefits of implementing pain-related disability and psychological assessment in dental practice for patients with temporomandibular pain and other oral health conditions",
abstract = "Background: Evidence in the field of dentistry has demonstrated the importance of pain-related disability and psychological assessment in the development of chronic symptoms. The Diagnostic Criteria for Temporomandibular Disorders offer a brief assessment for the diagnostic process in patients with orofacial pain (Axis II). The authors describe relevant outcomes that may guide general oral health care practitioners toward tailored treatment decisions and improved treatment outcomes and provide recommendations for the primary care setting. Methods: The authors conducted a review of the literature to provide an overview of knowledge about Axis II assessment relevant for the general oral health care practitioner. Results: The authors propose 3 domains of the Axis II assessment to be used in general oral health care: pain location (pain drawing), pain intensity and related disability (Graded Chronic Pain Scale [GCPS]), and psychological distress (Patient Health Questionnaire-4 [PHQ-4]). In the case of localized pain, low GCPS scores (0-II), and low PHQ-4 scores (0-5), patients preferably receive treatment in primary care. In the case of widespread pain, high GCPS scores (III-IV), and high PHQ-4 scores (6-12), the authors recommend referral to a multidisciplinary team, especially for patients with temporomandibular disorder (TMD) pain. Conclusions: The authors recommend psychological assessment at first intake of a new adult patient or for patients with persistent TMD pain. The authors recommend the pain-related disability screening tools for all TMD pain symptoms and for dental pain symptoms that persist beyond the normal healing period. Practical Implications: A brief psychological and pain-related disability assessment for patients in primary care may help the general oral health care practitioner make tailored treatment decisions.",
keywords = "general practice, Orofacial pain, primary health care",
author = "Visscher, {Corine M.} and Lene Baad-Hansen and Justin Durham and Goulet, {Jean Paul} and Ambra Michelotti and {Rold{\'a}n Barraza}, Carolina and Birgitta H{\"a}ggman-Henrikson and Ekberg, {Ewa Carin} and Karen Raphael",
year = "2018",
month = "6",
day = "1",
doi = "10.1016/j.adaj.2017.12.031",
language = "English (US)",
volume = "149",
pages = "422--431",
journal = "Journal of the American Dental Association",
issn = "0002-8177",
publisher = "American Dental Association",
number = "6",

}

TY - JOUR

T1 - Benefits of implementing pain-related disability and psychological assessment in dental practice for patients with temporomandibular pain and other oral health conditions

AU - Visscher, Corine M.

AU - Baad-Hansen, Lene

AU - Durham, Justin

AU - Goulet, Jean Paul

AU - Michelotti, Ambra

AU - Roldán Barraza, Carolina

AU - Häggman-Henrikson, Birgitta

AU - Ekberg, Ewa Carin

AU - Raphael, Karen

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Background: Evidence in the field of dentistry has demonstrated the importance of pain-related disability and psychological assessment in the development of chronic symptoms. The Diagnostic Criteria for Temporomandibular Disorders offer a brief assessment for the diagnostic process in patients with orofacial pain (Axis II). The authors describe relevant outcomes that may guide general oral health care practitioners toward tailored treatment decisions and improved treatment outcomes and provide recommendations for the primary care setting. Methods: The authors conducted a review of the literature to provide an overview of knowledge about Axis II assessment relevant for the general oral health care practitioner. Results: The authors propose 3 domains of the Axis II assessment to be used in general oral health care: pain location (pain drawing), pain intensity and related disability (Graded Chronic Pain Scale [GCPS]), and psychological distress (Patient Health Questionnaire-4 [PHQ-4]). In the case of localized pain, low GCPS scores (0-II), and low PHQ-4 scores (0-5), patients preferably receive treatment in primary care. In the case of widespread pain, high GCPS scores (III-IV), and high PHQ-4 scores (6-12), the authors recommend referral to a multidisciplinary team, especially for patients with temporomandibular disorder (TMD) pain. Conclusions: The authors recommend psychological assessment at first intake of a new adult patient or for patients with persistent TMD pain. The authors recommend the pain-related disability screening tools for all TMD pain symptoms and for dental pain symptoms that persist beyond the normal healing period. Practical Implications: A brief psychological and pain-related disability assessment for patients in primary care may help the general oral health care practitioner make tailored treatment decisions.

AB - Background: Evidence in the field of dentistry has demonstrated the importance of pain-related disability and psychological assessment in the development of chronic symptoms. The Diagnostic Criteria for Temporomandibular Disorders offer a brief assessment for the diagnostic process in patients with orofacial pain (Axis II). The authors describe relevant outcomes that may guide general oral health care practitioners toward tailored treatment decisions and improved treatment outcomes and provide recommendations for the primary care setting. Methods: The authors conducted a review of the literature to provide an overview of knowledge about Axis II assessment relevant for the general oral health care practitioner. Results: The authors propose 3 domains of the Axis II assessment to be used in general oral health care: pain location (pain drawing), pain intensity and related disability (Graded Chronic Pain Scale [GCPS]), and psychological distress (Patient Health Questionnaire-4 [PHQ-4]). In the case of localized pain, low GCPS scores (0-II), and low PHQ-4 scores (0-5), patients preferably receive treatment in primary care. In the case of widespread pain, high GCPS scores (III-IV), and high PHQ-4 scores (6-12), the authors recommend referral to a multidisciplinary team, especially for patients with temporomandibular disorder (TMD) pain. Conclusions: The authors recommend psychological assessment at first intake of a new adult patient or for patients with persistent TMD pain. The authors recommend the pain-related disability screening tools for all TMD pain symptoms and for dental pain symptoms that persist beyond the normal healing period. Practical Implications: A brief psychological and pain-related disability assessment for patients in primary care may help the general oral health care practitioner make tailored treatment decisions.

KW - general practice

KW - Orofacial pain

KW - primary health care

UR - http://www.scopus.com/inward/record.url?scp=85045122611&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85045122611&partnerID=8YFLogxK

U2 - 10.1016/j.adaj.2017.12.031

DO - 10.1016/j.adaj.2017.12.031

M3 - Article

AN - SCOPUS:85045122611

VL - 149

SP - 422

EP - 431

JO - Journal of the American Dental Association

JF - Journal of the American Dental Association

SN - 0002-8177

IS - 6

ER -