[Do questionnaires for patients improve the diagnosis of craniomandibular dysfunction with chronic facial pain? A patients' questionnaire study from outpatient practice].
OBJECTIVE
The differential diagnosis of craniomandibular dysfunction (CMD) is of central importance for the therapy and diagnosis of chronic facial pain. Nevertheless, opinions on causes and treatment differ extremely and are sometimes even contradictory. The necessity of obtaining a precise and thorough patient history is indisputable. This raises the question of whether a questionnaire can offer additional information in order to improve the quality of the history, diagnosis and therapy.


METHODS
From May 1998 until February 1999, 230 patients who received a monoblock were requested to fill out a questionnaire referring to the previous 4-6 weeks, as an addition to the initial diagnostic tests. In 175 cases we were able to repeatedly examine the patient and compare the effects of therapy with the questionnaires. The questionnaire contains 14 visual, 11-step analogue scales, which are to be marked spontaneously and subjectively. The test-retest reliance at 1 week before treatment was r=0.82 ( n=86). The questionnaire requests information on diverse kinds of pain, sensations and findings in the dental, oral, maxillary and facial areas. For evaluation, a summation-score is built.


RESULTS
To our surprise, from a total of 175 patients 41.7% ( n=73) indicated their pain exclusively on the questionnaire. The number and frequency of answers indicated CMD. The average score of the patients whose pain was only mentioned on the questionnaire (31.16+/-19.16) was just slightly below the score of patients with additional, verbal pain descriptions (36.49+/-20.79).


CONCLUSIONS
The picture provided by the answers is impressive for the patient, improves compliance and makes diagnosis easier. In the same way, one can document the success of therapy and explore individual outcomes which show a resistance to therapy.
Jürgens
J
J
Info@mkg-chir.de
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017271:Craniomandibular Disorders / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005157:Facial Pain / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D010147:Pain Measurement; D010349:Patient Compliance; D011795:Surveys and Questionnaires; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis*