Screening for psychosocial risk factors in patients with chronic orofacial pain: recent advances.
BACKGROUND
The authors compiled information about recent advances in screening for psychosocial risk factors considered to be yellow flags for potentially poor outcomes among patients with chronic orofacial pain (most commonly temporomandibular disorders).


METHODS
The authors conducted MEDLINE searches for the period 1995 through 2002 using the terms "temporomandibular disorders," "assessment" and "psychological," as well as "primary care," "screening" and "psychological disorders." They also searched personal files for relevant articles.


RESULTS
Psychosocial dysfunction is prevalent among patients with chronic orofacial pain. Yellow flags include high levels of disability; psychological disorders; and prolonged or excessive use of opiates, benzodiazepines, alcohol or other drugs. The authors identified several reliable, valid and brief patient self-administered questionnaires that can be used to screen for these yellow flags. Some of these are the Research Diagnostic Criteria/ Temporomandibular Disorders Axis II, Alcohol Use Disorders Identification Test and Patient Health Questionnaire.


CONCLUSIONS
Dentists can improve the quality of care for patients with chronic orofacial pain by screening for psychosocial risk factors and by referring patients with risk factors for psychological or psychiatric assessment and treatment.
Turner
Judith A
JA
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98195, USA. jturner@u.washington.edu
Dworkin
Samuel F
SF
D000203:Activities of Daily Living; D001008:Anxiety Disorders / Q000150:complications; D003866:Depressive Disorder / Q000150:complications; D005157:Facial Pain / Q000209:etiology / Q000523:psychology*; D006801:Humans; D008403:Mass Screening; D008960:Models, Psychological; D010147:Pain Measurement; D013001:Somatoform Disorders / Q000150:complications; D019966:Substance-Related Disorders / Q000150:complications; D011795:Surveys and Questionnaires; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000209:etiology / Q000523:psychology*