IADR Abstract Archives
Reliability of Intraoral Chair-side Somatosensory Examination - Preliminary Report
Objective: In the investigation of persistent orofacial pain, a comprehensive examination including assessment of somatosensory function is recommended by the Special Interest Group for Orofacial Pain of the International Association for the Study of Pain (IASP). A qualitative examination revealing signs of hyper-/hyposensitivity to touch and cold and hyper-/hypoalgesia for painful stimulation is commonly performed. Reliability is an important aspect, and has not earlier been reported for chair-side intraoral tests.
The objective of this study was to assess intraoral inter- and intra-examiner (test-retest) reliability of three qualitative measures of somatosensory function.
Methods: 13 female subjects (a pilot sample of an ongoing multicenter study) participated in the study; seven patients, diagnosed with atypical odontalgia (a condition commonly suggested to involve neuropathic pain mechanisms) and recruited from the Orofacial Pain Unit at Malmö University Dental School, Malmö, Sweden, and six subjects without orofacial pain complaints, recruited from the dental school staff. The mean age was 58±12 (range 38-76) years.
Each participant was examined twice on the same day by two blinded examiners (inter-examiner reliability). 1-2 weeks later, they were re-examined by one examiner (intra-examiner reliability).
We tested sensitivity to touch, cold, and pinprick pain on the buccal gingiva adjacent to the painful tooth and the corresponding contralateral gingival site; in pain-free subjects bilaterally on the buccal gingiva adjacent to the first maxillary premolar. Patients reported hyper-, hypo-, or normosensitivity to touch and cold and hyper-, hypo-, or normoalgesia for painful stimuli on pain side compared to pain-free side; pain-free subjects compared sensitivity between sides.
Kappa values were used to calculate correlations.
Results: Kappa values are presented in Table 1.
Table 1. Inter- and intra-examiner correlation of qualitative measures; Kappa values (n=13) | ||
Stimulus | Intra (test-retest) | Inter |
Touch | 0.81 | 0.81 |
Cold | 0.75 | 0.74 |
Painful | 0.86 | 0.61 |
≤ 0.2 is considered poor; 0.21–0.40 fair; 0.41–0.60 moderate; 0.61–0.80 good; and 0.81–1.00 excellent agreement | ||
Conclusion: Preliminary data suggest that the reliability of a simple chair-side qualitative somatosensory examination is good.
This study was supported by the Faculty of Odontology, Malmö University, NIH grant K12 DE14069 and R21-DE018768.