Reliability of Chair-side Intraoral Somatosensory Examination

Method: 46 subjects (34 female, 12 male; mean age 53±14 years) participated in the study: 25 patients with atypical odontalgia recruited from Malmö University (Sweden), University of Washington (USA) and Aarhus University (Denmark) and 21 healthy subjects. All participants were examined twice by the same examiner on two separate occasions separated by 1-2 weeks (intra-examiner reliability). Twenty-eight participants were re-examined on the first day by a second blinded examiner (inter-examiner reliability). Sensitivity to touch, cold, and pinprick stimulation was evaluated on the buccal gingiva adjacent to the painful site and the corresponding contralateral ‘mirror-image’ gingival site. In healthy subjects, tests were performed bilaterally on the buccal gingiva adjacent to the first maxillary premolars. Patients reported hyper-, hypo-, or normo-sensitivity/-algesia to touch, cold and pinprick stimuli on the painful side compared to the pain-free side; healthy subjects were asked to compare sensitivity between sides. Kappa values were calculated.

Result: Intra- and inter-examiner reliability Kappa values were in the range of 0.625 to 0.753, which is considered to be of good reliability. Kappa values were generally higher in healthy subjects than in patients and were similar between centers and stimulus modalities.

Conclusion: Reliability of a simple chair-side qualitative somatosensory examination is sufficient for an initial screening of orofacial somatosensory function.