Guidelines and recommendations for assessment of somatosensory function in oro-facial pain conditions - a taskforce report

Abstract

Summary The goals of an international taskforce on somatosensory testing established by the Special Interest Group of Oro-facial Pain (SIG-OFP) under the International Association for the Study of Pain (IASP) were to (i) review the literature concerning assessment of somatosensory function in the oro-facial region in terms of techniques and test performance, (ii) provide guidelines for comprehensive and screening examination procedures, and (iii) give recommendations for future development of somatosensory testing specifically in the oro-facial region. Numerous qualitative and quantitative psychophysical techniques have been proposed and used in the description of oro-facial somatosensory function. The selection of technique includes time considerations because the most reliable and accurate methods require multiple repetitions of stimuli. Multiple-stimulus modalities (mechanical, thermal, electrical, chemical) have been applied to study oro-facial somatosensory function. A battery of different test stimuli is needed to obtain comprehensive information about the functional integrity of the various types of afferent nerve fibres. Based on the available literature, the German Neuropathic Pain Network test battery appears suitable for the study of somatosensory function within the oro-facial area as it is based on a wide variety of both qualitative and quantitative assessments of all cutaneous somatosensory modalities. Furthermore, these protocols have been thoroughly described and tested on multiple sites including the facial skin and intra-oral mucosa. Standardisation of both comprehensive and screening examination techniques is likely to improve the diagnostic accuracy and facilitate the understanding of neural mechanisms and somatosensory changes in different oro-facial pain conditions and may help to guide management. assessments of all cutaneous somatosensory modalities. Furthermore, these protocols have been thoroughly described and tested on multiple sites including the facial skin and intraoral mucosa.Standardization of both comprehensive and screening examination techniques is likely to improve the diagnostic accuracy and facilitate the understanding of neural mechanisms and somatosensory changes in different orofacial pain conditions and may help to guide management.

Pressure pain threshold and pain perception in temporomandibular disorder patients: is there any correlation?

“…Our findings are also similar to those observed in patients with whiplash injuries 21 , fibromyalgia 25 and other chronic pain conditions 3 . PPT value reflects the pressure value that the individual first perceived to be painful 1 . Decreased PPT could reflect an increased excitability at any point of the nociceptive pathway 25 .…”

“…ORIGINAL ARTICLE DOI 10.5935/1806-0013.20150005 INTRODUCTION Quantitative sensory testing (QST) procedures have been used in clinical and research settings to assess pain threshold 1 . The common concepts in QST methods are that the assessment of normal and non-normal responses to various stimuli provides information about the functioning of the peripheral and central nervous system.…”

“…These responses can be quantified by the amount of physical stimuli required to evoke specific levels of sensory perception 2 . QST battery assembles a list of short form tests representing measurements of all relevant factors of the somatosensory system 1 . Pressure Pain Threshold (PPT) is one of these tests and it is defined as the minimum force applied which induces pain.…”

Quantitative methods for somatosensory evaluation in atypical odontalgia

“…14,15,16 These methods were previously described in detail by Svensson et al 13 Case-reports and literature reviews were excluded.…”

“…7,12 A research team recently published recommendations to standardize the evaluation of somatosensory function for orofacial pain conditions, and to allow data comparison between studies. 13 However, the usefulness and applicability of each QST method for the examination of AO patients remains undefined. Therefore, a systematic review was conducted to identify the most reliable quantitative QST method for the somatosensory evaluation of AO patients.…”