Questionnaire for Dental Practitioners to Screen for Trigeminal Neuralgia

Fuminari Komatsu, Kento Sasaki, Riki Tanaka, Kyosuke Miyatani, Yasuhiro Yamada, Yoko Kato, Yuichi Hirose
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Abstract

Abstract Objective Trigeminal neuralgia (TN) is a neurological disorder that often presents as severe toothache. The majority of TN patients visit dental clinics first, so TN represents a potential pitfall for dental practitioners. This report describes the development of a trigeminal neuralgia questionnaire (TNQ), assessing 10 characteristics of TN, to assist dentists in screening for TN in dental clinics, and evaluates the effectiveness of TNQ. Materials and Methods Fifty-three patients who visited the TN outpatient department in our institute and completed the TNQ were included in this study. All patients were examined by two neurosurgeons and neuroimaging was performed. Statistical Analysis Patients were classified into a TN group and a non-TN group. TNQ score was retrospectively compared between groups. Furthermore, history and characteristics of TN were investigated in the TN group to clarify the status of the reference situation. Results Thirty-seven cases were assigned to the TN group, and 16 cases to the non-TN group. Mean TNQ score was 8.3 in the TN group and 6.6 in the non-TN group. Setting a TNQ cutoff score of 7 offered 91% sensitivity and 56% specificity for TN. Investigation of the history of the present illness indicated that 39.2% of TN cases were improperly triaged and referred from initial dental clinics, and interdisciplinary practice was insufficient. Conclusion TNQ offers a reliable, convenient method to triage TN patients, and may assist dentists in screening for TN. Multidisciplinary practice is necessary for total management of TN and the TNQ is expected to connect dentists and TN specialists.
牙科医生筛查三叉神经痛的问卷调查
摘要目的三叉神经痛(TN)是一种神经系统疾病,常表现为严重的牙痛。大多数TN患者首先访问牙科诊所,因此TN代表了牙科从业者的潜在陷阱。本报告描述了三叉神经痛问卷(TNQ)的发展,评估TN的10个特征,以协助牙医在牙科诊所筛查TN,并评估TNQ的有效性。材料与方法在我院TN门诊就诊并完成TNQ的患者53例纳入本研究。所有患者均由两名神经外科医生检查并进行神经影像学检查。统计分析患者分为TN组和非TN组。回顾性比较两组间TNQ评分。此外,我们还调查了TN组的病史和特征,以澄清参考情况的现状。结果TN组37例,非TN组16例。TN组TNQ平均评分为8.3,非TN组为6.6。TNQ临界值设置为7分,TN的敏感性为91%,特异性为56%。对现有病史的调查表明,39.2%的TN病例分类不当,从最初的牙科诊所转诊,跨学科实践不足。结论TNQ为TN患者提供了可靠、便捷的分诊方法,可辅助牙科医生对TN进行筛查。TN的全面管理需要多学科的实践,TNQ有望将牙科医生和TN专家联系起来。
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