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Updated: Jun 7, 2025

Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Are orofacial pain assessment tools for adults who cannot self-report pain suitable for dental practice? A scoping
Caoimhin Mac Giolla Phadraig1, Alva Lawler2, Georgia MacHesney2
1Department of Child and Public Dental Health, Dublin Dental University Hospital and School of Dental Science, Trinity College Dublin, Dublin, Ireland.
Introduction:
This study aims to identify and appraise orofacial pain assessment tools designed to score pain in adults who cannot self-report and rate their suitability for dental practice.
Methods:
A protocolled systematic scoping review, in accordance with Joanna Briggs Institute methods was completed. A development panel (n = 7) reviewed attributes of each tool for suitability for use in dental practice, using predefined criteria.
Results:
Nine studies were included. Sample size ranged from n = 22 to n = 348; all participants were 65 years plus and had a cognitive impairment or dementia, excluding controls. Four tools were identified: Facial action coding system (FACS), mobilization-observation-behavior-intensity in dementia pain scale (MOBID I & II) and, orofacial pain scale-non-verbal individuals (OPS-NVI). Tools scored between two and thirteen out of twenty according to modified quality assessment criteria. No tool was deemed suitable for use in dental surgery, with the OPS-NVI scoring most favorably.
Conclusions:
No tools were deemed ideal for use within a dental clinic. Elements of some, particularly the OPS-NVI, may be adaptable for this purpose. Despite the difficulties dental practitioners face trying to assess pain in non-speaking patients, there was no suitable tool identified. Pathways need to be designed to facilitate inclusive orofacial pain assessment for those who cannot self-report pain.
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