Are orofacial pain assessment tools for adults who cannot self-report pain suitable for dental practice? A scoping review.

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.