Prevalence and impact of orofacial pain in older adults with dementia: a systematic review and meta-analysis.

PURPOSE: This systematic review and meta-analysis aimed to determine the prevalence and impact of orofacial pain among older adults with dementia. RESEARCH STRATEGIES: Observational studies were retrieved from EMBASE, LILACS, PubMed/MEDLINE, Scopus, Cochrane, Livivo, and Web of Science databases, in addition to gray literature. The search included studies without language or date restrictions. SELECTION CRITERIA: Eligible studies included participants aged 60 years or older with any type of dementia, reporting the presence, frequency, or characteristics of orofacial pain. Case reports, reviews, and experimental animal studies were excluded. DATA ANALYSIS: Data were extracted independently by calibrated reviewers. Meta-analyses were performed using RStudio software, calculating pooled prevalence rates with 95% confidence intervals. Heterogeneity was assessed using the I2 statistic. RESULTS: The overall prevalence of orofacial pain among older adults with dementia was 19%, regardless of dementia type. Associated factors included poor oral hygiene, presence of natural dentition, and xerostomia. Communication difficulties, particularly in non-verbal patients, represented the main diagnostic barrier. CONCLUSION: Approximately one in five older adults with dementia experiences orofacial pain, which significantly affects quality of life. However, underdiagnosis remains common due to cognitive and communicative limitations. Improving professional training, multidisciplinary collaboration, and public health strategies focused on oral healthcare in long-term care facilities are essential to enhance pain detection and management.