Orofacial pain is a common condition in the general population. It is likely that this is also
the case in older persons with a dementia. However, the assessment of (orofacial) pain in non-verbal
individuals is hampered by the subjective nature of pain, and their limited communicative abilities.
To overcome this drawback, several tools have been developed for the assessment of pain based on
observations of pain-specific facial activities, body movements, and vocalizations. Unfortunately,
none of the so far developed observational tools have been designed specifically for the assessment of
orofacial pain. While the recent psychometric testing of the Orofacial MOBID Pain Scale did not
yield reliable outcomes, the subsequently developed Orofacial Pain Scale for Non-Verbal Individuals
(OPS-NVI) is currently being evaluated and shows good promise to be reliable and valid. Besides the
assessment of orofacial pain, an important application of this instrument will be the investigation of
the probable causal association between impaired chewing and cognitive decline, in which orofacial
pain plays a mediating role by its negative influence on chewing ability. The identification of this
negative influence will urge opinion leaders and policy makers to improve the oral health status in
older persons with a dementia. Ultimately, pain-free oral functioning may lead to a higher quality of
life and might help stabilizing or improving cognition in this frail and vulnerable patient population.
Keywords: Behavior, chewing, cognition, dementia, observation, oral health, orofacial pain, psychometrics.
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