Global burden of orofacial pain in adults in low- and middle-income countries: A systematic review and meta-analysis

Orofacial pain (OFP) affecting the jaw, mouth, or facial area, is a prevalent public health issue globally with a significant burden in low-and middle-income countries (LMICs) due to limited oral health services. The objective of this study is to synthesize evidence on the prevalence of OFP among adults in LMICs and highlight its implications for oral health services and management. This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search was conducted across multiple bibliographic databases to identify observational studies reporting the prevalence of OFP in LMICs. Study quality was assessed using the Joanna Briggs Institute checklist. A random effects model was employed for meta-analysis, and heterogeneity was quantified using the l2 statistic. Twelve cross-sectional studies were included in the analysis. The pooled prevalence of toothache, a key component of OFP, was estimated at 23.3%. Significant heterogeneity was observed (l2= 99.5%), reflecting the multifaceted nature of OFP and its determinants. The variability in prevalence was influenced by geographical, socio-economic, and health system factors. The findings highlight the significant burden of OFP in LMICs, emphasizing the critical need for improved oral health services and targeted interventions. This study underscores the importance of prioritizing OFP in health policies to enhance management and treatment strategies in resource-constrained settings. Further research is needed to address existing knowledge gaps and develop effective strategies to mitigate OFP's impact.