OBJECTIVES: This study investigated racial differences in orofacial pain symptoms in a sample of older adults. Orofacial pain prevalence, persistence, severity, and behavioral impact were assessed. We also tested whether sex and race interact, such that racial differences are only observed for a single sex, or whether sex differences only occur within a single racial group. METHODS: Telephone interviews were conducted with a stratified random sample of 1,636 community-dwelling older (age 65+ years) north Floridians. RESULTS: Racial differences were not found for 12-month prevalence or pain ratings for any painful oral symptom, or in the total number of symptoms. The most consistent racial differences were in behavioral impact associated with pain. Blacks reported greater behavioral impact as defined by pain having reduced their daily activities or motivating them to take some action in response to pain. For toothache pain, that action was more likely to have been some form of self-medication. These relationships persisted after controlling for socioeconomic status, approach to health care, and pain intensity in multivariable models. CONCLUSION: Although pain prevalence is an important public health variable, this study suggests that other pain-related variables, such as behavioral impacts, are useful when describing disparities associated with orofacial pain.