Association between oral health and frailty: A systematic review of longitudinal studies

Abstract

Objective To systematically review longitudinal studies on the association between oral health and frailty indicated by any validated scale or index. Background Frailty and poor oral health are common among ageing populations; however, evidence from longitudinal studies is scarce. Methods Three databases (MEDLINE, EMBASE and LILACS) were searched for published literature up to July 2018 using prespecified search strategy. Grey literature was searched using OpenGrey and Google Scholar. Quality of included studies was checked using the Newcastle‐Ottawa Quality Assessment Scale (NOS) for longitudinal studies. Results Five longitudinal studies from three countries (Mexico, Japan, and UK) that examined the association between oral health and frailty were identified. All studies used Fried's frailty phenotype criteria for measuring frailty. Oral health indicators were number of teeth, periodontal disease, oral functions (functional dentition with occluding pairs and maximum bite force), use of removable dentures, accumulation of oral health problems and dry mouth symptoms. The studies showed significant association of number of teeth (two studies), oral functions (two studies), accumulation of oral health problems and number of dry mouth symptoms with frailty incidence, whereas periodontal disease showed inconsistent associations. Conclusion This systematic review identified significant longitudinal associations between oral health indicators and frailty that highlight the importance of oral health as a predictor of frailty in older age. There is a need for further research exploring the role of nutrition as a mediator of the relationship between oral health and frailty.

Prediction of Frailty and Dementia Using Oral Health Impact Profile from a Population-Based Survey

“…Additionally, Tanaka et al reported that accumulated poor oral status such as decreased chewing ability, articulatory oral motor skill, and tongue pressure strongly predicted the incidence of physical frailty (HR, 2.2) and disability (HR, 2.3) among the community-dwelling older adults [47]. Nevertheless, the association between periodontal disease and frailty was still inconclusive [19,46,48]. Therefore, it is likely that early detection of oral health problems and prevention of oral frailty at an earlier stage is essential for healthy aging.…”

Tongue thickness measured by ultrasonography is associated with tongue pressure in the Japanese elderly

“…Frailty relates to many factors in an individual’s life, particularly physical, psychological, and social factors. Recently, it has been reported that oral health is associated with physical frailty and mortality, hence the term “oral frailty” [1-3]. Oral frailty consists of factors such as the diminished condition of teeth and ability to chew, swallow, and converse.…”

Chewing ability and oral health‐related quality of life in frail elders after new complete dentures insertion: A paired controlled clinical trial

“…FP‐associated loss in muscle mass reduces bite force and disrupts masticatory function, which can hinder food comminution . In this context, poor oral health has been found to be associated with increased risk of frailty . The masticatory function of edentulous elderly people can be impaired the lack of dental prostheses or use of misfitted ones due to insufficient bite force and ability to grind food .…”

“…11 In this context, poor oral health has been found to be associated with increased risk of frailty. 12 The masticatory function of edentulous elderly people can be impaired the lack of dental prostheses or use of misfitted ones 13 due to insufficient bite force and ability to grind food. 14 Thus, frailty is considered as an aggravating factor in the aging process, and its incidence is increased in edentulous patients.…”