Impact of Oral Health Interventions on Sarcopenia and Frailty in Older Adults: A Systematic Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Search Strategy
2.3. Inclusion and Exclusion Criteria
2.4. Study Selection and Data Extraction
2.5. Quality Assessment
2.6. Data Synthesis
3. Results
3.1. Study Identification and Selection
3.2. Characteristics of Included Studies
3.3. Impact of Dental Interventions on Sarcopenia and Frailty
3.3.1. Oral Hygiene and Preventive Care
3.3.2. Oral Exercises and Functional Training
3.3.3. Swallowing and Multidisciplinary Therapy
3.3.4. Long-Term Effects of Oral Health and Nutrition Education
3.4. Certainty of Evidence
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
PRISMA | Preferred Reporting Items for Systematic Reviews and Meta-Analyses |
MeSHs | Medical Subject Headings |
KCL | Kihon Checklist |
CGA | Cognitive, functional, and depression scales |
BMI | Body mass index |
PEFR | Peak expiratory flow rate |
OHN | Complex educational program: oral health and nutrition |
GRADEpro | Guideline Development Tool |
Appendix A
Database | Search Query |
---|---|
PubMed | (“Dental Care”[MeSH Terms] OR “Oral Health”[MeSH Terms] OR “Mouth Rehabilitation”[MeSH Terms] OR “Dentures”[MeSH Terms]) AND (“Frailty”[MeSH Terms] OR “Physical Frailty”[MeSH Terms] OR “Frail Elderly”[MeSH Terms]) OR (“Sarcopenia”[MeSH Terms] OR “Muscle Weakness”[MeSH Terms]) |
Scopus | TITLE-ABS-KEY(“Dental Care” OR “Oral Health” OR “Mouth Rehabilitation” OR “Dentures”) AND TITLE-ABS-KEY(“Frailty” OR “Physical Frailty” OR “Frail Elderly”) OR TITLE-ABS-KEY(“Sarcopenia” OR “Muscle Weakness” OR “Muscle Strength”) |
SciELO | (“Cuidado Dental” OR “Salud Bucal” OR “Rehabilitación Oral” OR “Prótesis Dentales”) AND (“Fragilidad” OR “Fragilidad Física” OR “Anciano Frágil”) OR (“Sarcopenia” OR “Debilidad Muscular” OR “Fuerza Muscular”) |
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Study (Author, Year) | Participants (% Female) | Age (Years) | Setting/Length of Follow-Up | Fragility Measure | Intervention | Overview Results | Overview Impact on Fragility/Sarcopenia | Certainty of Evidence |
---|---|---|---|---|---|---|---|---|
Tuuliainen et al. (2020) [25] | 231 (75%) | >75 | Community-dwelling/6 months | Abbreviated CGA (cognitive, functional, and depression scales) | Denture hygiene education, oral mucosa cleaning, and nutritional guidance | Increased denture cleaning frequency (mean: +1.4 times/day, p < 0.05), reduced plaque (p < 0.01) | No significant frailty change: frailty score mean −0.3 (95% CI: −0.6 to 0.0) | Low |
Shirobe et al. (2022) [19] | 219 (75%) | Not reported | Community-dwelling/8 weeks | Tanaka Method: frailty assessment based on weight, BMI, grip strength, walking speed, and KCL | Tongue pressure training, masticatory exercises, and prosodic training | Significant increase in body weight (+1.2 kg, p < 0.05), BMI (+0.5, p = 0.002), grip strength (+1.5 kg, p < 0.01) | Reduction in frailty index: mean −1.1 (95% CI: −1.5 to −0.7, p < 0.01) | Moderate |
Kito et al. (2019) [20] | 86 (93%) | >65 | Residential care/12 weeks | Occlusal force, tongue pressure, tongue–lip motor function, grip strength, Timed Up and Go test | Oral exercises combined with dietary modifications (textured foods, chewing training) | Improved masticatory efficiency: particle size −1.5 mm (p < 0.05) | Moderate frailty reduction: frailty index change −0.6 (95% CI: −1.0 to −0.2, p < 0.05) | Moderate |
Iwao et al. (2019) [22] | 43 (84%) | ≥65 | Residential care/3 months | KCL, grip strength (<26 kg men/<18 kg women), timed up-and-go (>12 s) | Combined oral health and physical training (chewing exercises and balance tasks) | Improved grip strength (+2.4 kg, p < 0.05), reduced bacterial count (p < 0.01) | KCL frailty score improvement: −1.2 points (95% CI: −1.8 to −0.6, p = 0.002) | Very Low |
Ono et al. (2017) [21] | Residents in LTCF | Not reported | Residential care/3 months | Kihon Checklist (KCL), grip strength, walking speed | Long-term care prevention program (oral care, supervised swallowing training) | Improved grip strength (+1.8 kg, p = 0.03), increased walking speed (+0.2 m/s, p = 0.04) | Reduction in frailty index: −0.8 points (95% CI: −1.2 to −0.4, p = 0.01) | Very Low |
Shiraishi et al. (2021) [20] | 300 (78%) | 72 (mean) | Hospitalized/48 months | ROAG (voice, lips, mucous membranes, tongue, gums, teeth, saliva, swallowing) | Oral screening, assessment, education, counseling, oral and dysphagia rehabilitation, and medical treatment by dentists | Better oral health was associated with improved functional recovery and swallowing function | Improved food intake level scale (FILS) (p < 0.01) and modified Rankin Scale (mRS) (p < 0.001) | Very Low |
Izumi et al. (2019) [24] | 114 (75%) | ≥65 | Residential care/2, 4, and 12 weeks | Barthel Index, Peak Expiratory Flow Rate (PEFR) | Tongue-cleaning intervention | Increased PEFR significantly (p < 0.01), more effective in low BI group | Improvement in respiratory function but no direct frailty assessment | Low |
Tomata et al. (2017) [23] | 192 (64 intervention, 128 control) (66%) | ≥65 | Mixed (includes hospitalized, residential care and community-dwelling)/28 months | KCL | Complex educational program: oral health and nutrition (OHN) | There was a lower incidence of disability in the intervention group compared to the control (p = 0.018) | Significant reduction in disability-related frailty outcomes (HR = 0.78, p < 0.05) | Very Low |
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Celis, A.; Cáceres, B.; Escobar, B.; Barahona, P.; Dreyer, E.; Petermann-Rocha, F. Impact of Oral Health Interventions on Sarcopenia and Frailty in Older Adults: A Systematic Review. J. Clin. Med. 2025, 14, 1991. https://doi.org/10.3390/jcm14061991
Celis A, Cáceres B, Escobar B, Barahona P, Dreyer E, Petermann-Rocha F. Impact of Oral Health Interventions on Sarcopenia and Frailty in Older Adults: A Systematic Review. Journal of Clinical Medicine. 2025; 14(6):1991. https://doi.org/10.3390/jcm14061991
Chicago/Turabian StyleCelis, Andrés, Benjamín Cáceres, Bárbara Escobar, Pilar Barahona, Erik Dreyer, and Fanny Petermann-Rocha. 2025. "Impact of Oral Health Interventions on Sarcopenia and Frailty in Older Adults: A Systematic Review" Journal of Clinical Medicine 14, no. 6: 1991. https://doi.org/10.3390/jcm14061991
APA StyleCelis, A., Cáceres, B., Escobar, B., Barahona, P., Dreyer, E., & Petermann-Rocha, F. (2025). Impact of Oral Health Interventions on Sarcopenia and Frailty in Older Adults: A Systematic Review. Journal of Clinical Medicine, 14(6), 1991. https://doi.org/10.3390/jcm14061991