Oral Frailty and Ageing: Exploring Strategies for Pre-Ageing Oral Health Prevention

Background: Ageing is associated with physiological changes that affect oral health, including reduced salivary flow, diminished oral musculature, and increased susceptibility to periodontal disease and dental caries. Studies have shown that poor oral health in older adults correlates with systemic conditions such as cardiovascular disease, diabetes, and cognitive decline. The World Health Organization and national public health bodies increasingly recognise oral health as integral to healthy ageing. However, most oral health interventions are reactive, targeting older adults after deterioration has occurred. This reactive model contributes to increased healthcare costs and reduced quality of life. There is a growing call for a shift toward preventive and anticipatory care, especially in middle-aged populations. As such ageing populations face escalating challenges in maintaining good oral health, which is intimately linked to general systemic health, nutrition, and quality of life. Oral frailty - a concept encompassing diminished oral function and resilience - has emerged as a critical concern.

Researchers at the University of Chester have scoped the concept of oral frailty having identified the interconnection between structural changes in the mouth (tooth loss, poor oral hygiene), functional decline (chewing, swallowing, tongue pressure) with cognitive and social deterioration.

Problem: Despite growing awareness, preventive strategies targeting oral health before the onset of ageing-related decline are underdeveloped and under-implemented. Longitudinal studies (e.g., the Dunedin Study) suggest that oral health trajectories established in midlife strongly predict outcomes in older age, although there are significant knowledge gaps in the published literature, further impacted by:

1. Lack of consensus on the definition and measurement of oral frailty.
2. Limited longitudinal data on oral health decline in pre-ageing populations.
3. Few studies evaluating the cost-effectiveness of early preventive interventions.
4. Insufficient integration of oral health into general ageing and public health policies.

Aim: To investigate the concept of oral frailty in the context of overall ageing, societal impact, influence on healthcare inequalities, and develop evidence-based strategies for pre-ageing oral health prevention. This research will inform policy, workforce planning, and service delivery models that promote oral resilience before frailty sets in.