The relationship between oral function and frailty
Frailty is defined as a state in which an individual’s physiological reserve capacity, or the ability to recover from physical, mental, and social damage, declines, thereby increasing their susceptibility to physical disability. This frailty state is compounded by factors such as decreased food intake due to decreased appetite and malnutrition, which collectively constitute a vicious cycle, known as the frailty cycle. Dentistry also has a significant relationship with this frailty cycle in terms of food and nutrition intake and prevention of aspiration pneumonia, and oral health management is very important to prevent deterioration of the frailty state (Fig. 1).
Our research also focuses on the functions of the oral cavity, such as chewing, swallowing, and articulation. Additionally, we examine the association between oral frailty, which indicates a slight decline in oral function, and frailty. Two important keywords when examining this association are “oral hypofunction” and “oral health management.”
Oral hypofunction is a disease name that indicates oral functional decline in the elderly. Oral health management is an idea that includes three types of management: aligning the upper and lower teeth (dentition management), moving the mouth well, chewing and speaking well (functional management), and keeping the mouth clean (hygiene management). Our department has been integrating this concept of oral health management into our clinical and research work for over three decades.
Oral Health Care Initiatives
It is well-established that the surfaces of teeth, dentures, crowns, and filling materials in the oral cavity are coated with a biofilm, which is a complex community of microorganisms. This biofilm is associated with a number of oral diseases, including tooth decay and periodontal disease, as well as various systemic diseases, such as aspiration pneumonia.
Our department has been engaged in research on denture cleaners and mouthwashes that can more efficiently and rapidly remove this biofilm (Fig. 2).
Furthermore, we are engaged in the quantification of the cleanliness in the oral cavity and dentures through the use of an ATP (adenosine triphosphate) swab test, which is a valuable tool for the management of oral hygiene. Additionally, we are developing a tongue evaluation method based on ultrasonic diagnostic equipment, which will facilitate the management of oral function. These advancements prove beneficial for the treatment and patient guidance.
Based on the idea that oral health management prevents frailty, we will persist in our endeavors to identify and address oral frailty at its nascent stages, and to enhance quality of life and prolong the healthy life expectancy through oral health management.