Gerodontology[JOURNAL]
Sun
200 papers
Is BMI a Mediator in the Association Between Subjective Masticatory Function and Functional Disability? Findings From the Shizuoka Kokuho Database Study.
Sato Y, Tokuda C, Yamamoto S … +1 more , Tabara Y
Gerodontology · 2026 Jul · PMID 42385174 · Publisher ↗
BACKGROUND: Poor subjective masticatory function (SMF) and abnormal body mass index (BMI) have been shown to be associated with functional decline in later life. Oral dysfunction can precede weight loss and frailty, and...
BACKGROUND: Poor subjective masticatory function (SMF) and abnormal body mass index (BMI) have been shown to be associated with functional decline in later life. Oral dysfunction can precede weight loss and frailty, and BMI often shows a U-shaped association with disability. However, whether BMI is on the pathway from SMF to disability remains unclear. OBJECTIVES: To examine whether BMI mediates the association between poor SMF and incident functional disability. METHODS: We conducted a retrospective cohort study using the Shizuoka Kokuho Database of health checkups, medical claims and long-term care insurance data in Shizuoka Prefecture, Japan. Residents aged ≥ 65 years who attended health checkups, excluding those with prior long-term care certification, were eligible. SMF was assessed at the baseline checkup, BMI at the subsequent checkup and the outcome was new long-term care certification. Time-to-event mediation models estimated total, natural direct and natural indirect effects. Sensitivity analyses used BMI category transition as the mediator. RESULTS: Among 169,319 participants, 22.1% reported poor SMF. Poor SMF was associated with a higher risk of disability (hazard ratio [HR] 1.07; 95% confidence interval [CI] 1.03, 1.11). Low and high BMI were each associated with disability; only the low-BMI pathway contributed to mediation. The proportion mediated was 11.1% (95% CI 4.6, 46.4). Findings were consistent in sensitivity analyses using BMI transition. CONCLUSIONS: Poor SMF was associated with a higher risk of functional disability, partly accounted for by low BMI. Preventing low BMI among older adults with impaired mastication-together with oral-function care-may help to preserve independence.
Experiences of Complete Removable Denture Use Among Edentulous Older Adults and Their Family Members: A Qualitative Study in Public Primary Care.
Von Marttens A, Von Marttens R, Von Marttens MI … +4 more , Chirinos M, Fernández E, Basualdo J, Beltran V
Gerodontology · 2026 Jun · PMID 42333044 · Publisher ↗
OBJECTIVE: To explore how edentulous older adults and their family members experienced the use of complete removable dentures and to examine the meanings they attributed to this rehabilitation in relation to daily life,...
OBJECTIVE: To explore how edentulous older adults and their family members experienced the use of complete removable dentures and to examine the meanings they attributed to this rehabilitation in relation to daily life, social participation and perceived quality of life. BACKGROUND: Complete removable dentures remain the most common treatment for complete edentulism in public services. Although previous research has extensively documented clinical performance and patient-reported outcomes, less is known about how older adults and their families experience denture use in everyday life. Understanding these experiential and relational dimensions is important for informing more patient-centred prosthetic care. METHODS: This interpretive qualitative study was conducted in a public primary healthcare centre in Santiago, Chile. Semi-structured interviews were undertaken with 50 edentulous adults aged 60 years or older who had received complete removable dentures, and with 36 family members involved in their everyday support. In addition, one focus group was conducted with a purposive subset of older adults to deepen themes identified in the interviews. Audio-recorded data were transcribed verbatim and analysed using reflexive thematic analysis. RESULTS: Four interpretive themes were developed. Complete removable dentures were often experienced as a form of visible recovery, restoring appearance, confidence and ease of communication. At the same time, this recovery remained fragile when denture instability, particularly in the mandible, affected eating, speaking and social interaction. Many participants described daily adaptation through dietary restriction, vigilance and avoidance of potentially embarrassing situations. Family members played an important role by providing practical assistance, emotional support and help in managing meals, routines, and follow-up needs. CONCLUSIONS: For edentulous older adults, complete removable dentures were experienced as more than a technical replacement for missing teeth. While they often improved self-presentation and confidence, their functional limitations frequently sustained social and emotional burden. These findings support prosthetic care models that incorporate follow-up, family involvement and attention to psychosocial adaptation.
Response to Clinical Validity of the Oral Frailty Five-Item Checklist (OF-5) for the Diagnosis of Oral Hypofunction.
Furuya J, Tabata T, Teraoka M … +4 more , Hirayama M, Koyanagi K, Suzuki H, Hatanaka Y
Gerodontology · 2026 Jun · PMID 42294602 · Publisher ↗
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Screening Oral Hypofunction With the OF-5: Promise, Overlap and Clinical Transportability.
Ardila CM, Vivares-Builes AM, Pineda-Vélez E
Gerodontology · 2026 Jun · PMID 42290638 · Publisher ↗
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Documenting Oral Health-Related Life Experiences to Promote Positive Intergenerational Interactions.
John J, Zolkharnain AA, Mani SA … +3 more , Tennant M, Han HW, Srinivasan M
Gerodontology · 2026 Jun · PMID 42283456 · Publisher ↗
BACKGROUND: With the global rise in ageing populations, dental education must prepare students to care for older adults with empathy and competence. Ageism, defined as negative bias towards older individuals, can hinder...
BACKGROUND: With the global rise in ageing populations, dental education must prepare students to care for older adults with empathy and competence. Ageism, defined as negative bias towards older individuals, can hinder quality care and meaningful dentist-patient relationships. OBJECTIVE: This study aimed to explore whether documenting and narrating oral health-related life experiences of older adults could promote positive intergenerational attitudes and enhance empathy among dental students. METHODS: A reflective qualitative study was conducted among 3rd-year dental students enrolled in a Social and Behavioural Sciences module. A subgroup of students participated in an enhanced learning session that involved biographical interviews with older adults, focusing on their oral health journeys and related life stories. Students documented these narratives and produced reflective essays. Thematic analysis of the essays was performed to identify key domains of learning and professional development. RESULTS: Engagement with older adults' life stories fostered greater understanding of the psychosocial dimensions of ageing and oral health. Thematic analysis revealed enhanced empathy, improved communication skills and increased cultural sensitivity. Students recognized the importance of preparation, clear communication and digital tools for engagement. They also identified barriers such as financial constraints and access inequalities, demonstrating growing social awareness for older patients. CONCLUSION: Documenting and reflecting on oral health-related life experiences provided dental students with meaningful intergenerational learning opportunities that strengthened empathy, cultural sensitivity and readiness for geriatric dental care. Narrative-based reflection represents a valuable pedagogical tool to reduce ageist perceptions and promote inclusive care within dental education.
Perspectives and Experiences of Dentists on the Provision of Oral Healthcare to Frail Older Adults in General Dental Practices.
Dekkers E, van Dam BAFM, den Boer JCL … +2 more , Slot DE, Bruers JJM
Gerodontology · 2026 Jun · PMID 42257487 · Publisher ↗
BACKGROUND: Population ageing has increased the number of frail older adults living independently and retaining their natural dentition. To support oral healthcare professionals in caring for this patient group, the Roya...
BACKGROUND: Population ageing has increased the number of frail older adults living independently and retaining their natural dentition. To support oral healthcare professionals in caring for this patient group, the Royal Dutch Dental Association published the practice guideline Care for Frail Older Adults in the Dental Practice. However, little is known about how oral healthcare is currently provided in daily practice. OBJECTIVE: To explore general dental practitioners' (GDPs) experiences in providing oral healthcare to community-dwelling frail older adults, and to examine whether they were familiar with the practice guideline. METHODS: A qualitative study was conducted using semi-structured interviews with 11 GDPs between June and November 2024. Interviews were audio-recorded, transcribed verbatim and analysed thematically. RESULTS: Oral healthcare for frail older adults required additional attention, effort and coordination from GDPs and the entire dental team. GDPs emphasised the importance of long-term patient relationships, continuity of care, and the role of the dental team in prevention and early detection of decline. Barriers included time constraints, limited opportunities for referral and limited collaboration within primary care. Few GDPs provided home visits due to time or logistical constraints. Most GDPs were unfamiliar with the guideline. CONCLUSION: Providing oral healthcare to frail older adults requires additional effort and coordination within the dental team, and attention to interprofessional collaboration. While GDPs strive to deliver patient-centred and preventive care, practical, organisational and guideline-related barriers remain. These findings underscore opportunities for professional bodies and policymakers to support guideline dissemination, facilitate interprofessional collaboration, and ensure care for this vulnerable patient group.
Perspectives on Future Assisted Oral Care Among Community-Dwelling Older Adults Receiving Municipal Home Care: A Qualitative Study.
Johansson I, Eriksson I, Torgé CJ … +1 more , Jönsson B
Gerodontology · 2026 Jun · PMID 42257469 · Publisher ↗
OBJECTIVE: To explore community-dwelling older adults' expectations and perceptions of future needs and requests concerning assisted oral care from healthcare professionals in event of greater need for care. BACKGROUND:...
OBJECTIVE: To explore community-dwelling older adults' expectations and perceptions of future needs and requests concerning assisted oral care from healthcare professionals in event of greater need for care. BACKGROUND: Older adults with care needs often require support with oral care from care professionals, yet cognitive impairments may hinder their ability to express needs and preferences. MATERIALS AND METHODS: A qualitative study with an inductive approach and purposive sample was conducted. Eighteen community-dwelling older adults (≥ 65 years) receiving municipal home healthcare or home help services in southwest Sweden were interviewed individually. Information on oral health, oral care and anticipated future need for assisted oral care was gathered. Interviews were audio-recorded, transcribed verbatim, and analysed using qualitative content analysis. Ethical approval was obtained, and the study adhered to the COREQ checklist. RESULTS: The analysis generated an overall theme: 'Tensions between thoughts, envisioned standards and anticipated practicalities in future assisted oral care' and three subthemes 'Oral self-care is the last stronghold of independence, with staff support considered under specific conditions', 'Sensitive dialogue enables access to assisted oral care' and 'Tough but necessary to accept assisted oral care'. CONCLUSION: There are tensions in community-dwelling older adults' expectations of assisted oral care. A desire for independence and delayed assistance contrasts with the need for early communication before health decline impairs decision-making to ensure autonomy and person-centred care.
Developing and Validating a Nursing-Applied Oral Health Risk Assessment Tool for Care-Dependent Older German Adults: A Two-Panel Delphi Study.
Hillebrecht AL, Funck S, Ludwig E … +2 more , Waterkotte R, Barbe AG
Gerodontology · 2026 Jun · PMID 42226729 · Publisher ↗
INTRODUCTION: Implementation of oral health assessment tools in residential care for older adults remains challenging. We aimed to establish the content validity and practice relevance of the Mouth-related Risk Assessmen...
INTRODUCTION: Implementation of oral health assessment tools in residential care for older adults remains challenging. We aimed to establish the content validity and practice relevance of the Mouth-related Risk Assessment for Professional Nursing (Mu-RAP), a nursing-applied instrument designed to identify oral health risks in care-dependent older adults. METHODS: This sequential, two-panel Delphi study (with two rounds per panel) was conducted between May 2025 and February 2026. In Phase 1, a dentist panel of gerodontology experts (Round 1: n = 26; Round 2: n = 27) evaluated conceptual completeness and item relevance (numeric rating scales, qualitative feedback). In Phase 2, a heterogeneous nursing panel (Round 1: n = 66; Round 2: n = 35) assessed item relevance, clarity and feasibility for routine care (Likert-type scales, structured comments). Consensus thresholds were predefined (dentist panel ≥ 60% agreement; nursing panel ≥ 75%). RESULTS: Agreement for the refined 13-item instrument was high across both panels. In the first nursing round, 12 of 13 items reached the predefined relevance threshold. Two items were rephrased and achieved strong agreement in Round 2 (91.4% and 85.7%). Feasibility was rated as high (median usability rating 9/10) and 93.9% of participants would integrate Mu-RAP into routine care. CONCLUSION: The Mu-RAP achieved strong interprofessional consensus on its content validity, clarity and practical applicability. It may provide a framework for early identification of oral health risks in care-dependent older adults.
Staging in Gerodontology: A Framework.
Schwendicke F, McKenna G, Srinivasan M … +25 more , Bell A, Chebib N, Da Mata C, Dujic H, Gallagher J, Janssens B, Layton DM, Kanazawa M, Kossioni A, Maniewicz S, Matsuo K, Mourelle PM, Neri A, Ono T, Pojmonpiti S, Spyraki F, Srisanoi K, Syed SS, Tada S, Tsakos G, Walton TR, Thomson WM, Haesler JP, Dartevelle S, Müller F
Gerodontology · 2026 May · PMID 42212566 · Publisher ↗
INTRODUCTION: Comprehensively, systematically and reproducibly assessing and describing the (oral) health status and care needs of older adults is challenging. We aimed to provide a framework for evaluating and reporting...
INTRODUCTION: Comprehensively, systematically and reproducibly assessing and describing the (oral) health status and care needs of older adults is challenging. We aimed to provide a framework for evaluating and reporting older adults' oral health, capturing general and oral function and disease, as well as oral, systemic and socio-economic/social risk factors determining oral care complexity and capability, care needs and levels, and clinical management, including prevention, active and supportive therapy, as well as informing education, research, surveillance and health services. The present paper describes the first aspect, staging of oral health in this population. METHODS: Eight reviews were conducted to identify risk factors for deterioration of oral health in older adults; existing systematic reviews were further considered during the framework development. A 2.5-day workshop with 31 international researchers and stakeholders was held and a structured consensus process implemented to come to an agreed, internationally applicable framework. A 75% level of agreement was achieved after two rounds of voting. RESULTS: A case definition based on staging and grading, reflecting the current general and oral health and function, care complexity, and the risk of deterioration of oral health due to local, systemic, and socio-economic and social factors, was developed. Staging includes person-level (based on clinical frailty), function-level (based on clinical and subjective evaluations reflecting oral function, such as tooth loss and oral impacts), and disease-level (including caries, periodontal disease, and oral mucosa assessments) domains. CONCLUSION: Oral health staging in older adults can allow clinicians, carers, and policymakers to systematically and comprehensively define and classify patient cases in order to derive appropriate and adequate care. Staging should be used in combination with grading, and both may allow capturing the overall health status and care needs of older patients for health surveillance, research, and education purposes. Next steps will include validation, dissemination, and implementation of the framework.
Understanding Oral Health Management for People Living With Dementia: A Qualitative Meta-Synthesis.
Ruan JY, Qi X, Su J … +5 more , Mao W, Xie Y, Yu J, Wang J, Wu B
Gerodontology · 2026 May · PMID 42210602 · Publisher ↗
BACKGROUND: People living with dementia often experience oral health problems, and managing oral health in this population presents numerous challenges. Although qualitative data have presented these challenges from mult...
BACKGROUND: People living with dementia often experience oral health problems, and managing oral health in this population presents numerous challenges. Although qualitative data have presented these challenges from multiple perspectives, there remains a lack of qualitative evidence synthesis. This paper aimed to synthesize available qualitative evidence on the perceptions and experiences of oral health management for people living with dementia from the perspectives of patients, their caregivers, healthcare professionals, and social workers across diverse contexts. METHOD: This systematic review was registered in the International Prospective Register of Systematic Reviews (Registered Number: CRD420251110648). This review was conducted and reported in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement. We searched 11 databases and grey literature sources from inception to July 2025. We included qualitative designs or mixed-methods designs in which qualitative data were analysed separately from quantitative data and that addressed oral health management for people living with dementia. Studies published in English or Chinese were eligible. Study quality was assessed using the Critical Appraisal Skills Programme checklist for qualitative studies. Data were analysed through thematic synthesis, and confidence in the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation-Confidence in Evidence from Reviews of Qualitative Research. RESULTS: Sixteen studies were synthesized, yielding three themes: (1) recognizing the importance of oral health for people living with dementia as a process, (2) oral health management for people living with dementia having unique requirements, and (3) learning to manage oral health for people living with dementia across multiple domains. CONCLUSION: This review highlights critical gaps in oral health management for people living with dementia, emphasizing the need for oral health continuity of care, shared decision-making in oral health, and creating dementia-friendly oral health practice environments. These findings provide direction for practice and research aimed at improving person-centered oral care.
Older Adults' Oral Health in Institutional Care: Caregiver and Resident Perspectives on Challenges and Coping Strategies.
Bakar AMA, Bakri NN, Yusof N
Gerodontology · 2026 May · PMID 42210601 · Publisher ↗
BACKGROUND: Older adults in nursing homes experience complex oral health needs, yet oral care is often under-prioritised in long-term care settings. In Malaysia, evidence examining oral health practices within nursing ho...
BACKGROUND: Older adults in nursing homes experience complex oral health needs, yet oral care is often under-prioritised in long-term care settings. In Malaysia, evidence examining oral health practices within nursing homes remains limited, particularly in relation to daily oral care and service delivery. OBJECTIVE: To explore oral health challenges and coping strategies among older residents and caregivers in Malaysian nursing homes and to identify system-level factors influencing daily oral care. METHODS: A qualitative study was conducted using in-depth interviews with 10 residents and five focus group discussions, together with one individual interview, involving a total of 21 caregivers across six nursing homes (five private and one government) in Selangor. Data were analysed using reflexive thematic analysis following Braun and Clarke's approach. Trustworthiness was enhanced through triangulation of resident and caregiver data, peer debriefing and cross-checking transcripts against field notes. RESULTS: Five themes described oral health experiences in nursing homes. Residents reported challenges related to functional decline, denture discomfort and mild cognitive limitations. Structural and institutional barriers constrained access to oral care and dental services. Caregivers played a critical role in maintaining daily oral care but encountered challenges related to limited training, workload pressures and behavioural resistance, which may compromise residents' quality of life. Both residents and caregivers adopted adaptive coping strategies, while support from families, facilities and structured training acted as key facilitators. CONCLUSION: Oral health in Malaysian nursing homes is shaped by the interaction of resident capacity, caregiver preparedness and institutional context. Strengthening caregiver training, ensuring consistent oral care resources and integrating routine dental services into long-term care are critical to improving oral health outcomes for residents.
Health Literacy and Time-Specific Toothbrushing Practices in Older Adults: An Analysis of the Korean National Health and Nutrition Examination Survey, KNHANES IX (2023).
Son JY, Son SY
Gerodontology · 2026 May · PMID 42204889 · Publisher ↗
BACKGROUND: Evidence remains limited on whether health literacy is associated with time-specific toothbrushing occasions across the day. OBJECTIVE: To examine time-specific toothbrushing patterns according to health lite...
BACKGROUND: Evidence remains limited on whether health literacy is associated with time-specific toothbrushing occasions across the day. OBJECTIVE: To examine time-specific toothbrushing patterns according to health literacy levels and to determine whether lower health literacy was associated with failure to brush at key times among older adults in Korea. METHODS: Using the KNHANES IX (2023), we analysed 1,836 adults aged ≥ 65 years. Toothbrushing on the previous day was reported for eight occasions (before breakfast, after breakfast, before lunch, after lunch, before dinner, after dinner, after having a snack, and before bedtime). Health literacy (10-item scale; 10-40) was categorised as low (≤ 28), moderate (29-30), or high (≥ 31). Complex-sample weighted logistic regression estimated ORs (95% CIs) for failure to brush at specific times with hierarchical adjustment (demographic characteristics, socioeconomic status, health practices). RESULTS: Lower health literacy was more common among older adults and those with lower income/education. Brushing was most frequent after breakfast and after dinner. Compared with high health literacy, low health literacy was associated with higher odds of not brushing before breakfast (OR 1.43, 95% CI 1.02-2.00) and after lunch (OR 1.38, 95% CI 1.00-1.91) after adjustment for sociodemographic factors; associations were attenuated after full adjustment. No consistent associations were found for failure to brush after breakfast or before bedtime. CONCLUSIONS: Health literacy was associated with time-specific toothbrushing, with before-breakfast and after-lunch brushing identified as priority prevention targets among older adults.
Staging and Grading in Gerodontology-An Introduction.
Thomson WM, McKenna G, Srinivasan M … +2 more , Müller F, Schwendicke F
Gerodontology · 2026 May · PMID 42204840 · Publisher ↗
INTRODUCTION: Gerodontology lacks a unified framework to describe case complexity and assess the multidimensional determinants shaping oral health. METHODS: An international initiative developed an evidence-based case de...
INTRODUCTION: Gerodontology lacks a unified framework to describe case complexity and assess the multidimensional determinants shaping oral health. METHODS: An international initiative developed an evidence-based case definition for staging and grading older adults' oral health. RESULTS: Staging includes three domains: person, oral function (clinical and subjective), and oral disease (caries, periodontal disease, mucosal conditions) level staging. Grading incorporates risk factors at the oral, systemic, and social levels, including caries and periodontal risk, prosthetic maintenance, xerostomia, multimorbidity/polypharmacy, care dependency, nutritional status, socioeconomic position, and social support. CONCLUSIONS: This framework integrates biological, functional, systemic, and social factors within a single structure and reached strong international consensus. It offers a common language for clinical care, research, education, and policy. Further work should evaluate its feasibility, validity, and responsiveness. Companion papers in this issue provide the detailed staging and grading criteria.
Performance of Non-Dental Professional Caregivers in Oral Health Assessment Using the Oral Health Screener: Caregiver-Dentist Agreement and Inter-Rater Reliability.
Vandenbulcke PAI, De Witte D, Schoebrechts E … +5 more , De Lepeleire J, Declercq A, Declerck D, Duyck J, de Almeida Mello J
Gerodontology · 2026 May · PMID 42179168 · Publisher ↗
OBJECTIVE: To evaluate caregiver-dentist agreement and inter-rater reliability of the Oral Health Screener (OHS) following its optimisation for use in long-term care and to examine the effect of different caregiver OHS t...
OBJECTIVE: To evaluate caregiver-dentist agreement and inter-rater reliability of the Oral Health Screener (OHS) following its optimisation for use in long-term care and to examine the effect of different caregiver OHS training modalities. METHODS: This prospective reliability and agreement study was nested within a 2-year cluster-randomised controlled trial in Flemish nursing homes (Belgium). Professional caregivers and dentists independently assessed residents' oral health using the OHS every 6 months across five timepoints, blinded to each other's assessments. Caregivers received either e-learning only (IG1) or e-learning combined with on-site training (IG2). Agreement was analysed using percent agreement, Cohen's kappa, prevalence-adjusted bias-adjusted kappa (PABAK) and logistic generalised linear mixed models (GLMM). RESULTS: Fifty-one caregivers from six facilities and eight dentists assessed 193 residents. Within groups, IG1 showed higher agreement with dentists for self-reported items (GLMM 0.46-0.58) than for inspection-based OHS items (GLMM 0.10-0.48), whereas this difference was less pronounced in IG2 (self-reported items: GLMM 0.45-0.95, inspection-based items: GLMM 0.35-0.92). Comparing groups, GLMM analyses indicated overall higher reliability in IG2 for most items, except for chewing difficulty. Exploratory analyses suggested that longitudinal patterns varied across items. Inter-caregiver reliability analyses were exploratory due to the limited number of paired assessments. CONCLUSION: Non-dental professional caregivers showed acceptable agreement with dentists when assessing residents' oral health using the OHS. Although agreement varied across items due to prevalence and marginal imbalances, the findings suggest the potential added value of training and support when using the OHS as a first-line screening tool in care-dependent older adults. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT06536322 (July 23, 2024).
A Systematic Review and Meta-Analysis of the Global Prevalence of Dry Mouth in Older Adults.
Kamnoedboon P, Spyraki F, Thomson WM … +1 more , Srinivasan M
Gerodontology · 2026 May · PMID 42144904 · Publisher ↗
OBJECTIVE: The objective of this study is to update prevalence estimates for xerostomia and salivary gland hypofunction (SGH) among older adults through a systematic review and meta-analysis. BACKGROUND: Dry mouth is com...
OBJECTIVE: The objective of this study is to update prevalence estimates for xerostomia and salivary gland hypofunction (SGH) among older adults through a systematic review and meta-analysis. BACKGROUND: Dry mouth is common among older adults but is inconsistently assessed and reported. Xerostomia and SGH represent distinct conditions with different diagnostic approaches, leading to heterogeneity in prevalence estimates. MATERIALS AND METHODS: A systematic literature search of Medline (PubMed) and Web of Science was conducted from January 2018 to March 2025. This was supplemented by manual backward citation tracking of the foundational review to identify all eligible pre-2018 epidemiological studies. Only studies utilizing population-representative samples of adults aged 50 years and older with defined diagnostic criteria were included. Risk of bias was formally assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tool for Prevalence Studies. Pooled prevalence estimates were calculated using random-effects meta-analyses. (PROSPERO: CRD420251009592). RESULTS: A total of 37 studies-encompassing over 1.6 million participants-met the inclusion criteria. The pooled global prevalence of xerostomia among older adults was 21% (95% CI: 19%-23%). For SGH, the pooled prevalence measured via UWS was 12% (95% CI: 4%-24%), whereas SWS yielded a prevalence of 13% (95% CI: 3%-28%). High heterogeneity was observed across all analyses. Differences in diagnostic thresholds and saliva collection methods contributed to the observed variability. CONCLUSION: This updated meta-analysis confirms that xerostomia affects around one-fifth of older adults, while SGH is less common, depending on the diagnostic criteria used. Future research should focus on improving diagnostic consistency and sample representativeness to enable more consistent and robust estimates, and thereby better guide prevention and care in geriatric oral health.
Associations Between Multimorbidity, Polypharmacy and Oral Conditions in Older Adults: A Systematic Review and Meta-Analysis.
Srisanoi K, Maniewicz S, Leles CR … +3 more , McKenna G, Müller F, Srinivasan M
Gerodontology · 2026 May · PMID 42144901 · Publisher ↗
OBJECTIVE: This systematic review and meta-analysis evaluated the relationship between multimorbidity and polypharmacy on the oral health in older adults (aged 75 years or older). The PECO focus question set for this stu...
OBJECTIVE: This systematic review and meta-analysis evaluated the relationship between multimorbidity and polypharmacy on the oral health in older adults (aged 75 years or older). The PECO focus question set for this study was, 'What is the occurrence, association and impact of multimorbidity and polypharmacy on the oral conditions and its management in older adults?'. METHODS: Electronic searches of MEDLINE (PubMed), Embase, and the Cochrane Library were conducted using the PECO (Population Exposure Comparison Outcome) framework. About 3433 studies published until April of 2025 were screened. Risk of bias was assessed using the Newcastle-Ottawa Scale. All eligible studies were descriptively analysed; studies that provided sufficient information were meta-analysed. RESULTS: Twenty-three studies [21 cross-sectional and 2 cohort studies] were included. Polypharmacy showed a significant association with dry mouth, as demonstrated by the pooled analysis (OR = 2.05; 95% CI: 1.31-3.22), along with consistent findings linking a higher number of medications to dry mouth and hyposalivation. Poor oral health assessment tool (OHAT) scores were also consistently associated with polypharmacy. In contrast, findings regarding multimorbidity/comorbidity were not consistently associated with dry mouth or with poor OHAT scores. Both exposures showed inconsistent associations with number of teeth, edentulism, and oral function. Quality assessment indicated that the included studies were predominantly at low risk of bias. CONCLUSIONS: Polypharmacy may impact on dry mouth and hyposalivation in older adults, potentially independent of multimorbidity. However, the impact of multimorbidity and polypharmacy on other oral conditions remains unclear. Further high-quality evidence, particularly from longitudinal studies, is needed to clarify these relationships and establish causal associations. TRIAL REGISTRATION: PROSPERO Registration: CRD420251003698.
Adverse Oral Health in Older Adults With Head and Neck Cancer (And Oral Potentially Malignant Disorders): A Systematic Review.
Moore C, Walls N, Abujaber S … +3 more , Willis A, Allen F, McKenna G
Gerodontology · 2026 May · PMID 42144891 · Publisher ↗
OBJECTIVE: This systematic review evaluated oral health, including oral health-related quality of life (OHRQoL), in older adults with head and neck cancer (HANC) or oral potentially malignant disorders (OPMDs). The PICO/...
OBJECTIVE: This systematic review evaluated oral health, including oral health-related quality of life (OHRQoL), in older adults with head and neck cancer (HANC) or oral potentially malignant disorders (OPMDs). The PICO/PECO focus question for this study was: 'What is the incidence/prevalence of adverse oral health (O) among people aged 60 years or older (P) who have been diagnosed with HANC or an OPMD (E), relative to people aged 60 years or older who have not been diagnosed with HANC or an OPMD, or younger people aged less than 60 years who have been diagnosed with HANC or an OPMD (C)?' METHODS: A comprehensive literature search was performed across PubMed, OVID Medline, CENTRAL and Embase, guided by the PICO/PECO framework. Publications from 1960 up to April 2025 were considered, yielding 1070 records for initial screening. RESULTS: A total of eight studies were included for analysis. A narrative review only was presented. Findings from the included studies demonstrated conflicting results. Two cross-sectional studies demonstrated better post-treatment OHRQoL across some domains for older patients with HANC than younger patients; however, this was contradicted by data from two prospective cohort studies which showed no differences in post-treatment OHRQoL between older and younger patients with a history of HANC. Findings from a different prospective cohort study demonstrated a linear relationship between HANC patients' age and the incidence of post-radiotherapy moderate-severe xerostomia. There were no data on oral health consequences among older adults with OPMDs. CONCLUSIONS: This systematic review revealed inconclusive findings on the impact of HANC and OPMD on oral health in older adults. PROSPERO REGISTRATION: CRD420251003419.
Grading in Gerodontology: A Framework.
Schwendicke F, McKenna G, Müller F … +25 more , Bell A, Chebib N, Da Mata C, Dujic H, Gallagher J, Janssens B, Layton DM, Kanazawa M, Kossioni A, Maniewicz S, Matsuo K, Mourelle PM, Neri A, Ono T, Pojmonpiti S, Spyraki F, Srisanoi K, Syed SS, Tada S, Tsakos G, Walton TR, Thomson WM, Haesler JP, Dartevelle S, Srinivasan M
Gerodontology · 2026 May · PMID 42144884 · Publisher ↗
INTRODUCTION: Understanding and anticipating oral health deterioration in older adults requires more than describing their current oral and general health. Risk factors arising from oral, systemic and social domains stro...
INTRODUCTION: Understanding and anticipating oral health deterioration in older adults requires more than describing their current oral and general health. Risk factors arising from oral, systemic and social domains strongly influence disease progression, care complexity and the ability to maintain function over time. We aimed to establish a framework for staging and grading oral health and disease in older adults, with grading systematically assessing and describing determinants of oral health deterioration. The developed framework is intended to support care planning, education, research and health-service policy. METHODS: Eight reviews examining oral, systemic and social risk factors for worsening oral health in older adults informed framework development. Additional existing reviews were also considered. A 2.5-day international workshop involving 31 experts from 13 countries was conducted, during which structured subgroup discussions and Delphi-style anonymous voting were used to refine and agree on the framework. Consensus was predefined at 75% agreement, and that was subsequently reached for all statements in a single voting round. The current paper presents the grading aspect of the developed framework; it should be used jointly with the paper on staging oral health in older adults. RESULTS: Grading encompasses three levels of risk factors: (1) oral-level factors such as dental caries risk, periodontitis risk and risks associated with the maintenance of existing dental prostheses; (2) systemic-level factors including xerostomia, multimorbidity, polypharmacy and nutritional aspects and (3) social-level factors such as social status and social support. Together, these domains reflect the likelihood of oral health deterioration, the intensity and frequency of required supportive care and the potential complexity of clinical management. Grading complements staging-which describes the current oral health status-by identifying the underlying risks shaping each older adult's oral health trajectory. CONCLUSION: Grading provides a structured, evidence-based method for assessing risk and care complexity in older adults. When combined with staging, it should enable clinicians, caregivers and policymakers to classify cases comprehensively, tailor preventive and supportive interventions, and inform resource planning, surveillance, research and education. Future work should focus on validating, disseminating and implementing the framework across diverse care settings.
Functional Outcomes of Prosthetic Rehabilitation in Older Adults With Tooth Loss: A Systematic Review and Meta-Analysis.
Molinero-Mourelle P, Bell A, Chebib N … +6 more , Kanazawa M, Müller F, Neri A, Ono T, Shiramizu M, Tada S
Gerodontology · 2026 May · PMID 42144881 · Publisher ↗
OBJECTIVES: To assess the effect of prosthodontic treatment and management on oral function and oral-health-related patient reported outcome measures (PROMs) in older adults with tooth loss. METHODS: A systematic search...
OBJECTIVES: To assess the effect of prosthodontic treatment and management on oral function and oral-health-related patient reported outcome measures (PROMs) in older adults with tooth loss. METHODS: A systematic search of four databases identified clinical studies (≥ 10 participants) reporting functional or PROM outcomes in partially or fully edentulous adults ≥ 65 years rehabilitated with dental prostheses for ≥ 6 months. Pooled standardized mean differences in pre-post changes were estimated by prosthesis type and follow-up using random-effects models (REML), with heterogeneity assessed by Cochran's Q and I (p < 0.05). RESULTS: From an initial 7654 studies, 24 were included in this review, covering 1711 individuals. Fourteen studies assessed masticatory performance (MP), masticatory ability (MA), and maximum bite force (MBF). Complete dentures (CDs) showed modest functional improvement, while implant overdentures (IODs) consistently produced higher MP and MBF with significant long-term improvements. Eighteen studies evaluated OHRQoL using OHIP variants, OIDP, and modified GOHAI-11. IODs and fixed full-arch prostheses showed the greatest improvements, while CDs and removable partial dentures were associated with smaller but positive changes. Subjective MA improved over 6-12 months post insertion in regardless groups, with high heterogeneity. OHRQoL showed short-term benefits of implant-supported prostheses, particularly for OHIP-20, while OHIP-14 results were inconsistent over time, indicating more reliable functional and patient-reported outcomes with dental implants. CONCLUSIONS: Tooth loss leads to functional and psycho-social limitations, and although restorative measures can alleviate these shortcomings, they require ongoing maintenance, highlighting the complexity of care in this vulnerable older population. TRIAL REGISTRATION: PROSPERO International prospective register of systematic reviews (CRD420251077683).
Coronal and Root Caries in Older Adults: Associated Factors, Quality of Life Impact, and Treatment-A Scoping Review.
Dujic H, Heck K, Schwärzler J … +3 more , da Mata C, Tada S, Schwendicke F
Gerodontology · 2026 May · PMID 42138019 · Publisher ↗
BACKGROUND: Dental caries remains one of the most common chronic diseases affecting older adults worldwide. As edentulism decreases and more natural teeth are retained into old age, the number of susceptible tooth surfac...
BACKGROUND: Dental caries remains one of the most common chronic diseases affecting older adults worldwide. As edentulism decreases and more natural teeth are retained into old age, the number of susceptible tooth surfaces increases. Age-related factors such as polypharmacy, cognitive decline, and reduced oral hygiene skills, together with systemic and social factors, increase the risk of caries. Although the literature is extensive, the evidence for diagnosis and management remains fragmented and lacking clinical integration. OBJECTIVE: This scoping review aimed to assess and map current evidence on caries diagnostics and management in adults aged 60 years and older, focusing on diagnostic indices, associated factors, treatment strategies and outcomes, as well as oral health-related quality of life (OHRQoL). METHODS: A comprehensive search of MEDLINE, Embase, and the Cochrane Library identified 533 studies published between 2000 and 2025. Eligible studies included data on caries occurrence, incidence, increment, factors associated with caries, treatment, and OHRQoL in older adults. RESULTS: Most studies focused on caries occurrence and associated factors, with DMFT being the most common index. Reported caries proportions varied widely across studies (0.1%-100%). Seventy-five distinct variables were identified covering multiple domains, with older age, sex, and lower education being the most frequently cited. Only seven studies reported using risk assessment tools. Treatment strategies were less frequently addressed and often lacked feasibility or outcome metrics. OHRQoL was reported in 98 studies, mostly using GOHAI and OHIP. CONCLUSION: Current evidence focuses largely on epidemiological endpoints. Future studies should prioritize patient-relevant outcomes and include frail and dependent populations. TRIAL REGISTRATION: PROSPERO: CRD420251004339.
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