Oral health: integral component of overall health and important determinant of ageing

Oral health: integral component of overall health and important determinant of ageingConsiderable research has focused on the role of oral health in overall health and the ageing process. 1 Oral health and periodontal disease have been linked with conditions such as Alzheimer's disease, cancer, cardiovascular diseases, diabetes, inflammatory bowel disease, osteoporosis, pneumonia, and rheumatoid arthritis. 2Additionally, the association between poor oral health, periodontal disease, and increased mortality and frailty is well documented. 3Furthermore, poor oral health or oral frailty is associated with the development of physical frailty, physical disability, and systemic comorbidities. 4 Fewer teeth or severe tooth loss are key factors in the oral frailty index. 3,4Owing to the differences in health-care systems, 5 socioeconomic status, and societal values across regions, the prevalence and distribution of tooth loss or poor oral health conditions can differ across countries and continents. 6 Possible mechanisms linking poor oral health to an increased mortality risk include exacerbated immune responses or infection due to oral microbial dysbiosis, unresolved chronic inflammation, nutritional deficiencies, physical frailty, difficulties in social interactions that might make seeking oral care more challenging, 7 and disruptions to mental wellbeing. 1,2A new perspective advocating for a systems approach to ageing biology has been suggested-namely, the integrative emergence of hierarchical organisation, network dynamics, and resilience. 8The relationship between oral health and the development of frailty or functional disability, particularly in ageing populations, requires further study.Four categories of oral frailty indicators have been described and associated with systemic outcomes: oral health status deterioration; decline in oral motor skills; chewing, swallowing, and saliva disorders; and oral pain. 3However, high-quality research examining these factors in relation to functional disability and mortality within the same study cohort is scarce. 1 The study by T Abe 1 in The Lancet Healthy Longevity addresses this gap with a thorough investigation into the role of four key oral health factors-namely, masticatory function, oral hygiene, number of remaining teeth, and periodontal status-in predicting functional disability and mortality among older Japanese individuals.Their findings