Oral health care interventions on objective indicators of oral frailty in older adults: a systematic review and meta-analysis

Abstract Background Oral frailty is a significant risk factor for systemic frailty and poor health outcomes in older adults. While oral health care interventions may mitigate this decline, the evidence remains fragmented. This study evaluates the effectiveness of oral health care interventions in improving oral frailty indicators among older adults. Methods We searched PubMed, Embase, CIHNAL, Cochrane Library, Web of Science, and Scopus for randomized controlled trials and quasi-experimental studies assessing oral health care interventions in older adults aged ≥ 60 years. Outcomes included oral frailty indicators such as tongue pressure, chewing ability, swallowing ability, and dry mouth. Meta-analysis was performed using Review Manager software (version 5.4) with random-effects models. Statistical heterogeneity was assessed using the I² statistic and the χ² test. The systematic review was registered on PROSPERO (CRD420251067147). Results 18 studies (n = 1133) were included. Interventions statistically significantly improved tongue pressure (SMD = 0.54, P = 0.004), chewing ability (bite force: SMD = 0.40, P = 0.04, masticatory performance: SMD = 0.61, P = 0.03), swallowing ability (objective swallowing physiology: SMD = 0.51, P = 0.003), and dry mouth (MD = 0.13, P < 0.001). Subgroup analyses indicated differential effects based on intervention type and duration. Conclusion Oral health care interventions, particularly oral exercises, may effectively improve oral frailty indicators in older adults. In clinical practice, the most evidence-based interventions should be prioritized and tailored to individual responses.