Int J Stomatol ›› 2026, Vol. 53 ›› Issue (2): 155-165.doi: 10.7518/gjkq.2026118

• Expert Forum • Previous Articles    

Oral frailty in the elderly: comprehensive review from concept to intervention

Chang Liu(),Minquan Du()   

  1. State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, Dept. of Preventive Dentistry, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
  • Received:2025-08-01 Revised:2025-11-25 Online:2026-03-01 Published:2026-02-13
  • Contact: Minquan Du E-mail:liuc0728@whu.edu.cn;duminquan@whu.edu.cn
  • Supported by:
    Project of China Oral Health Foundation(ZS202501);2025 College Students’ Innovation and Entrepreneurship Project(S202510486504)

Abstract:

With the rapid increase in global aging population, oral health challenges among older adults require attention. As an emerging geriatric syndrome, oral frailty (OF) exhibits significant bidirectional associations with systemic health, severely influencing the functional status and quality of life among the elderly. This article presents a comprehensive review of the concept of OF, its epidemiological status, standardized assessment tools, and multidisciplinary intervention strategies. It outlines future research directions to offer comprehensive insights for clinical practice and scientific studies.

Key words: aging, oral frailty, assessment tool, comprehensive intervention

CLC Number: 

  • R787

TrendMD: 

Fig 1

Risk factors of OF"

Fig 2

OF-physical frailty pathway"

Fig 3

OF-psychosocial pathway"

Tab 1

Assessment tools of OF"

名称内容标准应用局限性
OF-6[5]

1)牙数减少(<20颗);

2)咀嚼力减弱(男性<14.2,女性<10.8);

3)舌压降低(男性<27.4 kPa,女性<26.5 kPa);

4)发音技能减退(男性<5.2次/s,女性<5.4次/s);

5)主观进食硬食物困难:询问“与半年前相比吃硬的东西是否比较困难”,若答“是”,则为阳性;

6)主观吞咽流质食物困难:询问“喝茶或汤是否会呛”,若答“是”则为阳性

符合1~2项指标为OF前期,3项及以上指标为OF用于快速筛查老年人OF情况;国外常用

1)需要专业的仪器和牙科卫生人员,耗时长,不易在社区普及进行大样本调查;

2)该量表主要基于日本老年人群开发,其跨文化适用性及对其他国家和地区老年人群的适用程度仍需后续研究验证

OFI-8[8]

1)与6个月前相比吃硬食物更困难;

2)最近喝茶喝汤会出现呛咳;

3)使用义齿;

4)经常感到口干;

5)外出次数是否比半年前少;

6)不能够咀嚼硬食物;

7)不是每天至少刷牙2次;

8)不是每年至少看1次牙医

前3项每项2分,其余5项每项1分,总分11分,≤2分为低风险,3分为中风险,≥4分为高风险即OF。量表评分每增加1分,就会导致OF发病率升高至原来的2.3倍,残疾发生风险提升至2.1倍

1)汉化OFI-8的信效度较好;

2)操作简易,无设备依赖;

3)筛查时效性;

4)场景适配度高;

5)中国最常用OFI-8

缺乏客观指标,若需确切诊断口腔问题,需更精确、更客观的口腔功能数据评估指标
OF-5[7]

1)牙数减少(<20颗);

2)与6个月前相比吃硬食物更困难;

3)最近喝茶喝汤会呛咳;

4)经常感到口干;

5)最近在发音清晰方面遇到困难,如果条件允许,测量重复发音(“ta”)频率

2项及以上即可诊断,发音(“ta”)频率<6.0次/s对身体虚弱、身体残疾和死亡率具有很强的预测效度,用于确定OF的患病率及其与多种不良健康结局相关性需要考虑地区差异
OMFI[36]

1)咀嚼困难;

2)进食干硬食物时需饮水;

3)下颌及舌运动困难;

4)语音障碍;

5)不能做面部表情

每个条目1~4分,分数越高表示口腔及颌面衰弱情况越严重具有良好的效度和信度,主要关注评估口腔及颌面部的功能,涵盖口腔干燥、牙齿状况及颌面部肌力等,详细评估口腔和颌面部的功能状态,并包括多个与OF相关的具体指标

1)该量表对吞咽功能及牙齿、舌头等部位的健康状况评估不足;

2)评估内容较为复杂,耗时长,需要专业操作

韩国老年牙科学会(Korean Academy of Geriatric Dentistry,KAGD)OF诊断量表[32]

1)咀嚼能力:通过咀嚼变色口香糖获得的色卡值被判定为1级或2级;

2)咬合力:使用Dental Pre-scaleⅡ?测量的咬合力低于500 N;

3)舌压:通过JMS舌压仪?测得的最大舌压低于30 kPa;

4)口腔干燥度:使用Mucus?仪器测得数值低于27.0;

5)吞咽困难:改良饮水测试得分≤3分;

6)口腔卫生:口腔健康评价工具(oral health assessment tool,OHAT)评分≥2分

2项及以上为OF该筛查问卷筛查OF具有显著效力(受试者工作特征曲线下面积为0.783;敏感性为87.8%;特异性为52.5%),诊断标准诊断准确性可接受(敏感性为95.1%;特异性为42.4%)诊断需要工具,耗时长

Tab 2

OF training methods for oral frailty intervention"

名称作用方法适用人群
张口训练[39]增强口腔肌肉灵活性和力量尽可能张大嘴保持10 s,休息10 s,早晚各2次,共5周期/d咀嚼、发音或吞咽困难者,尤其推荐给30 s内重复唾液吞咽试验(repeated saliva swallowing test,RSST)评分<3分者
舌压(抗阻)训练[39,42]可增强舌骨上肌群力量,显著提升舌压、吞咽功能及舌唇协调性,改善OF状态

1)器械辅助训练:使用硅胶舌压训练器推压硬腭,使器械头部受压塌陷保持后复位,每日训练3组(每组5次);

2)徒手训练:用力推舌抵上腭维持10 s(10次/组,2组/d),或结合舌部定向旋转(左/上/右/下)及吞咽练习(3组/次,2次/d,每周3 d),持续12周

吞咽/发音困难或颞下颌关节症状者,舌压<30 kPa者
韵律训练[39]最大化唇舌运动,改善舌骨运动、舌压和食管上括约肌宽度快速清晰响亮地发/ma/、/ba/、/ta/、/te/、/ka/音,每日2次,每次5遍口头轮替运动速率<6次/s者适宜
咀嚼训练[39]提升咀嚼能力,改善OF

1)直立状态下早晚咀嚼无糖口香糖,先节律性咀嚼2 min,后自由咀嚼3 min,持续12周;

2)每月1次的特殊粗制午餐(选用坚硬或粗糙的谷类、果蔬配料,切成大块,缩短烹饪时间并减少用水量),连续6个月

牙龈测试评分<3分者
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