• Journal of dental hygiene science
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• v.23 no.4
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• pp.378-388
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• 2023

Background: With increasing interest in health in old age, aspects of oral aging are being considered. The Korean Academy of Geriatric Dentistry recently proposed the diagnostic criteria for oral frailty in older adults in Korea. This study aimed to conduct a cross-sectional survey of factors related to oral frailty among community-dwelling older adults and identify differences in oral frailty status according to age and sex. Methods: Among 217 older adults aged ≥60 years who visited a senior center in Wonju, 206 completed all tests for oral frailty. Among them, data from those with a Korean Version of the Modified Barthel Index score ≥90 were used in the final analysis. After evaluating oral frailty diagnostic factors such as chewing ability, occlusal force, tongue pressure, oral dryness, oral cleanliness, and swallowing function, oral hypofunction was determined according to the oral frailty diagnostic criteria. Subsequently, the evaluation results were compared based on sex and age. Results: Significant differences in chewing ability, maximum occlusal pressure, and maximum tongue pressure were observed between sexes. However, these differences did not affect oral frailty diagnosis. All diagnostic factors of oral frailty, except for the risk of oral dryness and swallowing dysfunction, showed significant differences with age. However, no significant difference was observed in the prevalence of oral frailty. Additionally, this study found no relationship between sex and oral frailty factors using the oral frailty diagnostic criteria. However, it also found that age plays a significant role as an oral frailty diagnostic indicator, in addition to oral dryness and swallowing function. Conclusion: Sex and age did not affect oral frailty diagnosis. However, patients' chewing ability, occlusal force, and tongue pressure were affected by sex and age. Therefore, sex and age should be considered when diagnosing and intervening in oral frailty in the future.

• Journal of dental hygiene science
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• v.24 no.1
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• pp.1-8
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• 2024

Background: Oral frailty is defined as the functional decline of the oral function due to aging, and it is associated with frailty and chronic disease. Most of the frailty intervention is for adults aged 65 years and older. However, early intervention for preventive disorder is most important. The objective of this study was to identify the age at which oral frailty surpass the "normal" range. Methods: This cross-sectional study included 719 adults (aged 30~89 years) residing in Gangwon province in May 2023. Risk of oral frailty was assessed using criteria from The Korean Academy of Geriatric Dentistry including oral function such as swallowing and mastication, and frailty. Frailty was assessed using the Kihon Checklist. To determine when oral frailty surpass the "normal" status, statistical analysis including chi-squared tests and multiple logistic regression analysis were performed using R (ver. 4.3.1). Results: There were 388 (54.0%) individuals who had a "normal" status risk of oral frailty. The risk of oral frailty was higher in the 50~54 age group compared to the 30~34 age group (odds ratio [OR] 0.50, 95% confidence interval [CI] 0.28~0.91), after adjusting for gender, education, income, occupation, and frailty (OR 0.46, 95% CI 0.22~0.94). This means that from 50~54 years old, regardless of gender, education, income, occupation, or frailty condition, there is a distinction from the "normal" status. Conclusion: We found that intervention for oral frailty is needed starting from age 50 years. This is the stage where early indications of oral frailty become apparent. Early intervention for oral frailty can lead to a decrease in the prevalence of diseases and medical expenditure. Therefore, early intervention in middle-aged adults of oral frailty is necessary to improve the quality of life related to oral health.

• Journal of Korean society of Dental Hygiene
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• v.20 no.3
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• pp.347-357
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• 2020

Objectives: The purpose of the study was to investigate the relationship between frailty and oral health among some elderly community residents. Methods: A self-reported questionnaire was completed by 240 elderly in the Gwangju-Jeonnam area from October 1, 2019, to November 30, 2019, based on convenience sampling. The questionnaire consisted of general characteristics of the subjects, frailty level (Kihon checklist), and Geriatric Oral Health Assessment Index. Results: There were 66 (27.5%) frail elderly, and the GOHAI group with a score less than 45 constituted 187 (77.9%), which was higher than the group with a score of 45 or higher. The distribution of the frail elderly was indicated to be higher in the people with older age (p<0.05), lower educational level (p<0.01), current economic inactivity (p<0.05), living alone (p<0.01), more chronic diseases (p<0.01), and GOHAI score below 45 (p<0.01). Compared to those with a good oral health-related quality of life, those with a poor quality of life showed a 3.03 times higher risk of frailty (95% CI=1.291-7.107)(p<0.05). Conclusions: By recognizing the need for oral health care of the elderly through these results and by identifying the relationship between frailty and oral health, it is possible to consider oral health as a predictor of frailty.

• Journal of dental hygiene science
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• v.23 no.4
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• pp.320-329
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• 2023

Background: Oral frailty has garnered considerable interest following its identification as a risk factor for physical frailty. The Korean oral frailty diagnosis criteria have emphasized the need for extensive research on oral frailty diagnostic items and interventions. Our study performed an in-depth analysis of the tongue-palate pressure patterns in healthy community-dwelling older adults. Methods: Of the 217 older adults aged ≥60 years who visited a senior center in Wonju, 205 participants who completed tongue pressure measurement were included in the final analysis. Pressure changes over time were recorded by instructing the participants to press their tongue against the hard palate with for 7 seconds per cycle. The participants were divided into the normal and abnormal tongue pressure (NTP and ATP, respectively) groups based on whether they achieved the target tongue pressure at least once; tongue pressure patterns were compared between the groups. Furthermore, the average time taken to achieve the standard tongue pressure value was calculated for the participants in the NTP group and used to evaluate the decrease in tongue pressure in the ATP group. Results: Among the 205 participants, 40.5% had ATP. The tongue pressure graph revealed a gentle and consistent incline that was maintained even after achieving standard tongue pressure in the NTP group. The graph was more extreme in the ATP group, and the changes in the pressure type varied across individuals; the tongue pressure was only 48.4%, 40.7%, 31.9%, and 22.6% of the NTP in the participants in their 60s, 70s, 80s, and ≥90s, respectively (p<0.05). Conclusion: Tongue pressure weakness was observed in 40.5% of the healthy community-dwelling older adults. Furthermore, ATP graphs were observed in the patients with tongue pressure weakness. Thus, activities improving the oral function in community-dwelling older adults and systematic oral rehabilitation programs should be devised to promote normal swallowing.

• Journal of Korean society of Dental Hygiene
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• v.24 no.2
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• pp.109-119
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• 2024

Objectives: This study aimed to confirm the correlation between oral frailty and health-related quality of life (HINT-8) among older adults in Korea. Methods: The data of 1,318 individuals aged ≥65 years who participated in the eighth Korean National Health and Nutrition Examination Survey (2019) were analyzed using complex sample statistical analysis. Results: Chewing discomfort was found to decrease the HINT-8 scores by 1.246, 1.324, and 1.089 times in the physical, social, and mental domains, respectively. Speech discomfort was found to decrease the HINT-8 scores by 1.275, 1.449, and 1.175 times in the physical, social, and mental domains, respectively. The HINT-8 scores of participants with ≤19 natural teeth were lower in the physical and social domains. Similarly, the HINT-8 scores of participants with brushing frequency of ≤2 were lower in the positive health domain. Non-use of oral hygiene products led to a reduction in the HINT-8 score in the social health domain. Conclusions: Oral frailty in older adults reduces the health-related quality of life. Thus, it is necessary to formulate policies to manage oral frailty in this population and develop specialized programs for the management of oral frailty.

• Journal of the Korea Convergence Society
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• v.13 no.2
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• pp.47-54
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• 2022

The purpose of this study was to analyze the effect of masticatory ability on frailty in the elderly. General characteristics, subjective and objective masticatory ability, and frailty level were investigated in 224 elderly. The major findings were as; There were differences in masticating ability according to age, education level, employment status, living arrangement, and maxillary & mandibular dentures. The masticatory ability of the non-frail elderly was significantly higher than the frail elderly. The risk ratio of frailty was 2.33 times higher in subjects with poor mastication compared to subjects with good mastication ability. Also, as a result of adjusting for age, the risk ratio of frailty in the poor group was 2.30 times higher than in the group with good mastication ability. Through this, it is thought that the masticatory ability of the elderly is one of the predictors of frailty, and efforts to achieve healthy aging by preventing senescence through oral health management at the community level are thought to be necessary.

• Journal of dental hygiene science
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• v.23 no.4
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• pp.302-311
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• 2023

Background: Oral health is an important element of well aging. And oral health also affects overall health, mental health, and quality of life. In this study, we sought to identify oral health influencing factors and research trends for well-aging through text analysis of research on well-aging and oral health over the past 12 years. Methods: The research data was analyzed based on English literature published in PubMed from 2012 to 2023. Aging well and oral health were used as search terms, and 115 final papers were selected. Network text analysis included keyword frequency analysis, centrality analysis, and cohesion structure analysis using the Net-Miner 4.0 program. Results: Excluding general characteristics, the most frequent keywords in 115 articles, 520 keywords (Mesh terms) were psychology, dental prosthesis and Alzheimer's disease, Dental caries, cognition, cognitive dysfunction, and bacteria. Research keywords with high degree centrality were Dental caries (0.864), Quality of life (0.833), Tooth loss (0.818), Health status (0.727), and Life expectancy (0.712). As a result of community analysis, it consisted of 4 groups. Group 1 consisted of chewing and nutrition, Group 2 consisted oral diseases, systemic diseases and management, Group 3 consisted oral health and mental health, Group 4 consisted oral frailty symptoms and quality of life. Conclusion: In an aging society, oral dysfunction affects mental health and quality of life. Preventing oral diseases for well-aging can have a positive impact on mental health and quality of life. Therefore, efforts are needed to prevent oral frailty in a super-aging society by developing and educating systematic oral care programs for each life cycle.

• Research in Community and Public Health Nursing
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• v.27 no.1
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• pp.51-59
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• 2016

Purpose: The purpose of this study is to provide a disease management, nutrition education, and group exercise program for three months to the moderately frail elderly whose physical functions have deteriorated, and to investigate its effects in order to develop an intervention program. Methods: As a quasi-experiment, this study was conducted based on non-equivalence studies designed as a similar experiment. The milk intake group and calcium intake group participated in the disease education, individual nutrition education, and group exercise program for three months, and the control group was visited once in the three months by a nurse who provided disease education, nutrition education, and oral instruction of exercise, and asked them to exercise on their own every day. For the data analysis, ${\chi}^2$-test, ANOVA and $Scheff{\acute{e}}$ test were used. Results: After three months of intervention, there was a significant difference in the frailty level (p=.029) and bone density (p=.001) between the groups. Conclusion: The comprehensive intervention program had an effect on the bone density and the frailty level of the socially-vulnerable and moderately frail elderly, suggesting that the program can be used as a nursing intervention to prevent functional deterioration and damage of the moderately frail elderly.

• Journal of Korean Dental Science
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• v.16 no.2
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• pp.128-148
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• 2023

Dementia is an umbrella term that describes the loss of thinking, memory, attention, logical reasoning, and other mental abilities to the extent that it interferes with the activities of daily living. More than 50 million individuals worldwide live with dementia, which is expected to increase to 131 million by 2050. Recent research has shown that poor oral health increases the risk of dementia, while oral health declines with cognitive decline. In this narrative review, the literature was based on the "hypothesis" that dementia and oral health have a close relationship, and appropriate oral health and occlusal rehabilitation treatment can improve the quality of life of patients with dementia and prevent progression. We conducted a literature search in PubMed and Google Scholar databases, using the search terms "dementia," "major neurocognitive disorder," "dentition," "occlusion," "tooth loss," "dental prosthesis," "dental implant," and "occlusal rehabilitation" in the title field over the past 30 years. A total of 131 studies that scientifically addressed dementia, oral health, and/or oral rehabilitation were included. In a meta-analysis, the random effect model demonstrated significant tooth loss increasing the dementia risk 3.64-fold (pooled odds ratio=3.64, 95% confidence interval [2.50~5.32], P-value=0.0348). Tooth loss can be an important indicator of cognitive function decline. As the number of missing teeth increases, the risk of dementia increases. Loss of teeth can lead to a decrease in the ascending information to the brain and reduced masticatory ability, cerebral blood flow, and psychological atrophy. Oral microbiome dysbiosis and migration of key bacterial species to the brain can also cause dementia. Additionally, inflammation in the oral cavity affects the inflammatory response of the brain and the complete body. Conversely, proper oral hygiene management, the placement of dental implants or prostheses to replace lost teeth, and the restoration of masticatory function can inhibit symptom progression in patients with dementia. Therefore, improving oral health can prevent dementia progression and improve the quality of life of patients.