Healthy Aging pp 213-226 | Cite as

Oral Health and Healthy Aging

  • Sarah J. Dirks
  • Michael Monopoli


Historically, oral health has been segregated from overall health. Throughout the lifespan, poor oral health adds to overall disease burden and lower quality of life. Understanding the relationship between oral health, general health, and aging provides new opportunities to prevent disease and promote healthy aging. Good oral health is important from a cosmetic, functional, and disease perspective. Good oral health facilitates good nutrition which is critical in promoting healthy aging. Non-dental practitioners should address oral health as a component of an annual wellness visit.


Oral health Dental disease Xerostomia Periodontal disease Tooth decay Tooth loss Dentistry Oral cancer Candidiasis Oral infection Oral health-related quality of life 


  1. 1.
    Abad C, Haleem A. Prosthetic joint infections: an update. Curr Infect Dis Rep. 2018;20(7):15. Scholar
  2. 2.
    Abe S, Ishihara K, Adachi M, Sasaki H, Tanaka K, Okuda K. Professional oral care reduces influenza infection in elderly. Arch Gerontol Geriatr. 2006;43(2):157–64. Epub 2005 Dec 2.CrossRefGoogle Scholar
  3. 3.
    Adachi M, Ishihara K, Abe S, Okuda K. Professional oral health care by dental hygienists reduced respiratory infections in elderly persons requiring nursing care. Int J Dent Hyg. 2007;5(2):69–74.CrossRefGoogle Scholar
  4. 4.
    Alian A, McNally M, Fure S, Birkhed D. Assessment of caries risk in elderly patients using the cariogram model. J Can Dent Assoc. 2006;72(5):459–63.PubMedGoogle Scholar
  5. 5.
    AMDA. Oral health in the long-term care setting. Soci for Post-Acute and Long-Term Care Medicine. 2013. Manual purchased at:
  6. 6.
    American Dental Association. Antibiotic prophylaxis prior to dental procedures. Oral health topics 2017. Accessed 5/11/18.
  7. 7.
    Aminoshariae A, Kulild J, Donaldson M, Hersh E. Evidence-based recommendations for analgesic efficacy to treat pain of endodontic origin: a systematic review of randomized controlled trials. J Am Dent Assoc. 2016;147(10):826–39. Epub 2016 July 28.CrossRefPubMedGoogle Scholar
  8. 8.
    Azarpazhooh A, Leake JL. Systematic review of the association between respiratory diseases and oral health. J Periodontol. 2006;77(9):1465–82.CrossRefGoogle Scholar
  9. 9.
    Bacci C, Maglione M, Favero L, Perini A, Di Lenarda R, Berengo M, Zanon E. Management of dental extraction in patients undergoing anticoagulant treatment. Results from a large, multicentre, prospective, case-control study. Thromb Haemost. 2010;104(5):972–5. Epub 2010 Aug 30. Accessed 2/2/18.CrossRefPubMedGoogle Scholar
  10. 10.
    Bolland M, Hay D, Grey A, Reid I, Cundy T. Osteonecrosis of the jaw and bisphosphonates—putting the risk in perspective. N Z Med J. 2006;119(1246). ISSN 1175 8716 NZMJ 1, Page 1 of 6 URL: © NZMA. Accessed 5/11/2018.
  11. 11.
    Bonfá K, Mestriner S, Fumagalli I, Mesquita L, Bulgarelli A. Perception of oral health in home care of caregivers of the elderly. Revista Brasileira de Geriatria e Gerontologia. 2017;20(5):650–9. Scholar
  12. 12.
    Brennan M, Treister N, Schmidt B, Patton L, Simpson L, Voelker H, Hodges J, Lalla R. Dental disease before radiotherapy in patients with head and neck cancer patients. JADA. 2017;148(12):868–77.PubMedGoogle Scholar
  13. 13.
    Burks C, Jones C, Braz V, Swor R, Richmond N, Hwang K, Hollowell A, Weaver M, Platts-Mills T. Risk factors for malnutrition among older adults in the emergency department: a multicenter study. J Am Geriatr Soc. 2017;65:1741–7. 0002-8614/2017.CrossRefGoogle Scholar
  14. 14.
    Calvo J, Chávez EM, Jones J. Financial roadblocks to oral health for older adults. Generations. 2016;40(3):85–9. Scholar
  15. 15.
    Cardoso EM, Reis C, Manzanares-Céspedes MC. Chronic periodontitis, inflammatory cytokines, and interrelationship with other chronic diseases. Postgrad Med. 2018;130(1):98–104. Epub 2017 Nov 8. Accessed 2/2/18.CrossRefPubMedGoogle Scholar
  16. 16.
    Carey CM. Tooth whitening: what we now know. J Evid Based Dent Pract. 2014;(14 Suppl):70–6. Epub 2014 Feb 13. Review. Accessed online 5/25/18.
  17. 17.
    Chalmers J, Johnson V, Tang JH, Titler MG. Evidencebased protocol: oral hygiene care for functionally dependent and cognitively impaired older adults. J Gerontol Nurs. 2004;30(11):5–12.CrossRefGoogle Scholar
  18. 18.
    Clark M, Douglass A, Maier R, Deutchman M, Douglass J, Gonsalves W, Silk H, Tysinger J, Wrightson A, Quinonez R, Dolce M, Bowser J. Smiles for life: a national oral health curriculum. 3rd ed. Society of Teachers of Family Medicine. 2010. Available at:
  19. 19.
    Cochran D. Inflammation and bone loss in periodontal disease. J Periodontol. 2008;79(8 Suppl):1569–76. Scholar
  20. 20.
    Colterjohn T, de Beer J, Petruccelli D, Zabtia N, Winemaker M. Antibiotic prophylaxis for dental procedures at risk of causing bacteremia among post-total joint arthroplasty patients: a survey of Canadian orthopaedic surgeons and dental surgeons. J Arthroplast. 2014;29:1091–7.CrossRefGoogle Scholar
  21. 21.
    Compain H, Berquet A, Loison-Robert L, Ahossi V, Zwetyenga N. Duration of treatment with bisphosphonates at the time of osteonecrosis of the jaw onset in patients with rheumatoid arthritis. Review. J Stomatol Oral Maxillofac Surg. 2018. pii: S2468–7855(18)30001–6. Accessed 2/2/18.
  22. 22.
    Delwel S, Binnekade T, Perez R, Hertogh C, Scherder E, Lobbezoo F. Oral health and orofacial pain in older people with dementia: a systematic review with focus on dental hard tissues. Clin Oral Investig. 2017;21(1):17–32. Epub 2016 Sept 8.CrossRefPubMedGoogle Scholar
  23. 23.
    Delwel S, Binnekade T, Perez RS, Hertogh C, Scherder E, Lobbezoo F. Oral hygiene and oral health in older people with dementia: a comprehensive review with focus on oral soft tissues. Clin Oral Investig. 2018;22(1):93–108. Epub 2017 Nov 1.CrossRefPubMedGoogle Scholar
  24. 24.
    Doganay O, Atalay B, Karadag E, Aga U, Tugrul M. Bleeding frequency of patients taking ticagrelor, aspirin, clopidogrel, and dual antiplatelet therapy after tooth extraction and minor oral surgery. J Am Dent Assoc. 2018;149(2):132–8.CrossRefGoogle Scholar
  25. 25.
    Dye BA, Thornton-Evans G, Li X, Iafolla TJ. Dental caries and tooth loss in adults in the United States, 2011–2012. NCHS Data Brief. 2015;(197):1–8.
  26. 26.
    Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco RJ. CDC Periodontal Disease Surveillance workgroup. Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res. 2012;91:914–20.CrossRefGoogle Scholar
  27. 27.
    Ettinger RL. The role of the dentist in geriatric palliative care. J Am Geriatr Soc. 2012;60(2):367–8.CrossRefGoogle Scholar
  28. 28.
    Furuta M, Yamashita Y. Oral health and swallowing problems. Curr Phys Med Rehabil Rep. 2013;1(4):216–22. Scholar
  29. 29.
    Geist S, Geist J. Improvement in medical consultation responses with a structured request form. J Dent Educ. 2008;72(5):553–61.PubMedGoogle Scholar
  30. 30.
    Gerritsen A, Allen F, Witter D, Bronkhorst E, Creugers N. Tooth loss and oral health-related quality of life: a systemic review and meta-analysis. Heath Qual Life Outcomes. 2010;8:126. Published online 2010. Nov 5. Accessed 2/4/18.
  31. 31.
    Gillam J, Gillam D. The assessment and implementation of mouth care in palliative care: a review. J R Soc Promot Heal. 2006;126(1):33–7.CrossRefGoogle Scholar
  32. 32.
    Glick M, Williams D, Kleinman D, Vujicic M, Watt R, Weyant B. A new definition for oral health developed by the FDI World Dental Federation opens the door to a universal definition of oral health. J Am Dent Assoc. 2016;147(12):915–7.CrossRefGoogle Scholar
  33. 33.
    Haag D, Peres K, Balasubramanian M, Brennan D. Oral conditions and health-related quality of life: a systematic review. J Dent Res. 2017;96(8):864–74. Epub 2017 June 5.CrossRefPubMedGoogle Scholar
  34. 34.
    Haber J, Hartnett E, Allen K, Hallas D, Dorsen C, Lange-Kessler J, Lloyd M, Thomas E, Wholihan D. Putting the mouth back in the head: HEENT to HEENOT. Am J Public Health. 2015;105(3):437–41.CrossRefGoogle Scholar
  35. 35.
    Hassel A, Safaltin V, Grill S, Schröder J, Wahl H, Klotz AL, Habibi E, Rammelsberg P, Zenthöfer A. Risk factors for tooth loss in middle and older age after up to 10 years: an observational cohort study. Arch Oral Biol. 2018;86:7–12. Epub 2017 Nov 6.CrossRefPubMedGoogle Scholar
  36. 36.
    Hebling E, Pereira A. Oral health-related quality of life: a critical appraisal of assessment tools used in elderly people. Gerodontology. 2007;24(3):151–61.CrossRefGoogle Scholar
  37. 37.
    Hossaini-zadeh M. Current concepts of prophylactic antibiotics for dental patients. Dent Clin North Am. 2016;60(2):473–82. Scholar
  38. 38.
    Hua F, Xie H, Worthington H, Furness S, Zhang Q, Li C. Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia. Cochrane Database Syst Rev. 2016;10:CD008367.PubMedGoogle Scholar
  39. 39.
    Hudson L, Chittams J, Griffith C, Compher C. Malnutrition identified by Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition is associated with more 30-day readmissions, greater hospital mortality, and longer hospital stays: a retrospective analysis of nutrition assessment data in a major medical center. JPEN J Parenter Enteral Nutr. 2018;42:892. Scholar
  40. 40.
    Hyde S, Dupuis V, Mariri BP, Dartevelle S. Prevention of tooth loss and dental pain for reducing the global burden of oral diseases. Int Dent J. 2017;67:19–25. Scholar
  41. 41.
    Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJL, Marcenes W. Global burden of severe tooth loss: a systematic review and meta-analysis. J Dent Res. 2014;93(7 Suppl):20S–8S. Scholar
  42. 42.
    Kayser-Jones J, Bird WF, et al. An instrument to assess the oral health status of nursing home residents. Gerontologist. 1995;35(6):814–24. Figure 2, p. 823.CrossRefGoogle Scholar
  43. 43.
    Kufta K, Forman M, Swisher-McClure S, Sollecito T, Panchal N, et al. Oral Oncol. 2018;76:42–51. Scholar
  44. 44.
    Li C, Lv Z, Shi Z, Zhu Y, Wu Y, Li L, Iheozor-Ejiofor Z. Periodontal therapy for the management of cardiovascular disease in patients with chronic periodontitis. Cochrane Database Syst Rev. 2017;(11):CD009197.
  45. 45.
    Lo J, O’Ryan FS, Gordon NP, et al. Prevalence of osteonecrosis of the jaw in patients with oral bisphosphonate exposure. J Oral Maxillofac Surg. 2010;68:243.CrossRefGoogle Scholar
  46. 46.
    Makhija SK, Gilbert GH, Clay OJ, Matthews JC, Sawyer P, Allman RM. Oral health–related quality of life and life-space mobility in community-dwelling older adults. J Am Geriatr Soc. 2011;59(3):512–8.CrossRefGoogle Scholar
  47. 47.
    Manski R, Moeller J. Barriers to oral health across selected European countries and the USA. Int Dent J. 2017;67(3):133–8. Scholar
  48. 48.
    Martins J, Chagas OL, Velasques B, Bobrowski Â, Correa M, Torriani M. The use of antibiotics in odontogenic infections: what is the best choice? A systematic review. J Oral Maxillofac Surg. 2017;75(12):2606.e1–2606.e11. Epub 2017 Aug 17.CrossRefGoogle Scholar
  49. 49.
    Naito M, Kato T, Fujii W, Ozeki M, Yokoyama M, Hamajima N, Saitoh E. Effects of dental treatment on the quality of life and activities of daily living in institutionalized elderly in Japan. Arch Gerontol Geriatr. 2010;50(1):65–8. Epub 2009 Mar 3.CrossRefPubMedGoogle Scholar
  50. 50.
    Nakamura M, Ojima T, Nakade M, Ohtsuka R, Yamamoto T, Suzuki K, Kondo K. Poor oral health and diet in relation to weight loss, stable underweight, and obesity in community-dwelling older adults: a cross-sectional study from the JAGES 2010 project. J Epidemiol. 2016;26(6):322–9. Epub 2016 Jan 30.CrossRefPubMedGoogle Scholar
  51. 51.
    National Cancer Institute. SEER stat fact sheets: Oral cavity and pharynx cancer. Updated 2014. Accessed 1/19/2018.
  52. 52.
    Nathwani S, Wanis C. Novel oral anticoagulants and exodontia: the evidence. Br Dent J. 2017;222(8):623–8. Scholar
  53. 53.
    National Institute of Dental and Cranial Research. 2017. Accessed 2/5/18.
  54. 54.
    Nishimura R, Otto C, Bonow R, et al. 2014 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol. 2017;63:e57–185. Scholar
  55. 55.
    Nordenram G, Davidson T, Gynther G, Helgesson G, Hultin M, Jemt T, Lekholm U, Nilner K, Norlund A, Rohlin M, Sunnegårdh-Grönberg K, Tranæus S. Qualitative studies of patients’ perceptions of loss of teeth, the edentulous state and prosthetic rehabilitation: a systematic review with meta-synthesis. Acta Odontol Scand. 2013;71(3–4):937–51. Epub 2012 Oct 29.CrossRefPubMedGoogle Scholar
  56. 56.
    Porter J, von Fraunhofer J. Success or failure of dental implants? A literature review with treatment considerations. Gen Dent. 2005;53(6):423–32; quiz 433, 446.PubMedGoogle Scholar
  57. 57.
    Poxleitner P, Engelhardt M, Schmelzeisen R, Voss P. The prevention of medication-related osteonecrosis of the jaw. Dtsch Arztebl Int. 2017;114(5):63–69. Published online 2017 Feb 3. Accessed 1/26/18.
  58. 58.
    Quagliarello V, Ginter S, Han L, Van Ness P, Allore H, Tinetti M. Modifiable risk factors for nursing home-acquired pneumonia. Clin Infect Dis. 2005;40(1):1–6.CrossRefGoogle Scholar
  59. 59.
    Riley P, Glenny A, Worthington H, Littlewood A, Fernandez Mauleffinch L, Clarkson JE, McCabe MG. Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors. Cochrane Database Syst Rev. 2017;(11):CD011990.
  60. 60.
    Rouxel P, Heilmann A, Demakakos P, Aida J, Tsakos G, Watt RG. Oral health-related quality of life and loneliness among older adults. Eur J Ageing. 2016;14(2):101–9. eCollection 2017 June. Accessed on 1/26/18.CrossRefPubMedPubMedCentralGoogle Scholar
  61. 61.
    Rouxel P, Tsakos G, Chandola T, Watt R. Oral health-a neglected aspect of subjective well-being in later life. J Gerontol B Psychol Sci Soc Sci. 2016. pii: gbw024.Google Scholar
  62. 62.
    Ruggiero S, Dodson T, Fantasia J, Goodday R, Aghaloo T, Mehrotra B, O’Ryan F. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw--2014 update. J Oral Maxillofac Surg. 2014;72(10):1938–56. Epub 2014 May 5.CrossRefPubMedGoogle Scholar
  63. 63.
    Salam S, Yusuf H, Milosevic A. Bleeding after dental extractions in patients taking warfarin. Br J Oral Maxillofac Surg. 2007;45(6):463–6. Epub 2007 Jan 23. Accessed 2/2/18.CrossRefGoogle Scholar
  64. 64.
    Schreuder W, Peacock Z. Antiplatelet therapy and exodontia. J Am Dent Assoc. 2015;146(11):851–6. Scholar
  65. 65.
    Shahab L, Goniewicz M, Blount B, Brown J, McNeill A, Alwis U, Feng J, Wang L, West R. Nicotine, carcinogen, and toxin exposure in long-term e-cigarette and nicotine replacement therapy users. Ann Intern Med. 2017;166:390–400. Scholar
  66. 66.
    Sheetal A, Hiremath V, Patil A, Sajjansetty S, Kumar S. Malnutrition and its oral outcome – a review. Clin Diagn Res. 2013;7(1):178–80.Google Scholar
  67. 67.
    Shi Z, Xie H, Wang P, Zhang Q, Wu Y, Chen E, Ng L, Worthington HV, Needleman I, Furness S. Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia. Cochrane Database Syst Rev. 2013;(8):CD008367.
  68. 68.
    Simpelaere I, Van Nuffelen G, Vanderwegen J, Wouters K, De Bodt M. Oral health screening: feasibility and reliability of the oral health assessment tool as used by speech pathologists. Int Dent J. 2016;66(3):178–89. Epub 2016 Feb 8. Accessed 2/2/18.CrossRefPubMedGoogle Scholar
  69. 69.
    Slack-Smith L, Lange A, Paley G, O’Grady M, French D, Short L. Oral health and access to dental care: a qualitative investigation among older people in the community. Gerodontology. 2010;27(2):104–13. Scholar
  70. 70.
    Sjögren P, Nilsson E, Forsell M, Johansson O, Hoogstraate J. A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly people in hospitals and nursing homes: effect estimates and methodological quality of randomized controlled trials. J Am Geriatr Soc. 2008;56(11):2124–30. Scholar
  71. 71.
    Sollecito TP, Abt E, Lockhart PB, Truelove E, Paumier TM, Tracy SL, Tampi M, Beltrán-Aguilar ED, Frantsve-Hawley J. The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints: evidence-based clinical practice guideline for dental practitioners--a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc. 2015;146(1):11–16.e8. Epub 2014 Dec 18.CrossRefPubMedGoogle Scholar
  72. 72.
    Spittle L, Muzzin K, Campbell P, DeWald J, Rivera-Hidalgo F. Current prescribing practices for antibiotic prophylaxis: a survey of dental practitioners. J Contemp Dent Pract. 2017;18(7):559–66.CrossRefGoogle Scholar
  73. 73.
    Tan H, Peres KG, Peres MA. Retention of teeth and oral health-related quality of life. J Dent Res. 2016;95(12):1350–7. Epub 2016 July 28.CrossRefPubMedGoogle Scholar
  74. 74.
    Taylor GW, Borgnakke W. Periodontal disease: associations with diabetes, glycemic control and complications. Oral Dis. 2008;14(3):191–203.CrossRefGoogle Scholar
  75. 75.
    Thomson WM, Poulton R, Milne BJ, Caspi A, Broughton JR, Ayers KMS. Socioeconomic inequalities in oral health in childhood and adulthood in a birth cohort. Community Dent Oral Epidemiol. 2004;32(5):345–53. Scholar
  76. 76.
    Toniazzo MP, Amorim P, Muniz F, Weidlich P. Relationship of nutritional status and oral health in elderly: Systematic review with meta-analysis. Clin Nutr. 2017. pii: S0261–5614(17)30105-X;
  77. 77.
    Van Dyke T, Kornman K. Inflammation and factors that may regulate inflammatory response. J Periodontol. 2008;79(8 Suppl):1503–7. Scholar
  78. 78.
    Veitz-Keenan A, Ferraiolo D. Oral care with chlorhexidine seems effective for reducing the incidence of ventilator-associated pneumonia. Evid Based Dent. 2017;18(4):113–4. Scholar
  79. 79.
    Vissink A, Spijkervet FK, Van Nieuw A. Aging and saliva: a review of the literature. Spec Care Dentist. 1996;16(3):95–103.CrossRefGoogle Scholar
  80. 80.
    Walid A, Hesham K. Dental extraction in patients on warfarin treatment. Clin Cosmet Investig Dent. 2014;6:65–9.Google Scholar
  81. 81.
    Wall T, Nasseh K, Vujicic M. Majority of dental-related emergency department visits lack urgency and can be diverted to dental offices. Health Policy Institute. Research Brief. Amer Den Assoc. Aug: 2014. Accessed 4/24/18.
  82. 82.
    Wilson A. Epigenetic regulation of gene expression in the inflammatory response and relevance to common diseases. J Periodontol. 2008;79(8 Suppl):1514–9. Scholar
  83. 83.
    World Health Organization: Oral health. Accessed Mar 2018.
  84. 84.
    Zaremba M, Daniluk T, Rozkiewicz D, Cylwik-Rokicka D, Kierklo A, Tokajuk G, Dabrowska E, Pawińska M, Klimiuk A, Stokowska W, Abdelrazek S. Incidence rate of Candida species in the oral cavity of middle-aged and elderly subjects. Adv Med Sci. 2006;51(Suppl 1):233–6.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Sarah J. Dirks
    • 1
  • Michael Monopoli
    • 2
  1. 1.Department of PeriodonticsUniversity of Texas Health Science CenterSan AntonioUSA
  2. 2.DentaQuest FoundationBostonUSA

Personalised recommendations