Oral Aging in Older Adults: Mechanisms, Assessment and Clinical Relevance in Gerodontology: A Narrative Review

OBJECTIVE: This narrative review synthesizes current evidence on oral aging in older adults across three clinically relevant domains: mechanisms, assessment and clinical relevance for gerodontology. BACKGROUND: Older adults experience a disproportionate burden of oral disease, tooth loss, oral hypofunction and oral frailty. These conditions are often managed as isolated dental problems despite their interconnections with function, nutrition, quality of life and broader geriatric vulnerability. METHODS: This narrative review synthesizes current evidence on oral aging in older adults across three clinically relevant domains: biological mechanisms, assessment approaches and relevance to gerodontological care. RESULTS: Oral aging reflects interactions among oral dysbiosis, chronic periodontal inflammation, immune dysregulation, cellular senescence, impaired tissue repair and declining oral function. Emerging assessment approaches include salivary biomarkers, oral functional phenotyping, epigenetic clocks and multimodal computational methods; current evidence supports interpreting these measures as tissue-specific and complementary, rather than as direct substitutes for systemic measures. Relevant clinical strategies include periodontal care, prosthetic rehabilitation, oral functional exercise and integrated multidisciplinary care. CONCLUSIONS: Oral aging is a multidimensional construct linking biological change, functional decline and geriatric vulnerability. Future progress requires stronger validation of assessment tools, clinically meaningful functional endpoints and greater integration of oral health within aging care.