Dental Factors Associated With Oropharyngeal Dysphagia in Institutionalised Older Adults: A Systematic Review

Aging is associated with a decline in physiological functions. Dysphagia, a disorder among older adults, impairs feeding and is related to morphological and functional changes in the stomatognathic system, which worsen with age-related physiological decline, particularly among institutionalised older adults.

To systematically review the association between oral health conditions, dental status, xerostomia, and dysphagia among institutionalised older adults.

This systematic review followed PRISMA guidelines and included a search of PubMed/MEDLINE and Embase for observational and randomised clinical trial studies published up to December 2024, with an update in January 2025.

From 1761 identified articles, 44 were reviewed, and 11 met the inclusion criteria. These studies employed subjective measures such as dysphagia questionnaires, the Eating Assessment Tool-10 (EAT-10), the Dysphagia Risk Evaluation Protocol (PARD), and interviews using the Minimum Data Set for Nursing Home Resident Assessment (MDS-NH). Objective assessments included clinical evaluations, indirect and direct swallowing tests, and video analyses of feeding behaviour. Findings indicate that older individuals with fewer functional teeth, absent occlusal pairs, compromised natural teeth, gingivitis, or dental caries have a higher risk of dysphagia. In contrast, occlusal contact, natural teeth, or well-fitted dentures are associated with reduced swallowing difficulties. Neither denture use alone nor oral hygiene showed a direct association with dysphagia. However, severe xerostomia and reduced salivary flow were associated with a higher risk of dysphagia.

Dysphagia is associated with poor oral health and xerostomia in institutionalised older adults, though further research is needed to clarify these relationships.