Towards an operational definition of oral frailty: A e-Delphi study

Necessity and influencing factors for integrating oral health in cancer care for older people: a narrative review

“…Academic literature confirms that cancer treatments affect the oral tissues [ 8 , 10 , 13 – 15 , 17 – 20 ]. Studies suggest that the integration of oral healthcare in the cancer care pathway improve the treatment outcomes of cancer therapies and the overall health and well-being of patients with cancer [ 10 , 27 – 30 ].…”

“…Various acute and chronic oral complications due to cancer diagnosis and associated treatments can occur [ 10 ]. Evidence indicates that older people are prone to oral frailty, defined as a set of phenomena and processes that result in age-related changes in various oral conditions, e.g., the number of remaining teeth, oral hygiene, oral dysfunction, saliva function, decreased interest in oral health, and reduced physical and mental reserve capacity for regular oral healthcare [ 8 , 10 ]. Cancer treatments worsen oral frailty increasing oral diseases and infections, such as caries, periodontal diseases, edentulism, and dry mouth, acting as a precursor to calorie/nutrient deficiency, pain, infections, difficulty in speaking, loss of confidence, and social isolation, resulting in limited oral functional ability, orofacial pain, poor general physical health, psychological status, and functional capacity in older people with cancer.…”

“…Cancer treatments worsen oral frailty increasing oral diseases and infections, such as caries, periodontal diseases, edentulism, and dry mouth, acting as a precursor to calorie/nutrient deficiency, pain, infections, difficulty in speaking, loss of confidence, and social isolation, resulting in limited oral functional ability, orofacial pain, poor general physical health, psychological status, and functional capacity in older people with cancer. This can result in malnutrition, which in turn negatively impacts the immune system, which is an important process in fighting cancer, further influencing the treatment outcome of older people with cancer [ 3 , 8 , 10 , 21 – 26 ]. 3.…”

Oral frailty: a concept analysis

“…Except for the conceptual definition, researchers developed the operational definition of oral frailty as well [ 31 , 32 ]. As of 2018, Tanaka et al defined the conceptual definition of oral frailty as the accumulation of poor oral health.…”

“…They then proposed the operational definition as the co-existence of a poor status in ≥ 3 out of the six measures: the number of natural teeth, chewing ability, articulatory oral motor skill, tongue pressure, subjective difficulties in eating and swallowing [ 31 ]. Parisius et al developed the definition of oral frailty as the age-related functional decline of orofacial structures [ 33 ], and proposed that its operational definition should include difficulty eating hard or tough foods, inability to chew all types of foods, decreased ability to swallow solid foods, decreased ability to swallow liquids, overall poor swallowing function, impaired tongue movement, speech or phonatory disorders, and hyposalivation or xerostomia [ 32 ]. The different uses of the concept are described in Table 1 .…”