Intraoral Condition as a Risk Factor for Dysphagia in Non-Hospitalized Older People: An Updated Systematic Review.

Abstract

Aim: To investigate the association between intraoral conditions and OD in community-dwelling elderly populations to identify key screening indicators.

Methods: A systematic search was conducted across PubMed, Scopus, and Cochrane databases for original research published between 2015 and 2025, following PRISMA guidelines. Inclusion criteria focused on studies involving subjects aged 65 years or older that examined the relationship between oral health status and OD. Methodological quality was assessed using the JBI critical appraisal checklist. The analysis methods and inclusion criteria were documented in a protocol published in the Prospective International Register of Systematic Reviews (PROSPERO) under the registration number CRD420261324418.

Results: Fifteen articles met the inclusion criteria. All included studies demonstrated at least one positive correlation between an intraoral component and dysphagia. Key findings include; a reduced number of remaining teeth, lack of occlusal support, and poor functional tooth units (FTUs) were consistently associated with increased OD risk. Both subjective xerostomia and objective hyposalivation were linked to increased swallowing effort and impaired bolus transport. Reduced tongue strength, lip force, and buccinator muscle strength were identified as significant risk factors for sarcopenic dysphagia.

Conclusion: Intraoral conditions play a critical role in the oral preparatory phase of swallowing. Establishing a standardized list of intraoral indicators-such as tooth count, salivary flow, and muscle strength is essential for health professionals to effectively screen for dysphagia risk during routine oral examinations.