Associação entre perda dentária e fragilidade em idosos: uma revisão narrativa

Abstract

Introduction: Population aging is a global phenomenon associated with an increased prevalence of chronic conditions and geriatric syndromes, including frailty. Tooth loss remains highly prevalent among older adults and has been associated with adverse health outcomes, potentially representing an important marker of physiological vulnerability. Objective: To critically analyze the scientific evidence regarding the association between tooth loss and frailty in older adults, discussing its potential mechanisms and clinical and institutional implications. Methods: A narrative literature review was conducted using PubMed, SciELO, and Google Scholar databases, employing descriptors related to frailty, oral health, and older adults. Observational studies, systematic reviews, and meta-analyses published within the last ten years were included. After screening and full-text evaluation, 18 studies were included in the analysis. Results: The included studies demonstrated a consistent association between tooth loss and frailty across different geographic and population contexts. Older adults with fewer natural teeth or absence of functional dentition showed higher prevalence and increased risk of frailty progression. Longitudinal evidence indicates that tooth loss is associated with transitions from robustness to pre-frailty and frailty. Proposed mechanisms include nutritional alterations due to impaired masticatory efficiency, reduced protein intake, and sarcopenia development, as well as chronic inflammatory processes associated with inflammaging and immunosenescence. Psychosocial factors, including social isolation and reduced social participation, also contribute to this association. Social determinants, such as socioeconomic inequalities and limited access to dental care, play an important role in modulating this relationship. In the military institutional context, the high prevalence of tooth loss observed among individuals assisted by the Brazilian Navy suggests that oral health may represent a relevant clinical marker of functional vulnerability. Conclusion: Tooth loss is consistently associated with frailty in older adults, reflecting the complex interaction between nutritional, inflammatory, immunological, functional, and psychosocial factors. Preservation of functional dentition and access to adequate dental care represent important strategies for promoting healthy aging. Future studies within the Brazilian Navy Health System may contribute to a better understanding of this association and support institutional strategies aimed at frailty prevention and preservation of functional capacity and quality of life in aging populations.