The symptom network of oral health conditions in older populations with oral frailty: a cross-sectional study

Abstract Background Population aging is increasing globally, with oral frailty affecting 24% of the older population. Previous studies have demonstrated the relationship between oral frailty and poor oral health symptoms but the interactions and core symptoms among these oral symptoms remain vague. Objective To clarify the relationship between oral frailty and oral symptoms, explore the intrinsic connections between these symptoms, and identify core symptoms to provide more effective management and treatment strategies for oral frailty and related health issues. Methods The study conducted a cross-sectional study from January 2024 to April 2024, included 547 participants using a convenient sampling method. The study adopted the Geriatric Self-Efficacy Scale for Oral Health (GSEOH), Oral Frailty Index-8, FRAIL scale, and oral symptoms, including the simplified oral hygiene index score (OHI-S), plaque index, periodontal pocket depth and gingival index, teeth numbers and tooth mobility index. T-test, Chi-Square test, Mann–Whitney test and binary logistic regression were used to explore the relationship between oral symptoms and oral frailty, and symptom network analysis and subgroup network analysis were used to explore the intrinsic connections between oral symptoms and identify core symptoms. Results The study found that while teeth number and GSEOH were significantly associated with oral frailty (teeth number: β = -0.262, P  = 0.013) (GSEOH: β = -0.056, P  = 0.000), the centrality of teeth number and GSEOH was the lowest compared to other oral symptoms. oral hygiene status (CI-S and plaque index), and gingival index were the core symptoms in older adults, and gingival index was the strongest bridge node. Conclusion The study explored the relationship between oral symptoms and oral frailty using network analysis. The study recommended that communities implement routine oral functional assessments to increase the denture restoration rate and identify oral frailty at an early stage, as well as educational and promotional programs aimed at maintaining oral hygiene and function. Future research should further analyze the causal relationships between oral symptoms, particularly periodontal pocket depth, oral frailty, and overall frailty.