Oral Aging: Age-Related Changes and Their Association With Systemic Aging

Aging is not driven by a single event but results from the synergistic effects of multiple mechanisms, including genetic instability, epigenetic dysregulation, metabolic imbalance, and disrupted cellular stress responses. Oral aging represents a localized manifestation of systemic aging in the oral cavity and acts as a key contributor to the accelerated aging of the whole body. It not only affects local oral homeostasis but also interacts bidirectionally with systemic aging through pathways such as the release of inflammatory mediators. Age-related oral diseases, such as root caries, gingival recession, alveolar bone resorption, xerostomia, taste impairment, and tooth loss and dentition defects, severely compromise the function of the oral and maxillofacial system in older adults and may exacerbate or trigger systemic diseases. Current research on oral aging faces several critical challenges, including limited translation from basic to clinical studies, an incomplete understanding of the mechanisms linking oral aging to systemic aging, and lack of strategies for early diagnosis and effective intervention. Future efforts should be focused on leveraging multi-omics approaches to construct comprehensive molecular maps of oral aging, systematically elucidating its developmental mechanisms and networks for interactions with systemic aging, and accelerating the clinical translation of novel intervention strategies, such as senolytic drugs. A systematic understanding of the biological mechanisms and developmental patterns of oral aging will not only support the preservation of natural dentition but also provide critical insights into oral and systemic health interactions and promote overall health. Furthermore, it may pave the way for novel preventive and therapeutic strategies for age-related oral diseases.