*Review* **Poor Oral Health as a Determinant of Malnutrition and Sarcopenia**

**Domenico Azzolino 1,2,\*,**†**, Pier Carmine Passarelli 3,**†**, Paolo De Angelis 3, Giovan Battista Piccirillo 3, Antonio D'Addona 3 and Matteo Cesari 1,2**


Received: 7 November 2019; Accepted: 27 November 2019; Published: 29 November 2019

**Abstract:** Aging is accompanied by profound changes in many physiological functions, leading to a decreased ability to cope with stressors. Many changes are subtle, but can negatively a ffect nutrient intake, leading to overt malnutrition. Poor oral health may a ffect food selection and nutrient intake, leading to malnutrition and, consequently, to frailty and sarcopenia. On the other hand, it has been highlighted that sarcopenia is a whole-body process also a ffecting muscles dedicated to chewing and swallowing. Hence, muscle decline of these muscle groups may also have a negative impact on nutrient intake, increasing the risk for malnutrition. The interplay between oral diseases and malnutrition with frailty and sarcopenia may be explained through biological and environmental factors that are linked to the common burden of inflammation and oxidative stress. The presence of oral problems, alone or in combination with sarcopenia, may thus represent the biological substratum of the disabling cascade experienced by many frail individuals. A multimodal and multidisciplinary approach, including personalized dietary counselling and oral health care, may thus be helpful to better manage the complexity of older people. Furthermore, preventive strategies applied throughout the lifetime could help to preserve both oral and muscle function later in life. Here, we provide an overview on the relevance of poor oral health as a determinant of malnutrition and sarcopenia.

**Keywords:** sarcopenia; nutrition; oral health; older people; malnutrition; swallowing; life course approach
