Ageing of the Oral Mucosa: Mechanisms and Consequences

Mar 31, 2026International dental journal

Aging of the Mouth Lining: How It Happens and What It Leads To

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Longevity & Aging on OpenScience ↗PubMed ↗DOI ↗

Abstract

Oral mucosal ageing involves structural changes like epithelial atrophy and salivary gland degeneration.

The ageing process transforms the oral mucosa, leading to functional decline.
Structural changes are driven by genomic instability and accumulation of proinflammatory senescent cells.
Stem cell exhaustion and dysregulated stress responses are also involved in the ageing process.
An immunological state of 'inflammaging' contributes to the decline in innate and adaptive immunity.
Alterations in the oral microbiome further exacerbate these age-related changes.
These factors collectively impair regeneration, sensory function, and salivary secretion, increasing susceptibility to chronic oral diseases.

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Oral mucosal ageing represents a fundamental reprogramming of the tissue microenvironment, a dynamic process that underlies the functional decline and heightened disease susceptibility observed in the elderly. This review synthesises current evidence to reconceptualise oral mucosal ageing as an active reprogramming of the tissue microenvironment, delineating the interplay between structural, molecular, and immunological changes, and exploring how these alterations drive functional decline and increase susceptibility to age-related oral diseases. Through a comprehensive analysis of experimental and clinical studies from human and animal models, we demonstrate that the ageing process fundamentally transforms the oral mucosa. Key findings include structural changes such as epithelial atrophy, extracellular matrix remodelling, and salivary gland degeneration, driven molecularly by genomic instability, accumulation of proinflammatory senescent cells, stem cell exhaustion, and dysregulated stress responses. These are compounded by an immunological state of 'inflammaging' and functional decline in innate and adaptive immunity, further exacerbated by shifts in the oral microbiome. Collectively, these deficits lead to impaired regeneration, diminished sensory function, and reduced salivary secretion, creating a permissive landscape for chronic oral diseases. In conclusion, oral mucosal ageing is a dynamic process of microenvironmental reprogramming driven by cellular senescence, immunosenescence, and structural decay. This actively underpins the heightened vulnerability to oral disease in the elderly, providing a mechanistic foundation for developing targeted interventions to preserve oral health in ageing populations.

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Ageing of the Oral Mucosa: Mechanisms and Consequences

Abstract

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