Tongue and chewing drills improved oral function

Oral function — chewing, swallowing, speaking clearly and producing saliva — declines with age, and that decline feeds into poorer nutrition, choking risk and social withdrawal. Oral exercises, such as tongue-strengthening or chewing drills, are widely recommended in community and dental-hygiene settings, yet they have often been promoted ahead of the evidence. This review set out to establish whether randomised trials actually show measurable improvement in oral function among older adults, and which specific exercise types carry the signal, so recommendations can be based on pooled data rather than convention.

The authors followed PRISMA guidelines and searched PubMed, Ovid Embase, the Cochrane Library and CINAHL up to August 2022 for randomised controlled trials comparing oral exercise interventions with control conditions in older adults. Study quality was assessed with the Risk of Bias 2.0 tool. From 1,007 identified records, 19 studies entered the qualitative synthesis and 8 contributed to the meta-analysis, with pooled mean differences estimated using a random-effects model. The included interventions targeted four functional domains: masticatory function, swallowing, pronunciation and salivary function.

Tongue exercises produced a significant improvement in swallowing function, with a pooled mean difference of 7.06 (95% CI 4.72 to 9.41). Masticatory exercises significantly enhanced masticatory function, with a pooled mean difference of 37.77, though the confidence interval was wide at 15.61 to 59.92, indicating considerable imprecision. Lip exercises, by contrast, showed no significant effect on swallowing function, with a pooled mean difference of 1.43 and a confidence interval crossing zero. The authors conclude that tongue and masticatory exercises in particular may improve oral function in older adults.

This gives the widely recommended practice of oral exercise a firmer evidence base, while narrowing it: the benefit appears tied to specific exercises targeting specific functions rather than to oral exercise as a generic category. The wide confidence interval on the masticatory result and the small number of pooled trials mean effect sizes should be treated as provisional. Open questions include how long gains persist after training stops, whether they translate into better nutritional status or fewer choking events, and whether standardised outcome measures would reduce the heterogeneity that limits pooling here.

If you think of strength training as something for limbs, this is a reason to think the muscles involved in chewing and swallowing behave similarly — they respond to targeted work, and the response is specific to what is trained. The finding that lip exercises did not improve swallowing is a useful reminder that not every oral drill does the same job. For older readers or those supporting older relatives, it suggests oral function is a modifiable part of ageing rather than a fixed decline, though this review reports function measures, not downstream health outcomes.