###### Abstract  
Most previous studies on orofacial muscle strength have focused on older adults with conditions associated with sensorimotor deficits, such as stroke. However, the modifiable oral health factors that directly impact orfacial muscle strength and swallowing ability in healthy older adults remain unexplored. This pilot study explored the potential factors associated with orofacial muscle strength, particularly oral health conditions, in 70 healthy adults aged \(\geq\)65 years living independently without any diseases that cause dysphagia or sensorimotor deficits. The Iowa Oral Performance Instrument (IOPI) was used to assess orofacial muscle strength (tongue elevation, and cheek and lip compression). Statistical analyses were conducted using an independent \(t\)-test, one-way ANOVA, and multivariate linear regression. In the final regression models after adjustment, older age and fewer remaining teeth were significantly associated with reduced tongue and cheek strengths (\(p<0.05\)). Socio-demographic factors, such as age, and oral health conditions, such as discomfort in pronunciation or mastication due to oral problems, poor self-rated oral health, and reduced salivary flow, were associated with tongue, cheek, and lip muscle strengths (\(p<0.05\)). Early active oral health interventions can help prevent a decline in orfacial muscle strength in healthy older adults. cheek muscle strength; lip muscle strength; oral health status; orofacial muscle strength; remaining teeth; salivary flow rate; tongue muscle strength [1]Applied sciences  
1050  
Moreover, the weakening of the orofacial muscles becomes more evident with age [9]. These muscles are located in the cheeks, lips, and tongue in the lower face and perform several functions that are crucial for the maintenance and quality of life, including mastication, deglutition, respiration, and articulation [9; 10]. The orofacial muscles thus play a vital role in manipulating food and creating intraoral pressure during the swallowing process, particularly in the oral stage [9; 11; 12]. Several studies have shown that the thickness of the masticatory masseter muscle and the strength of the tongue muscle tend to decrease with age [10; 13]. A reduction in the strength of orofacial muscles leads to poor chewing abilities [13] and dysphagia, a condition where the swallowing of food or liquid becomes difficult due to problems in the swallowing process [14]. Although geriatric diseases such as cerebrovascular diseases are the main cause of dysphagia [15], recent studies have suggested that older age itself is an independent risk factor for the disorder, as a growing number of older adults living in the community have dysphagia symptoms [16; 17]. In addition, the weakening of the buccinators or tongue muscles, among other orofacial muscles, is a clinical indicator that can predict the development of dysphagia [18; 19]. In particular, [PERSON] [12] reported that the diadochokinetic rate, which represents the tongue's motor skill, is related to swallowing ability, and that the tongue's role is more important in the oral phase of swallowing. Prolonged dysphagia in older adults can lead to changes in meal patterns, increasing the risk of malnutrition [20], and can cause life-threatening complications such as aspiration pneumonia and suffocation [21]. Moreover, the fear of eating and drinking or prolonged mealtimes due to dysphagia can reduce an individual's quality of life [21; 22]. Despite the critical role of orofacial muscles in mastication and swallowing, the function or status of these muscles in healthy older adults living independently has not received much attention. Most previous studies have focused on older adults staying in nursing homes or hospitals due to stroke or Parkinson's disease for long periods of time [19; 23; 24], primarily because cerebrovascular diseases and neurogenic disorders negatively impact the sensorimotor system of orofacial muscles [25; 26].