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Oral frailty has emerged as an important geriatric syndrome characterized by subtle, multifactorial declines in oral function that precede clinically apparent oral dysfunction. Accumulating evidence indicates that oral frailty is closely associated with physical frailty, sarcopenia, malnutrition, cognitive decline, cardiovascular disease, and mortality, suggesting its potential role as an early indicator of multisystem functional deterioration. However, practical approaches for early detection and intervention remain challenging because conventional assessments of oral function require specialized equipment and professional expertise. This review summarizes recent advances in the assessment, clinical significance, and management strategies of oral frailty. We discuss the utility and limitations of questionnaire-based screening tools, including the Oral Frailty Index-8 (OFI-8) and Oral Frailty 5-item Checklist (OF-5), which enable simple identification of individuals at increased risk in community and clinical settings. Furthermore, we introduce our findings from the FESTA study demonstrating that cystatin C–related indices, including the creatinine-to-cystatin C ratio and the estimated glomerular filtration rate cystatin C-to-creatinine ratio, reflect skeletal muscle mass and are associated with oral functional decline, particularly reduced tongue pressure. Comparative and longitudinal analyses further suggest that oral frailty is independently associated with progression of physical frailty and that OF-5 may serve as a predictive marker for future functional decline. Given the bidirectional relationship between oral dysfunction and physical frailty, integrated management involving dental care, nutritional support, physical exercise, and medical intervention is essential. Combining simple oral frailty screening tools with objective systemic biomarkers may facilitate early detection and promote medical–dental collaboration aimed at preventing frailty progression and extending healthy life expectancy.