The ALPL gene encodes tissue-nonspecific alkaline phosphatase, whose dysfunction leads to hypophosphatasia, a hereditary disorder characterised by impaired skeletal mineralisation and muscle weakness.54 The MSRA gene encodes methionine sulfoxide reductase A, crucial for protein repair and combating oxidative stress,46 which is a significant driver of ageing and muscle dysfunction.22 These findings suggest that skeletal integrity and protein homeostasis may play roles in the pathogenesis of oral frailty. This evidence concerns the gene ALPL and hypophosphatasia.