Dry mouth among the elderly in Korea: a survey of prevalence, severity, and associated factors

Evaluation and management of dry mouth and its complications in rheumatology practice

INTRODUCTION

The symptom of dry mouth has multiple potential etiologies and can be a diagnostic clue to the presence of common systemic diseases encountered in rheumatology practice. The presence of decreased saliva flow (i.e. salivary hypofunction) defines a subset of dry mouth patients in whom there may be reversible drug effects, an iatrogenic insult such as head and neck irradiation, or a disease that directly involves the salivary glands (e.g. Sjögren's disease). The assessment of salivary hypofunction includes sialometry, salivary gland imaging, salivary gland biopsy, and an assessment for relevant systemic diseases. Optimal management of dry mouth requires accurate definition of its cause, followed by general measures that serve to alleviate its symptoms and prevent its complications.

AREAS COVERED

Through a literature search on xerostomia and salivary hypofunction, we provide an overview of the causes of dry mouth, highlight the potential impact of salivary hypofunction on oral and systemic health, detail routine evaluation methods and treatment strategies, and emphasize the importance of collaboration with oral health care providers.

EXPERT OPINION

Our Expert Opinion is provided on unmet needs in the management of dry mouth and relevant research progress in the field.

E-cigarette, cannabis and combustible tobacco use: associations with xerostomia among California adolescents

OBJECTIVE

Xerostomia (subjective experience of dry mouth), while less common in younger populations, can contribute to caries and oral discomfort. Use of e-cigarettes and cannabis among adolescents is increasing and may be a xerostomia risk factor. This study evaluates xerostomia prevalence in an adolescent population, overall and by e-cigarette, cannabis and combustible tobacco use.

METHODS

Cross-sectional analyses of 12-month follow-up data (N=976; collected 2020-2021) from a cohort of adolescents recruited from public high schools in Northern California (USA) compared self-reported past 30-day e-cigarette, cannabis and other tobacco use and dry mouth (overall dry mouth experience; shortened xerostomia inventory, SXI). Dry mouth experience (never, occasionally, frequently/always) was modelled using ordered logistic regression with school-level clustering and adjustment for gender, race/ethnicity, alcohol use, asthma, physical activity and mutually for e-cigarette, cannabis and tobacco use.

RESULTS

Past 30-day use prevalence was 12% for e-cigarettes, 16% for cannabis and 3% for combustible tobacco. Occasional dry mouth experience (54%) was more common than frequent/always experience (5%). Frequent/always dry mouth was more prevalent among frequent (>5 days/month) e-cigarette (14%) and cannabis (19%) users and combustible tobacco users (19%) than non-users of those respective products (all comparisons p < 0.001). In covariable-adjusted models, frequent e-cigarette use was no longer significantly associated with dry mouth experience (OR: 1.40; 95% CI: 0.69, 2.84), while frequent cannabis use (OR: 3.17; 95% CI: 1.47, 6.82) and combustible tobacco use (OR: 1.92; 95% CI: 1.38, 2.68) were associated with greater odds of reporting more frequent dry mouth. Findings were qualitatively similar using the SXI.

CONCLUSIONS

In this study, xerostomia was not independently associated with e-cigarette use but was one potential health concern of adolescent cannabis and combustible tobacco use.

World Workshop on Oral Medicine VIII: Development of a Core Outcome Set for Dry Mouth: A Systematic Review of Outcome Domains for Xerostomia

OBJECTIVE

The purpose of this study was to identify all outcome domains used in clinical studies of xerostomia, that is, subjective sensation of dry mouth. This study is part of the extended project "World Workshop on Oral Medicine Outcomes Initiative for the Direction of Research" to develop a core outcome set for dry mouth.

STUDY DESIGN

A systematic review was performed on MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials databases. All clinical and observational studies that assessed xerostomia in human participants from 2001 to 2021 were included. Information on outcome domains was extracted and mapped to the Core Outcome Measures in Effectiveness Trials taxonomy. Corresponding outcome measures were summarized.

RESULTS

From a total of 34,922 records retrieved, 688 articles involving 122,151 persons with xerostomia were included. There were 16 unique outcome domains and 166 outcome measures extracted. None of these domains or measures were consistently used across all the studies. The severity of xerostomia and physical functioning were the 2 most frequently assessed domains.

CONCLUSION

There is considerable heterogeneity in outcome domains and measures reported in clinical studies of xerostomia. This highlights the need for harmonization of dry mouth assessment to enhance comparability across studies and facilitate the synthesis of robust evidence for managing patients with xerostomia.

The effect of mucosal dryness on the electrogustometric threshold

Electrogustometry (EGM) is one of the most useful diagnostic tools widely used to evaluate the taste function by measuring the perception threshold to electrogustatory stimuli on the tongue. However, the effects of oral environments on electrogustometric threshold (EGMT) remain to be established despite its simple applicability. Thus, this study aims to determine the effect of mucosal dryness on EGMT in 68 healthy subjects. The experiment was conducted in two different conditions. First, the baseline EGMT was measured when the dryness of the tongue surface was normal. Second, the EGMT was remeasured after the tongue was intentionally desiccated. The current study showed that the mean of the EGMT was significantly increased when the tongue was desiccated, possibly indicating the reduced sensitivity to electrogustatory stimuli. Such an alteration may be related to the disturbed EGM electrical circuit through the dried mucosa with enhanced impedance. Thus, these findings suggested that mucosal dryness should be considered for better evaluation of gustatory function using EGM.

Short-term and long-term unstimulated saliva flow following unilateral vs bilateral radiotherapy for oropharyngeal carcinoma

BACKGROUND

We aimed to compare unstimulated saliva flow using 3-minute modified Schirmer test (MST) following bilateral vs unilateral radiotherapy (RT) in oropharyngeal carcinoma (OPC).

METHODS

We reviewed OPC patients treated with definitive intensity-modulated radiation therapy (IMRT) between 2011 and 2017. MST was measured at baseline, 1-/6-/12-/24-month post-RT. MST values were compared between bilateral-RT vs unilateral-RT groups. Multivariable logistic regression analysis (MVA) identified predictors of hyposalivation (MST < 25 mm).

RESULTS

Total 498 bilateral-RT and 36 unilateral-RT patients were eligible. The MST values at 1-/6-/12-/24-month post-RT were all significantly reduced from baseline for the entire cohort. Baseline unilateral-RT and bilateral-RT MST values (in mm) were similar (P = .2), but much higher for unilateral-RT 1-month (mean: 19.1 vs 13.0, P = .03), 6-month (20.5 vs 9.3, P < .001), 12-month (20.1 vs 11.9, P < .01), and 24-month post-RT (22.2 vs 13.9, P = .04). MVA confirmed that unilateral RT reduced the likelihood of hyposalivation vs bilateral RT (OR 2.36, P = .006).

CONCLUSION

Unilateral RT reduces unstimulated salivary flow in OPC patients.

Factors associated with hyposalivation and xerostomia in older persons in South Brazil

OBJECTIVE

This study aimed to investigate characteristics associated with xerostomia and hyposalivation in older persons.

BACKGROUND

Saliva is one of the most important body fluids and plays an important role in food bolus formation, lubricating the oral mucosa and protecting teeth against demineralisation.

MATERIALS AND METHODS

This is a cross-sectional study nested within a cohort and includes a sample of 872 older persons living independently in the community, both in rural and urban areas in Carlos Barbosa, Brazil. Data collection included standardised interviews to identify sociodemographic, behavioural and health-related variables, as well as oral clinical examination performed by two trained/calibrated dentists. Poisson regressions with robust variance were used to calculate the crude and adjusted prevalence ratios (PR) and their respective 95% confidence intervals.

RESULTS

The mean age was 68.5 ± 6.7 years, and the majority of the sample consisted of women (65.3%). The prevalence of xerostomia, of low stimulated salivary flow rate and low at rest salivary flow rate were 338 (38.8%), 494 (56.6%), 320 (36.7%), respectively. In the final adjusted model, women had a significantly increased prevalence of xerostomia (PR = 1.34; 95% CI: 1.12-1.61), as well as participants taking medication continuously (PR = 1.45; 95% CI: 1.16-1.82) and those with depressive symptoms (PR = 1.49; 95% CI: 1.27-1.76). Lower at rest (PR = 1.45, 95% CI: 1.22-1.72) and lower stimulated salivary flow were more prevalent in women (PR = 1.27, 95% CI: 1.11-1.44), while lower stimulated salivary flow was more prevalent in older persons taking medication continuously (PR = 1.24, 95% CI: 1.07-1.43).

CONCLUSION

Salivary hypofunction and xerostomia were more prevalent in women and in those with continuous medication use; however, depressive symptoms were associated only with xerostomia. Measures are required to promote oral comfort in cases of xerostomia, thereby reducing the unpleasant sensation of dry mouth and hyposalivation consequences in clinical practice.

How Common is Dry Mouth? Systematic Review and Meta-Regression Analysis of Prevalence Estimates

The aim of this paper is to systematically review the literature to estimate the overall prevalence of xerostomia/hyposalivation in epidemiological studies. An electronic search was carried out up to February 2018 with no language restrictions. A total of 5760 titles were screened and just twenty-nine papers were included in review and the meta-analysis after a two independently reviewers applied the selection criteria. Data were extracted from PubMed and Web of Science databases. Eligibility criteria included original investigations from observational population-based studies that reported the prevalence of xerostomia or data that allowed the calculation of prevalence of xerostomia and/or hyposalivation. Studies conducted in samples with specific health conditions, literature reviews, case reports and anthropological studies, as conferences or comments were excluded. Sample size, geographic location of the study, study design, age of the studied population, diagnosis methods, and evaluation criteria used to determine xerostomia e/or hyposalivation were extracted for meta-analysis and meta-regression. Multivariate meta-regression analysis was performed to explore heterogeneity among studies. The overall estimated prevalence of dry mouth was 22.0% (95%CI 17.0-26.0%). Higher prevalence of xerostomia was observed in studies conducted only with elderly people. Despite diverse approaches to the condition's measurement, just over one in four people suffer from xerostomia, with higher rates observed among older people. Moreover, the measurement methods used currently may over- or underestimate xerostomia. These findings highlight the need for further work on existing and new clinical measure and will be useful to determine which one is more reliable in clinical and epidemiological perspectives.

Influence of dental factors on oropharyngeal dysphagia among recipients of long-term care

OBJECTIVE

The study evaluated the association of the sociodemographic, behavioural variables and the oral conditions with the presence of oropharyngeal dysphagia in long-term care older persons.

BACKGROUND

Due to the influence of ageing, swallowing may be altered both in people with natural teeth and in those who have dentures or tooth loss.

MATERIALS AND METHODS

This cross-sectional study evaluated 115 individuals older than 60 years, living in long-term care institutions of the State of Rio Grande do Sul in 2016. The diagnosis of dysphagia happen using a clinical speech evaluation, based on the research of signals and symptoms of alterations during deglutition, and on an oral sensory-motor evaluation. The dental clinical evaluation examined the oral cavity, teeth and dental prostheses, including a Xerostomia assessment. Poisson Regressions with robust variance was calculated were used to estimate crude and adjusted Prevalence Ratios(PR) and their IC95%.

RESULTS

The sample was mostly comprised of older women (67.0%), with more than 81 years of age (44.3%) and edentulous (54.3%). Diagnosis of oropharyngeal dysphagia was verified in 60.9% of the participants. In the final model, older persons who presented no pair (PR=1.52(CI95%=1.02-2.40)) had a highest prevalence of oropharyngeal dysphagia, when compared to older persons who presented 8 to 14 mixed pairs, as well as those older persons who had more complaints related to symptoms of Xerostomia (PR=2.86(CI95% 1.58-5.18)).

CONCLUSION

Institutionalised older persons with a poor oral health condition are associated with a higher prevalence of oropharyngeal dysphagia, as well as with the presence of Xerostomia.

A relationship between salivary flow rates and Candida counts in patients with xerostomia

Context:

Most of the adult population is colonized by Candida in their oral cavity. The process of colonization depends on several factors, including the interaction between Candida and salivary proteins. Therefore, salivary gland hypofunction may alter the oral microbiota and increase the risk for opportunistic infections, such as candidiasis. Hence, it is necessary to evaluate the relationship between salivary flow rates (SFRs) and Candida colony counts in the saliva of patients with xerostomia.

Aims:

This study aims to determine and evaluate the relationship between SFRs and Candida colony forming units (CFUs) in patients with xerostomia.

Settings and Design:

This study was a descriptive study.

Subjects and Methods:

The study participants were taken from the patients attending outpatient department in a private dental college. Fifty patients, who reported xerostomia in a questionnaire of the symptoms of xerostomia, were selected. Chewing stimulated whole saliva samples were collected from them and their SFRs were assessed. Saliva samples were inoculated in the Sabouraud dextrose agar culture media for 24–48 h, and Candida CFUs were counted.

Statistical Analysis Used:

Chi-squared test was used to analyze the data.

Results:

There was a significant inverse relationship between salivary flow and candida CFUs count when patients with high colony counts were analyzed (cutoff point of 400 or greater CFU/mL). Females had less SFR than males. Most of the patients who had hyposalivation were taking medication for the underlying systemic diseases. Candida albicans was the most frequent species.

Conclusions:

There was a significantly negative correlation between SFRs and Candida CFUs in the patients with xerostomia.

Evaluation of Xerostomia in Different Psychological Disorders: An Observational Study

INTRODUCTION

Psychiatric diseases like anxiety, depression, schizophrenia and bipolar disorders are increasing at an alarming rate. These diseases can affect the quantity and quality of saliva leading to multiple oral diseases. Although many researchers have evaluated xerostomia in general population, its prevalence is not been assessed in patients suffering from different psychological disorders.

AIM

To investigate the prevalence of xerostomia and to assess the correlation between xerostomia and dryness of lip and mucosa in different psychological disorders.

MATERIALS AND METHODS

A cross-sectional observational study was conducted over a period of six months in Department of Psychiatry and Department of Oral Medicine. Patients with anxiety, depression, schizophrenia and bipolar disorder, as diagnosed by an experienced psychiatrist, were given a questionnaire to evaluate the xerostomia. Patients with symptoms of xerostomia were subjected to oral examination by a skilled oral diagnostician to check for dryness of lips and mucosa. One hundred patients from each group of psychiatric diseases were included in the study using a consecutive sampling technique. An equal number of healthy individuals reporting to oral medicine department for routine oral screening were included as control group after initial psychiatric evaluation.

RESULTS

In this study statistically significant increase in the xerostomia in psychiatric patients was recorded when compared to the control group (p<0.01). Xerostomia was significantly higher in anxiety patients (51%) followed by depression (47%), bipolar disorder (41%), schizophrenia (39%) and control group (27%). The majority of the psychiatric patients had 'moderate' to 'severe' xerostomia whereas the control group had 'mild' xerostomia. Xerostomia was significantly higher in younger age group (18-49 years) than in older age group and females patients had higher xerostomia than male patients. Psychiatric patients had significantly more dryness of lip and mucosa than healthy controls. A moderate to strong spearman correlation (r=0.72) was observed between xerostomia and psychological alterations.

CONCLUSION

A positive association was established between psychological alterations and xerostomia and dryness of lip and mucosa. Emotional alterations may act as a precipitating factor that could influence the salivary secretion resulting in multiple oral diseases. Psychiatrists can screen for xerostomia and collaborate with dentists for comprehensive management of xerostomia in psychiatric patients.

Prevalence of xerostomia in an adolescent inpatient psychiatric clinic: a preliminary study

OBJECTIVE

Adolescents with psychiatric conditions may be at risk for xerostomia. In this preliminary study, we estimated xerostomia prevalence in adolescents ages 9 to 17 years from an inpatient psychiatric clinic (N = 25) and examined whether: (1) gender and age were associated with xerostomia and (2) xerostomia was associated with self-reported cavities.

METHODS

We used a modified 11-item Xerostomia Index to identify xerostomia (no/yes) and asked if adolescents ever had or currently have cavities (no/yes).

RESULTS

The mean age was 14 years (SD = 2.3) and 72% were male. Sixty percent reported xerostomia (SD = 50). There were no significant associations between xerostomia and gender (p = 0.99) or age (p = 0.66), or between xerostomia and past (p = 0.26) or current cavities (p = 0.11). Larger proportions of adolescents with xerostomia reported previous and current cavities.

CONCLUSIONS

Sixty percent of adolescents from an inpatient psychiatric clinic reported having xerostomia, which may lead to increased caries risk over time. Additional research should examine the prevalence and consequences of xerostomia in high-risk adolescents.

Prevalence of xerostomia in patients attending Shorish dental speciality in Sulaimani city

Objectives: The aim of this study was to investigate the prevalence of xerostomia among dental patients and explore the possible risk factors and symptoms associated with this condition. Patient and Methods: The prevalence of xerostomia and its associations were investigated among patients (n=1132) who were visiting the department of oral medicine at shorish dental speciality in sulaimani city. The age range was between 10-79 years. 512 (45.2%) of participants were males and 620 (54.8%) were females. The data collected were age, sex, systemic diseases, medications and habit of smoking. Logistic regression models to estimate odds ratios and 95% confidence intervals were used to investigate the association of xerostomia with age, systemic diseases and medications and Chi Square test was also used to analyze the data. Results: Prevalence of xerostomia was 16.07%. Prevalence of xerostomia was significantly higher among females (19.51%) than males (11.91%) (P=0.001). The most common diseases with the highest prevalence of xerostomia were psychological disorders (57.14%) followed by diabetes mellitus (53.84%), neurological disorders (40%), thyroid disorders (37.5%) and hypertension (36.48%). The most common medication with the highest prevalence of xerostomia was antihistamine (66.66%) followed by psychotherapeutic medications (60%), pain medications (55.88%), endocrinologic agents (51.21%), antidyslipidic agents (50%) and antihypertensive medication (38.98%). Xerostomia was significantly associated with ageing (OR: 1.02, P=0.000), systemic diseases (OR: 2.80, P=0.000) and medications (OR: 5.17, P=0.000). There was a high prevalence of reported symptoms of xerostomia and these symptoms were more prevalent among females, Prevalence of xerostomia was higher in heavy smoker patients (19.48%) than non smoker patients but not significantly (16.14%) (p= 0.44). Conclusions: There was a high prevalence of xerostomia among dental patients; xerostomia was significantly more prevalent among females and significantly associated with age, systemic diseases and medications; xerostomia adversely affects oral functions; dentist must be familial with sign and symptoms of xerostomia and can have an active role in the management of xerostomia and preventing or treating complications.

Key words:Ageing, medications, xerostomia, prevalence.

Factors associated with self-rated oral health among community-dwelling older Japanese: A cross-sectional study

OBJECTIVES

A cross-sectional study was carried out to investigate the determinants of self-rated oral health among community-dwelling older people in Japan.

METHODS

The participants were 897 (357 men and 540 women) aged 65 years and over who participated in a comprehensive geriatric health examination, which included an oral examination, a face-to-face interview assessing cognitive function, questionnaires regarding depressive symptoms and functional capacity, and a medical examination. The oral examination measured indices of oral health status: number of present teeth, number of functional teeth, occlusal force and amount of resting saliva. Multiple logistic regression analyses were carried out to determine the factors associated with poor self-rated oral health.

RESULTS

The mean age of the participants was 73.5 ± 5.0 years. The prevalence of poor and rather poor self-rated oral health was 11.5% and 29.5%, respectively. Multiple logistic regression analyses showed that the number of present teeth (odds ratio [OR] 0.97, 95% confidence intervals [CI] 0.95-0.99), difficulty in mastication (OR 3.20, CI 2.18-4.70), presence of xerostomia (OR 1.43, CI 1.02-2.01), total score on the MoCA-J (OR 1.06, CI 1.01-1.11), and reduction in frequency of leaving the house (OR 1.64, CI 1.12-2.41) were significantly associated with poor self-rated oral health.

CONCLUSIONS

The present results suggested that self-rated oral health was a significant factor in oral health status as well as overall well-being among community-dwelling older Japanese people.

Oral health-related quality of life in diabetic patients: comparison of the Persian version of Geriatric Oral Health Assessment Index and Oral Health Impact Profile: A descriptive-analytic study

BACKGROUND

Diabetes mellitus is one of the systemic disease which is show important oral manifestation and influence oral health. This study describes how diabetes mellitus affects oral health and oral health-related quality of life. The aim of this study was to evaluate the oral health and oral health-related quality of life of diabetic patients and compare the discriminative capability of Persian versions of two GOHAI and OHIP-14 questionnaires in these patients.

METHODS

A total of 350 patients with Type II diabetes mellitus, referring to the Diabetes Clinic, were selected and data were collected by GOHAI and OHIP-14 questionnaires completed by patients and clinical examinations. Oral health parameters (CAL,BI,GI,PLI,DMFT and xerostomia) were measured, also concurrent validity and conformity of two questionnaires were assessed. In order to test Discriminant analysis capabilities of two questionnaires, ADD and SC scores of questionnaires were divided into two parts and a logistic regression model was designed, which included subjective and objective variables.

RESULTS

Mean patients age was 55 years (with 75.4% female patients). The results showed that some oral conditions such as xerostomia, clinical attachment loss, number of missing teeth and plaque index were correlated to diabetes control level (HbA1c) and type of anti-diabetic medication. ADD and SC scores of two questionnaires were at high level. However, the effect of oral problems on decreasing OHRQoL was evident. Both questionnaires had acceptable concurrent validity and conformity. Moreover, there was a strong correlation between GOHAI and OHIP-14. OHIP-14 questionnaire had a higher discriminant analysis capability compared to GOHAI and better diagnosed patients who needed dental treatments: patients with higher GI, xerostomia and those wearing partial dentures.

CONCLUSION

Diabetic patients did not show acceptable oral health status and in some extent, oral problems affected oral health-related quality of life. Psychotherapy courses and solving oral problems of the patients can improve OHRQoL. OHIP-14 had higher discriminant analysis capability and was more effective in diagnosing oral problems.

Association of Xerostomia and Assessment of Salivary Flow Using Modified Schirmer Test among Smokers and Healthy Individuals: A Preliminutesary Study

BACKGROUND AND OBJECTIVE

Several oral diseases such as dental caries, periodontitis and oral infections can be a major concern in patients suffering from mouth dryness. Whole mouth salivary flow is affected by many factors which may include habits like smoking. The aim of the present study was to investigate the incidence of xerostomia and hyposalivation among smokers.

MATERIALS AND METHODS

The study groups included 60 smokers and 60 healthy non-tobacco users as case and control groups respectively. A questionnaire was used to collect the smoking habits and symptoms associated with xerostomia. Measurement of unstimulated whole mouth salivary flow for 3 minutesutes was performed using modified Schirmer test. The results were subjected to statistical analysis.

RESULTS

The prevalence of xerostomia symptom was 37% in smokers and it was 13% in non-smokers, with a statistically significant difference between groups (p=0.003). The prevalence of hyposalivation was 43% in smokers, whereas it was only 8% in the control group (p< 0.001).

CONCLUSION

Xerostomia symptoms with significant reduction in unstimulated whole mouth salivary flow were associated with long term smoking.

Prevalence and factors associated with xerostomia and hyposalivation among community-dwelling older people in Japan

OBJECTIVE

This study investigated the prevalence and factors associated with xerostomia and hyposalivation among community-dwelling older people.

BACKGROUND

Xerostomia and hyposalivation are common symptoms in the older population.

MATERIALS AND METHODS

This study included with 894 community-dwelling, Japanese older people (355 men, 539 women; age 65-84 years) who participated in a comprehensive geriatric health examination, which included questionnaires and interviews regarding medical history, medications, Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), depressive condition. The Zung Self-Rating Depression Scale (SDS) was used to evaluate depression. Resting salivary flow rate was evaluated by the modified cotton roll method.

RESULTS

In this study, 34.8% of the participants (mean age, 73.5 ± 5.0 years) complained about xerostomia, while the prevalence of hyposalivation was 11.5%. Multiple regression analysis revealed hypnotics use [odds ratio (OR) = 1.71, 95% confidence interval (CI) = 1.13-2.61], SDS (OR = 1.05, CI = 1.04-1.07) and TMIG-IC total points (OR = 0.87, CI = 0.76-0.99) to be significantly associated with xerostomia. In contrast, female gender (OR = 2.59, CI = 1.55-4.31) and the use of agents affecting digestive organs (OR = 1.78, CI = 1.11-2.86) were associated with hyposalivation.

CONCLUSION

Our findings showed that the prevalence of xerostomia and hyposalivation were approximately 1 in 3 and 1 in 10 respectively. The factors associated with psychological factors and high-level functional competence, while hyposalivation was associated with medications and gender, as well as systemic and/or metabolic differences. It is important to consider these multidimensional factors associated with xerostomia and hyposalivation.

Oral Health and Swallowing Problems

Oral health impacts systemic health. Therefore, oral care is an important consideration in maintaining quality of life (QOL). Previously, maintenance and improvement of oral hygiene was considered essential for achieving oral health. In addition to oral hygiene, oral care in terms of oral function is now considered to maintain QOL. Ingestion of exogenous nutrients via the oral cavity is fundamental to the function of all higher animals, not only human beings. Chewing and swallowing processes are critical for normal food intake, and adequate saliva supply and oral care to allow proper functioning of these processes are indispensable for maintaining QOL. In this review, we will summarize the relationship between chewing and swallowing and effects of saliva secretion on these functions, and discuss methods to maintain ingestion of exogenous nutrients and prevent swallowing problems, especially in elderly people.

Xerostomia in complete denture wearers: prevalence, clinical findings and impact on oral functions

OBJECTIVES

To investigate the prevalence of dry mouth in a select sample of edentulous Jordanian older population wearing complete dentures and to evaluate its impact on oral functions.

BACKGROUND

The prevalence and impact of Xerostomia as a cofactor in causing denture problems in Jordanians have not been previously investigated.

MATERIALS AND METHODS

This study included 455 participants (253 men and 202 women). Perception of dry mouth was measured by a pilot-tested questionnaire. Xerostomic status was confirmed clinically. Complete denture function was also assessed.

RESULTS

One hundred and thirty six subjects (29.9%) had reported a subjective feeling of dry mouth with a prevalence of 24.9% in men (n = 63) and 36.1% in women (n = 73) (p < 0.01). 136 of the 145 subjects with satisfactory dentures showed one or more signs suggestive of Xerostomia. The majority of xerostomic participants with different sets of complete dentures were dissatisfied with oral functions (p < 0.05). There was a significant association between dry mouth and increasing age, female gender and smoking status (p < 0.05).

CONCLUSION

Among complete denture wearers, Xerostomia is significantly more prevalent in women and associated with increased age and smoking. Xerostomia adversely affects oral functions and overall satisfaction with dentures.

Factors associated with dry mouth in dependent Japanese elderly

OBJECTIVES

To identify factors associated with dry mouth.

BACKGROUND

Dry mouth adversely affects oropharyngeal health, particularly in elderly, and can lead to pneumonia. A better understanding of the epidemiology of dry mouth is therefore important in improving treatment strategies and oral health in high-risk elderly patients.

METHODS

We conducted a cross-sectional study involving 383 dependent Japanese elderly individuals (65-84 [n = 167] and ≥85 [n = 216] years) at eight long-term care facilities and hospitals. Thirty-four potential factors associated with dry mouth were examined by multiple logistic regression analysis. The primary outcome was dry mouth, as diagnosed by tongue dorsum moisture.

RESULTS

We identified that body mass index and severity of physical disability were identified as a potential factors associated with dry mouth in the super-elderly (≥85 years) group, whereas severity of physical disability, outcome measurement time, high daily water consumption, mouth breathing, use of antidepressants and diuretics, and high frequency of daily brushing (≥2 times per day; Odds ratio: 5.56; 95% Confidence Interval: 1.52-20.00) were associated with dry mouth in the 65- to 84-year-old group.

CONCLUSION

To our knowledge, this is the first study to identify a link between frequency of daily brushing and dry mouth and suggests that tooth brushing should be encouraged in high-risk dependent Japanese elderly (65-84 years), particularly those taking antidepressants and/or diuretics.