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Ramírez L, Sánchez I, González-Serrano J, Muñoz M, Martínez-Acitores ML, Garrido E, Hernández G, López-Pintor RM. Factors influencing xerostomia and oral health-related quality of life in polymedicated patients. Gerodontology 2024; 41:424-432. [PMID: 37944110 DOI: 10.1111/ger.12724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES To evaluate whether the severity of xerostomia in older polymedicated patients impacts oral health-related quality of life (OHRQoL). BACKGROUND Medication-associated xerostomia is common in older people. Xerostomia may impair OHRQoL. MATERIALS AND METHODS This cross-sectional study included older hypertensive patients from two health centres. We assessed the severity of xerostomia and OHRQoL using the Xerostomia Inventory (XI) tool, and the Oral Health Impact Profile-14 (OHIP-14) instrument, respectively. We measured unstimulated (UWS) and stimulated (SWS) salivary flows. Univariate and multiple linear regression analyses evaluated the associations of XI and OHIP-14 and different explanatory variables. RESULTS Of the 218 patients enrolled, 51.8% had xerostomia, and 38.1% and 27.5% suffered from UWS and SWS hyposalivation, respectively. Patients with xerostomia, UWS, and SWS hyposalivation scored significantly higher on the XI. However, only those with xerostomia or UWS hyposalivation had significantly higher OHIP-14 scores. A moderate correlation was observed between XI and OHIP-14 scores. The multiple regression model showed that factors with the greatest impact on XI were the patient's complaint of xerostomia, UWS flow rate, age and sex. However, only the XI score was significantly associated with the OHIP-14 score. CONCLUSION Xerostomia has a negative impact on OHRQoL in older polymedicated patients, but this impact is less than in other types of xerostomia. Longitudinal studies are needed to determine whether changes in the detected explanatory variables influence XI and OHIP scores in these patients.
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Affiliation(s)
- Lucía Ramírez
- Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University, Madrid, Spain
| | - Isabel Sánchez
- Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University, Madrid, Spain
| | - José González-Serrano
- Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University, Madrid, Spain
| | - Marta Muñoz
- Department of Clinical Dentistry, School of Biomedical Science, European University of Madrid, Madrid, Spain
| | | | | | - Gonzalo Hernández
- Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University, Madrid, Spain
| | - Rosa María López-Pintor
- Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University, Madrid, Spain
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韦 靖, 赵 秋, 黄 维, 刘 星, 张 雪. [Analysis of the Occurrence and Influencing Factors of Oral Frailty in Elderly Residents of Elderly Care Facilities]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2024; 55:947-957. [PMID: 39170015 PMCID: PMC11334268 DOI: 10.12182/20240760602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Indexed: 08/23/2024]
Abstract
Objective To investigate the occurrence and influencing factors of oral frailty in elderly residents of elderly care facilities and to provide a basis for the development of effective intervention programs for oral frailty in this population. Methods A combination of subjective and objective measurements of oral frailty, a general information questionnaire, a leisure activity questionnaire, the Dietary Variety Score (DVS), the Short Nutritional Assessment Questionnaire (SNAQ), the Short-Form Mini Nutritional Assessment (MNA-SF), Barthel Index (BI), the Mini-Mental State Examination (MMSE), 15-Item Geriatric Depression Scale (GDS-15), and the Generalized Anxiety Disorder Scale-2 (GAD-2) were used to survey 348 elderly residents in three elderly care facilities in Chengdu and to analyze the factors related to oral frailty. Results The prevalence of oral frailty in elderly residents of elderly care facilities was 31.0% (108/348). Multivariate logistic regression analysis revealed that advanced age (odds ratio [OR]=1.347, 95% confidence interval [CI]: 1.237-1.496, P<0.001), cognitive impairment (OR=6.769, 95% CI: 2.628-18.916, P<0.001), and depression (OR=8.632, 95% CI: 1.931-44.387, P=0.007) were risk factors for oral frailty in elderly residents of elderly care facilities. High scores in leisure activities (OR=0.883, 95% CI: 0.786-0.986, P=0.030), and dietary diversity (OR=0.199, 95% CI: 0.069-0.530, P=0.002) were protective factors against oral frailty. Conclusion The prevalence of oral frailty is relatively high among elderly residents of elderly care facilities. Risk factors for oral frailty include advanced age, cognitive impairment, and depression, while increased levels of leisure activities and dietary diversity can help prevent the occurrence of oral frailty in elderly individuals.
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Affiliation(s)
- 靖怡 韦
- 口腔疾病防治全国重点实验室 国家口腔医学中心 国家口腔疾病临床医学研究中心 四川大学华西口腔医院 消毒供应室 (成都 610041)State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Sterile Supply, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - 秋艳 赵
- 口腔疾病防治全国重点实验室 国家口腔医学中心 国家口腔疾病临床医学研究中心 四川大学华西口腔医院 消毒供应室 (成都 610041)State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Sterile Supply, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - 维 黄
- 口腔疾病防治全国重点实验室 国家口腔医学中心 国家口腔疾病临床医学研究中心 四川大学华西口腔医院 消毒供应室 (成都 610041)State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Sterile Supply, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - 星 刘
- 口腔疾病防治全国重点实验室 国家口腔医学中心 国家口腔疾病临床医学研究中心 四川大学华西口腔医院 消毒供应室 (成都 610041)State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Sterile Supply, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - 雪梅 张
- 口腔疾病防治全国重点实验室 国家口腔医学中心 国家口腔疾病临床医学研究中心 四川大学华西口腔医院 消毒供应室 (成都 610041)State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Sterile Supply, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Yeğinoğlu S, Ereş G. Xerostomia in a Group of Turkish Patients Using an Online Survey During the COVID-19 Pandemic. Cureus 2024; 16:e64930. [PMID: 39156360 PMCID: PMC11330654 DOI: 10.7759/cureus.64930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2024] [Indexed: 08/20/2024] Open
Abstract
Background Xerostomia is defined as the subjective feeling of dry mouth and affects millions of patients worldwide. Most studies are based on samples of the elderly in nursing homes. This study aimed to investigate the presence of xerostomia and the severity of self-reported xerostomia by sociodemographic variables and to evaluate xerostomia symptoms (self-reported halitosis, burning mouth, and mouth sores) in young adults. Methodology A questionnaire regarding sociodemographic data and the 11-item Xerostomia Inventory was delivered to patients aged 20-65 years who applied to the Ankara University Faculty of Dentistry for dental treatment before the COVID-19 pandemic. Statistical analyses were performed to determine the relationships between the presence of xerostomia and other variables such as age, gender, the presence of a systemic disease, medication use, smoking, alcohol consumption, and the use of removable prostheses. Results A total of 300 patients were included in the study. Xerostomia presence of 54.6% (164 patients) was identified. A significant relationship was found between age and xerostomia (p = 0.023; p = 0.001). The presence of xerostomia decreased as age increased. Xerostomia was more common in female patients (p = 0.028; p = 0.004). The presence of xerostomia was found to be high, not only in the elderly but also in younger adults. Conclusions This study sheds light on the current status, symptoms, and etiology of xerostomia presence in the young population in Turkey. Factors associated with xerostomia were age, female gender, and the number of cigarettes smoked per day. In this study, the high presence of xerostomia was due to smoking.
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Affiliation(s)
- Sevilay Yeğinoğlu
- Periodontology, Karabük Oral and Dental Health Hospital, Ministry of Health, Karabük, TUR
| | - Gülden Ereş
- Periodontology, Faculty of Dentistry, Ankara University, Ankara, TUR
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Biary T, Finkelman M, Tassabehji NM. Pre-doctoral dental students' knowledge, training, perceptions, and attitudes regarding obesity and treatments: A survey study. J Dent Educ 2024; 88:832-839. [PMID: 38356369 DOI: 10.1002/jdd.13481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 01/03/2024] [Accepted: 01/17/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE The aims of this study were to assess first-year predoctoral dental students' knowledge, training, perceptions, and attitudes on obesity and to compare knowledge, perceptions, and attitudes before and after attending an educational presentation. METHODS A presentation explaining the impact of obesity and its treatments on oral health was developed and presented to first-year predoctoral dental students (D1's) in the Doctor of Dental Medicine program. Before ("pre") and after ("post") the presentation, attending students were given the opportunity to take an anonymous and voluntary survey. Questions on the survey covered topics on knowledge, training, perceptions, and attitudes about obesity. RESULTS Thirty-four of the 213 students in the course (response rate = 16.0%) attended the presentation and completed both the pre- and post-surveys. Most participating students reported receiving 0-5 h of education on obesity since starting their dental education. Regarding pre-survey answers to knowledge-based items, the percentage of students answering, "strongly agree" (representing the greatest knowledge level) ranged from 5.9% to 61.8% across items. Significant improvements from pre- to post-survey were observed for all knowledge-based items except a statement that obesity is associated with serious medical conditions. Significant improvements were also found for perception-based items asking about accommodations for patients and the importance of assessing dietary habits. Additionally, at post-survey, students reported significantly less discomfort asking about dietary habits and weight loss medications. CONCLUSION Dental curricula policy makers and developers should consider the incorporation of obesity and its treatments, with nutrition experts teaching the content.
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Affiliation(s)
- Tamara Biary
- Department of Endodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Mathew Finkelman
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Nadine M Tassabehji
- Department of Comprehensive Care, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
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5
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Moon S, Oh E, Chung D, Choi R, Hong GRS. Validation of the Korean version of the Summated Xerostomia Inventory among older adults residing in nursing homes. BMC Public Health 2024; 24:1466. [PMID: 38822313 PMCID: PMC11143705 DOI: 10.1186/s12889-024-18875-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/17/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Xerostomia is commonly experienced by older individuals. We sought to develop and evaluate the reliability and validity of the Korean version of the Summated Xerostomia Inventory (K-SXI) among older adults residing in long-term care facilities (LTCFs) in Korea. METHODS In this secondary data analysis study using cross-sectional data, a cross-cultural adaptation process was conducted for the Korean version before data collection. Data collection was conducted from July 2021 to January 2022, targeting 544 older adults in 16 LTCFs. Data analysis included intraclass correlation coefficient (ICC) for test-retest reliability, and Cronbach's α for internal consistency reliability. Exploratory and confirmatory factor analyses were used to verify construct and convergent validity. Test-retest analysis was performed 6 weeks after baseline. Convergent and concurrent validities were assessed with age group and the xerostomia standard single question, respectively. RESULTS A total of 544 older adults participated in this study. The mean of total K-SXI score was 11.70 (standard deviation, 4.96) points. The ICC value was calculated to be 0.90, and Cronbach's α of K-SXI was 0.92. Exploratory factor analysis revealed a single factor, explaining 74.8% of the total variance, however, some goodness-of-fit indices of the single factor model were found to be unsuitable in confirmatory factor analysis. The convergent and concurrent validity were supported. CONCLUSION The present study provides evidence supporting the validity and reliability of the K-SXI for measuring xerostomia in institutionalized older adults in Korea.
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Affiliation(s)
- SeolHwa Moon
- Department of Nursing, Hoseo University, #20, Hoseo-ro 79beon-gil, Baebang-eup, Asan, 31499, Korea
| | - Eunmi Oh
- Research Institute of Nursing Science, Hanyang University, #222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea
| | - Daum Chung
- College of Nursing, Hanyang University, #222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea
| | - Rina Choi
- College of Nursing, Hanyang University, #222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea
| | - Gwi-Ryung Son Hong
- College of Nursing, Hanyang University, #222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea.
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Rojo BL, Brown S, Barnes H, Allen J, Miles A. Home-based oral health program for adults with intellectual disabilities: An intervention study. Disabil Health J 2024; 17:101516. [PMID: 37648601 DOI: 10.1016/j.dhjo.2023.101516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Poor oral health is common in adults with intellectual disabilities leading to risk of mouth and lung infections. Yet, little is known about the benefits of preventative oral health programs. OBJECTIVE/HYPOTHESIS This prospective longitudinal experimental mixed methods study evaluated the efficacy of an oral health program aimed at improving knowledge and behaviours in adults with intellectual disabilities living in supported housing. METHODS A 90-min training session was provided to residents and their staff at 12 houses (56 residents; 67 staff). Follow-up training sessions (at 1 week, 1,2,3 months) were tailored to the learning abilities, behavioural/physical challenges, and independence of residents. Outcome measures were collected pre, 1, 2 and 3 months (n = 36): dental exam, plaque index, gingival signs, tongue coating index and behavioural rating scale. At 3 months, support workers (n = 10) and residents (n = 19) were interviewed. Residents' interviews were supported by Talking Mats®. RESULTS Most residents (94%) required support for oral cares; with 63% fully dependant on their support workers. 24 (63%) residents had significantly improved plaque scores at 3 months (p < .001). Resident interviews were restricted by communication competency but supported interviews indicated positive responses to 3-sided toothbrush 91%, interdental brush/flosser 60%, and mouthwash 100%. Support worker interviews revealed perceived health and social benefits including fresher breath and benefits of routines. CONCLUSIONS Oral health programs for adults with intellectual disabilities living in supported housing are well received by staff and residents, leading to changes in oral care routines and measurable changes in oral health.
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Affiliation(s)
| | - Sarah Brown
- Speech Science, The University of Auckland, New Zealand
| | | | - Jacqui Allen
- Surgery, The University of Auckland, New Zealand
| | - Anna Miles
- Speech Science, The University of Auckland, New Zealand.
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Horncastle AJ, Gauld TD, Smith MB, Thomson WM. Comparing approaches to determining poor oral health among older adults in a national survey. Gerodontology 2023. [PMID: 38009567 DOI: 10.1111/ger.12729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVES To compare the clinical validity of the three approaches in residential care facility residents. BACKGROUND In NZ residential care facilities, the interRAI assessment tool is used by trained registered nurses for assessing oral status when new residents are admitted, but its validity has been questioned. Although Locker's global oral health item has been used to measure oral health in surveys and health services research, it is not routinely used in care facilities, yet its clinical validity has been demonstrated in population-based samples. Self-perceived oral health need may also be useful. MATERIALS AND METHODS Using a secondary analysis of clinical and self-reported data from a national survey of nursing home residents (the 2012 New Zealand Older People's Oral Health Survey, or OPOHS), we compared the validity of Locker's item, the interRAI tool and self-reported treatment need for identifying three key clinical indicators of poor oral health among dentate older adults; those were coronal caries (3+ teeth affected), root caries (1+ teeth affected) and xerostomia. Analyses were conducted using STATA, and survey weighting was used to obtain estimates for a source population of 25-843 individuals. RESULTS The prevalence of 3+ teeth with coronal caries was 28.7% (23.9, 34.0), the prevalence of 1+ teeth with root caries was 33.7% (28.7, 39.0), the prevalence of xerostomia was 23.1% (18.4, 28.3). Marked gradients in prevalence risk ratio were seen across different categories of Locker's global oral health item and the interRAI assessment tooth for coronal caries and xerostomia. Locker's global oral health item gave a better fitting model and was more discriminative in detecting coronal caries than the interRAI assessment tool (Lockers AIC = 0.76, interRAI AIC = 0.81). None of the approaches was particularly discriminative for root surface caries experience. CONCLUSION Self-reported approaches are discriminative for poor oral health. Standardised assessment tools used in residential care facilities should consider including a self-assessment component such as Locker's global oral health item.
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Affiliation(s)
- Alice J Horncastle
- Department of Oral Sciences, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Taylor D Gauld
- Department of Oral Sciences, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Moira B Smith
- Department of Public Health, Faculty of Medicine, Wellington School of Medicine, University of Otago, Wellington, New Zealand
| | - W Murray Thomson
- Department of Oral Sciences, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
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Verhoeff MC, Koutris M, Vries RD, Berendse HW, Dijk KDV, Lobbezoo F. Salivation in Parkinson's disease: A scoping review. Gerodontology 2023; 40:26-38. [PMID: 35246869 DOI: 10.1111/ger.12628] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES We aimed to provide an overview of the available literature that includes both objective assessments (namely hypersalivation and hyposalivation) and the subjective experience (namely xerostomia and drooling) of salivary problems in patients with Parkinson's disease. BACKGROUND In patients with Parkinson's disease, there may be complaints of salivary problems such as xerostomia or drooling. This can have consequences for their oral health and quality of life. To date, systematic reviews have focused on drooling only. MATERIALS AND METHODS A literature search in 4 databases was performed up to 12 February 2021. Two researchers independently assessed studies for eligibility. RESULTS In total, 63 studies were included. The prevalence of self-reported xerostomia ranged from 49% to 77%, and that of self-reported drooling ranged from 5% to 80%. Ten articles reported a significantly lower mean salivary flow in patients with Parkinson's disease than in controls. None of the articles with both a control group and a patient group reported a significantly higher salivary flow in patients with Parkinson's disease. When questioned about subjective salivary problems, a significantly higher prevalence of both xerostomia (7 studies) and drooling (14 studies) was found in patients with Parkinson's disease than in controls. Patients with Parkinson's disease have a lower salivary flow rate and higher prevalence of both xerostomia and drooling than controls. CONCLUSION The complexity of salivary problems present in patients with Parkinson's disease necessitates a multidisciplinary approach in order to avoid mutually counteracting treatments from different healthcare professionals.
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Affiliation(s)
- Merel C Verhoeff
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Michail Koutris
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ralph de Vries
- Medical Library, Vrije Universiteit, Amsterdam, Amsterdam, The Netherlands
| | - Henk W Berendse
- Amsterdam University Medical Centres (Amsterdam UMC), Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Karin D van Dijk
- Amsterdam University Medical Centres (Amsterdam UMC), Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Sleep Wake Centre, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Wiriyakijja P, Niklander S, Santos-Silva AR, Shorrer MK, Simms ML, Villa A, Sankar V, Kerr AR, Riordain RN, Jensen SB, Delli K. World Workshop on Oral Medicine VIII: Development of a Core Outcome Set for Dry Mouth: A Systematic Review of Outcome Domains for Xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol 2023:S2212-4403(23)00068-8. [PMID: 37198047 DOI: 10.1016/j.oooo.2023.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/11/2022] [Accepted: 01/25/2023] [Indexed: 03/08/2023]
Abstract
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.
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Leung KCM, Chu CH. Dental Care for Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:214. [PMID: 36612536 PMCID: PMC9819414 DOI: 10.3390/ijerph20010214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/10/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
There is a global increase in the older population. Unfortunately, dental conditions in the older population can sometimes be poor as a result of worsened physical conditions and the cumulative damage caused by dental diseases in the past. Many suffer from oral diseases such as dental caries and periodontal disease but receive no regular dental care. Oral conditions and systemic problems are interrelated. Chronic medical problems and polypharmacy are common among them. These conditions may lead to xerostomia with or without a decrease in saliva output. Additionally, many older adults have deteriorated masticatory function associated with physical health issues such as frailty. Preventive measures are crucial to stop oral diseases from progressing and the replacement of missing teeth is needed when masticatory function is impaired. Older adults also suffer a higher risk of oral cancer because of their less resilient but more permeable oral mucosa. With the increasing need for elderly dental care, dentists should equip themselves with knowledge and skills in geriatric dentistry. They should help older adults to develop and maintain the functional ability that enables well-being in older age. This communication article aims to discuss the relevant medical conditions, common dental diseases, and dental care for older adults.
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11
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Krajewski MP, Mo Q, Lu CH, Cantos A, Feuerstein S, Brandt MJ, Wahler RG. Medication Use Among Patients Reporting Xerostomia of an Academic Dental Clinic. J Pharm Technol 2022; 38:264-271. [DOI: 10.1177/87551225221108599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Global prevalence of xerostomia has been reported at 22% (range 0.01%-45%), negatively impacting oral health, nutrition intake, and quality of life. The causal relationship between xerostomia and medications remains uncertain but greater understanding could guide interventions. Objective: To describe the demographic characteristics and medication regimens in patients with xerostomia of an academic dental clinic. Method: This is a retrospective academic dental clinic record review from July 1, 2018 to October 27, 2020. Patient records were obtained from the University at Buffalo, School of Dental Medicine. Xerostomia status was determined via query of electronic health records and validated by manual review. Pharmacologic class and xerostomic potential of medications were identified by the Veterans Affairs Drug Classification System and drug compendia, respectively. Predictors of medication use were assessed using a multiple logistic regression model. Results: Of 37 403 examined records, 366 (0.98%) were identified as xerostomic. After excluding confounding factors (Sjogren’s and radiation), 275 of 317 patients received at least one xerostomic medication, majority were female (240, 66%) versus male (126, 34%). Mean ± (SD) age was 64.9 ± 15.11 years. A total of 208 (57%) patients were aged ≥65. The median number of total and xerostomic medications were 8 (interquartile range [IQR], 4-12) and 4 (IQR, 2-7), respectively. The 3 most prevalent xerostomic pharmacologic classes were antidepressants (131, 35%), gastric medications (101, 28%), and vitamin D (87, 24%). Conclusion: Despite observed prevalence of xerostomia lower than global prevalence, xerostomic medication burden for patients experiencing xerostomia was high. Pharmacist-led interprofessional collaborations should be investigated to reduce xerostomic burden.
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Affiliation(s)
- Michael P. Krajewski
- School of Pharmacy and Pharmaceutical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
- School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | - QingXiang Mo
- School of Pharmacy and Pharmaceutical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
| | - Chi-Hua Lu
- School of Pharmacy and Pharmaceutical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
| | - Albert Cantos
- School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | - Steve Feuerstein
- School of Pharmacy and Pharmaceutical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
| | | | - Robert G. Wahler
- School of Pharmacy and Pharmaceutical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
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12
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Physical Frailty and Oral Frailty Associated with Late-Life Depression in Community-Dwelling Older Adults. J Pers Med 2022; 12:jpm12030459. [PMID: 35330459 PMCID: PMC8954826 DOI: 10.3390/jpm12030459] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/11/2022] [Accepted: 03/11/2022] [Indexed: 11/29/2022] Open
Abstract
Late-life depression is a major mental health problem and constitutes a heavy public health burden. Frailty, an aging-related syndrome, is reciprocally related to depressive symptoms. This study investigated the associations of physical frailty and oral frailty with depression in older adults. This large-scale cross-sectional study included 1100 community-dwelling older adults in Taiwan. The participants completed a dental examination and questionnaires answered during personal interviews. The 15-item Geriatric Depression Scale was used to assess depression, and information on physical conditions and oral conditions was collected. Multivariable logistical regression analysis was conducted to examine associations of interest. Significant factors associated with depression were pre-physical frailty (adjusted odds ratio (aOR) = 3.61), physical frailty (aOR = 53.74), sarcopenia (aOR = 4.25), insomnia (aOR = 2.56), pre-oral frailty (aOR = 2.56), oral frailty (aOR = 4.89), dysphagia (aOR = 2.85), and xerostomia (aOR = 1.10). Depression exerted a combined effect on physical frailty and oral frailty (aOR = 36.81). Physical frailty and oral frailty were significantly associated with late-life depression in community-dwelling older adults in a dose–response manner. Developing physical and oral function interventions to prevent depression among older adults is essential.
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13
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Thomson WM, Smith MB, Ferguson CA, Moses G. The Challenge of Medication-Induced Dry Mouth in Residential Aged Care. PHARMACY 2021; 9:162. [PMID: 34698291 PMCID: PMC8544708 DOI: 10.3390/pharmacy9040162] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 12/27/2022] Open
Abstract
With a reported prevalence between 20% and 30%, dry mouth is more common among older people than any other age group. The major risk factor for dry mouth is polypharmacy. Older people take more medications than any other age group, not only for symptomatic relief of various age-associated chronic diseases, but also to reduce the likelihood of the complications that may arise from those conditions. Most aged care residents take even more medications than older people who are living in their own homes. The greater the number of medications taken, the greater the associated anticholinergic burden, and the more likely it is that the individual will suffer from dry mouth. The condition not only affects the dentition and ability to wear dentures, but also the sufferers' quality of life. Treating dry mouth is a considerable challenge for clinicians. As medication use is by far the most important risk factor, there is a need for pharmacists, doctors and dentists to work together to prevent this from occurring. Medication review and deprescribing is a key strategy, but there have not yet been any randomised control trials of its efficacy in reducing the occurrence of dry mouth.
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Affiliation(s)
- William Murray Thomson
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin 9054, New Zealand
| | - Moira B. Smith
- Department of Public Health, Wellington School of Medicine, Faculty of Medicine, University of Otago, Wellington 6021, New Zealand; (M.B.S.); (C.A.F.)
| | - Catherine Anna Ferguson
- Department of Public Health, Wellington School of Medicine, Faculty of Medicine, University of Otago, Wellington 6021, New Zealand; (M.B.S.); (C.A.F.)
| | - Geraldine Moses
- School of Pharmacy, University of Queensland, Brisbane 4102, Australia;
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14
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Reisine S, Schensul JJ, Salvi A, Grady J, Ha T, Li J. Oral health-related quality of life outcomes in a randomized clinical trial to assess a community-based oral hygiene intervention among adults living in low-income senior housing. Health Qual Life Outcomes 2021; 19:227. [PMID: 34583694 PMCID: PMC8477498 DOI: 10.1186/s12955-021-01859-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/08/2021] [Indexed: 11/19/2022] Open
Abstract
Background Quality of life outcomes have been used frequently in clinical trials of oral health interventions. This study assessed the effects of a randomized trial on oral health related quality of life comparing an individual-based oral hygiene intervention to a community-based intervention. Methods Participants were recruited from six low-income senior housing residences. Buildings were randomly assigned to receive the individual-based intervention followed by the community-based intervention or to receive the community-based intervention followed by the individual intervention. Participants’ oral hygiene was assessed at baseline (T0), one month after the first intervention (T1) and one month after the second intervention (T2) and six months after the T2 assessment (T3). Oral hygiene was measured by the Gingival Index (GI) and Plaque scores (PS). Surveys collected data on beliefs, attitudes, behaviors and self-reported health status at T0, T1 and T2. Only oral hygiene and quality of life, measured by the General Oral Health Assessment Index (GOHAI), was assessed at all time points. general linear mixed models (GLMM) were used to assess changes in GOHAI over time, the interaction of condition by time and the contribution of psychosocial, behavioral, health status and background variables to changes in GOHAI. Results 331 people completed T0 assessments; 306 completed T1; 285 completed T2 and 268 completed T3. Scores on GOHAI at T0 ranged from 10 to 48 with a mean of 39.7 (sd = 7.8) and a median of 42. At T1, mean GOHAI was 40.7 (sd = 8.2), at T2 mean GOHAI was 41.1 (sd = 7.8) and at T3, GOHAI was 42.3 (sd = 8.2). GLMM showed that GOHAI improved significantly from T0 to T3 (p = 0.01) but the time by intervention interaction was not significant indicating that both interventions were effective in improving GOHAI but one intervention was not better than the other. Ethnicity, health status, worries, self-efficacy, number of missing teeth and symptoms of dry mouth were related to improvements in GOHAI. Neither GI nor PS were related to GOHAI. Conclusions The participants reported relatively good oral health related quality of life which improved significantly over time. Improvement occurred among all participants regardless of condition, suggesting that either intervention would be effective in future studies. Trial Registry: Clinicaltrials.gov, Clinical Trials ID #NCT02419144; Title: A Bi-level Intervention to Improve Older Adult Oral Health Status; Registered 04/07/2015 URL: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0005H9X&selectaction=Edit&uid=U0000KBK&ts=2&cx=-rajj5q
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Affiliation(s)
- Susan Reisine
- Division of Behavioral Sciences and Community Health, School of Dental Medicine, University of Connecticut, 263 Farmington Avenue, Farmington, CT, 06030, USA.
| | - Jean J Schensul
- Institute for Community Research, Two Hartford Square West, Suite 100, 146 Wyllys St., Hartford, CT, 06106, USA
| | - Apoorva Salvi
- Oregon Health and Science University, 3181 S.W. Sam Jackson Park Road, Portland, OR, 97239, USA
| | - James Grady
- Department of Community Medicine, University of Connecticut School of Medicine, 195 Farmington Avenue, Farmington, CT, 06030, USA
| | - Toan Ha
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto St., Pittsburgh, PA, 15261, USA
| | - Jianghong Li
- Institute for Community Research, Two Hartford Square West, Suite 100, 146 Wyllys St., Hartford, CT, 06106, USA
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15
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Coffey N, O' Leary F, Burke F, Roberts A, Howlett C, Plant B, Hayes M. "Oral Nutritional Supplements: Sugar Content and Potential Dental Implications". Gerodontology 2021; 39:354-358. [PMID: 34569084 DOI: 10.1111/ger.12592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/13/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The objectives of this article are to list the most commonly prescribed Oral Nutritional Supplements in the UK and Ireland and their sugar content; and to raise awareness among the dental profession regarding their uses and potential dental risks involved. BACKGROUND Many older patients benefit from Oral Nutritional Supplements. Prescribers may not consider dental implications of these. Patients may not think to disclose these medications to their dentist. MATERIALS AND METHODS A list of commonly prescribed Oral Nutritional Supplements in the UK and Ireland was compiled. Nutritional information was obtained from the manufacturers' website and arranged in order of decreasing sugar content. Potential dental implications are discussed and recommendations made for dental practitioners. RESULTS Pre-formed Oral Nutritional Supplements can contain between 6.6 and 27.2 g of sugar per serving. Powdered Oral Nutritional Supplements, which are to be mixed with 200 ml whole milk, contain between 16.4 and 35.0 g sugar per serving. The "shot"-type Oral Nutritional Supplements contain less sugar, ranging from 0.0 to 4.0 g per serving. CONCLUSIONS The sugar content of frequently prescribed Oral Nutritional Supplements can be high. While they are beneficial in assisting the patient to maintain a healthy BMI, they may increase the risk of dental caries. Dental professionals should enquire specifically about Oral Nutritional Supplements during history taking, particularly in groups who are likely to be prescribed such supplements. Consideration should also be given to increasing caries-preventive measures for patients who take these supplements.
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Affiliation(s)
- Niamh Coffey
- ¹Department of Restorative Dentistry, Cork University Dental School and Hospital, University College Cork, Cork, Ireland
| | - Fiona O' Leary
- ¹Department of Restorative Dentistry, Cork University Dental School and Hospital, University College Cork, Cork, Ireland
| | - Francis Burke
- ¹Department of Restorative Dentistry, Cork University Dental School and Hospital, University College Cork, Cork, Ireland
| | - Anthony Roberts
- ¹Department of Restorative Dentistry, Cork University Dental School and Hospital, University College Cork, Cork, Ireland
| | | | | | - Martina Hayes
- ¹Department of Restorative Dentistry, Cork University Dental School and Hospital, University College Cork, Cork, Ireland
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16
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Laugisch O, Holtfreter B, Pink C, Samietz S, Völzke H, Kocher T. Polypharmacy and saliva volumes in the northeast of Germany - The Study of Health in Pomerania. Community Dent Oral Epidemiol 2021; 50:139-146. [PMID: 33829548 DOI: 10.1111/cdoe.12644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Associations between saliva volumes or salivary flow rates and potentially xerogenic medication are rarely evaluated in cohorts with a wide age range. This cross-sectional cohort study investigated possible relationships between the regular consumption of potentially xerogenic medication and stimulated saliva volumes. METHODS Data from the German Studies of Health in Pomerania (SHIP-2 and SHIP-Trend-0) were pooled. Potentially xerogenic medications were identified using the Workshop on Oral Medicine VI criteria. Stimulated saliva was sampled using Salivette®, and saliva volumes expressed as μl/min were determined. Applying linear mixed models with adjustment for time point of saliva collection, associations of (a) age and sex with regularly consumed medication, (b) age and sex with saliva volumes, and (c) the number of regularly consumed xerogenic medications with saliva volumes were evaluated. RESULTS Six thousand seven hundred and fifty-three participants aged 20-83 years (mean 53.4 ± 14.9) were included. The average number of medications did not differ markedly between females (2.21 ± 2.46) and males (2.24 ± 2.83). Males took more potentially xerogenic medication (1.0 ± 1.3) than did females (0.9 ± 1.3). Also, males took more potentially xerogenic cardiovascular medications than did females (0.9 ± 1.2 versus 0.7 ± 1.1), while females were prescribed a higher number of potentially xerogenic medications affecting the nervous system (0.2 ± 0.5 versus 0.1 ± 0.4). The average stimulated saliva volume was 967.0 ± 433.3 µL/min. Regularly consumed and potentially xerogenic medications were associated with lower saliva volumes. Older age correlated not only with a higher number of total medications and a higher number of xerogenic medications affecting either the cardiovascular (in males) or the nervous system (in females), but also with lower saliva volumes. CONCLUSIONS Ageing was associated with polypharmacy, especially with the intake of potentially xerogenic medication, and lower average saliva volumes. With regard to complications of dry mouth, anamnesis of medication consumption is of high importance.
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Affiliation(s)
- Oliver Laugisch
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany.,Department of Periodontology and Peri-implant Diseases, Philipps University, Marburg, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Christiane Pink
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Stefanie Samietz
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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