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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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Redd WD, McCallen JD, Xue Z, Kiran A, Barlowe TS, Reed CC, Eluri S, Dellon ES. Association between time from esophageal food impaction to endoscopy and adverse events. Gastrointest Endosc 2024; 99:525-536.e3. [PMID: 37951280 PMCID: PMC10954388 DOI: 10.1016/j.gie.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/20/2023] [Accepted: 11/07/2023] [Indexed: 11/13/2023]
Abstract
BACKGROUND AND AIMS Guidelines recommend emergent or urgent EGD for esophageal food impaction (EFI), but data on how time to EGD impacts the risk of adverse events remain limited. We determined whether EFI-to-EGD time was associated with adverse events. METHODS In this retrospective cohort study of patients with endoscopically confirmed EFI, adverse events were classified as esophageal (mucosal tear, bleeding, perforation) or extraesophageal (aspiration, respiratory compromise, hypotension, arrhythmia). Esophageal perforation and extraesophageal adverse events requiring intensive care unit admission were classified as serious adverse events. Baseline characteristics, event details, and procedural details were compared between patients with and without adverse events. Multivariable logistic regression was performed to assess for an association between EFI-to-EGD time and adverse events. RESULTS Of 188 patients with EFI, 22 (12%) had any adverse event and 2 (1%) had a serious adverse event. Patients with adverse events were older and more likely to have an esophageal motility disorder, to tolerate secretions at presentation, and to have a higher American Society of Anesthesiologists score. EFI-to-EGD time was similar in those with and without adverse events. On multivariable analysis, EFI-to-EGD time was not associated with adverse events (odds ratio, 1.00 [95% confidence interval, .97-1.04] for 1-hour increments; odds ratio, 1.03 [95% confidence interval, .86-1.24] for 6-hour increments). Results were similar after stratifying by eosinophilic esophagitis status and after adjusting for possible confounders. CONCLUSIONS Because the time from EFI to EGD is not associated with adverse events, emergent EGD for EFI may be unnecessary, and other considerations may determine EGD timing.
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Affiliation(s)
- Walker D. Redd
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Justin D. McCallen
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Zeyun Xue
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Akshatha Kiran
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Trevor S. Barlowe
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Craig C. Reed
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Swathi Eluri
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Evan S. Dellon
- Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, NC
- Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine; University of North Carolina School of Medicine, Chapel Hill, NC
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Yang X, Xue C, Chen K, Gao D, Wang H, Tang C. Characteristics of elderly diabetes patients: focus on clinical manifestation, pathogenic mechanism, and the role of traditional Chinese medicine. Front Pharmacol 2024; 14:1339744. [PMID: 38273819 PMCID: PMC10808572 DOI: 10.3389/fphar.2023.1339744] [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] [Received: 11/16/2023] [Accepted: 12/28/2023] [Indexed: 01/27/2024] Open
Abstract
Diabetes mellitus has become a major public health issue globally, putting an enormous burden on global health systems and people. Among all diseased groups, a considerable part of patients are elderly, while their clinical features, pathogenic processes, and medication regimens are different from patients of other ages. Despite the availability of multiple therapies and techniques, there are still numerous elderly diabetes patients suffering from poor blood glucose control, severe complications, and drug adverse effects, which negatively affect the quality of life in their golden years. Traditional Chinese Medicine (TCM) has been widely used in the treatment of diabetes for several decades, and its relevant clinical practice has confirmed that it has a satisfactory effect on alleviating clinical symptoms and mitigating the progression of complications. Chinese herbal medicine and its active components were used widely with obvious clinical advantages by multiple targets and signaling pathways. However, due to the particular features of elderly diabetes, few studies were conducted to explore Traditional Chinese Medicine intervention on elderly diabetic patients. This study reviews the research on clinical features, pathogenic processes, treatment principles, and TCM treatments, hoping to provide fresh perspectives on the prevention and management strategies for elderly diabetes.
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Affiliation(s)
- Xiaofei Yang
- Beijing University of Chinese Medicine, Beijing, China
- Institute of Metabolic Diseases, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chongxiang Xue
- Beijing University of Chinese Medicine, Beijing, China
- Institute of Metabolic Diseases, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Keyu Chen
- Institute of Metabolic Diseases, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Dongyang Gao
- Institute of Metabolic Diseases, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Han Wang
- Beijing University of Chinese Medicine, Beijing, China
| | - Cheng Tang
- Beijing University of Chinese Medicine, Beijing, China
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Khavandgar Z, Warner BM, Baer AN. Evaluation and management of dry mouth and its complications in rheumatology practice. Expert Rev Clin Immunol 2024; 20:1-19. [PMID: 37823475 PMCID: PMC10841379 DOI: 10.1080/1744666x.2023.2268283] [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: 06/02/2023] [Accepted: 10/04/2023] [Indexed: 10/13/2023]
Abstract
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.
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Affiliation(s)
- Zohreh Khavandgar
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD
| | - Blake M. Warner
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD
| | - Alan N. Baer
- Johns Hopkins University School of Medicine, Baltimore, MD
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Raoof M, Verhoeff MC, Kooshki R, Aarab G, Lobbezoo F. Self-reported oral moistening disorders in obstructive sleep apnoea: A scoping review. J Oral Rehabil 2024; 51:226-239. [PMID: 37282351 DOI: 10.1111/joor.13532] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/29/2023] [Accepted: 06/01/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Obstructive sleep apnoea (OSA) is a highly prevalent problem with significant consequences. Continuous positive airway pressure (CPAP) and oral mandibular advancement device (MAD) are considered the standard treatments for OSA. Patients may experience self-reported oral moistening disorders (OMDs) (i.e. xerostomia or drooling) at the beginning, throughout and after treatment. This affects oral health, quality of life and treatment effectiveness. The exact nature of the associations between OSA and self-reported OMD is still unknown. We aimed to provide an overview of the associations between self-reported OMD on the one hand and OSA and its treatment (namely CPAP and MAD) on the other hand. In addition, we sought to determine whether OMD affects treatment adherence. MATERIALS AND METHODS A literature search in PubMed was performed up to 27 September 2022. Two researchers independently assessed studies for eligibility. RESULTS In total, 48 studies were included. Thirteen papers investigated the association between OSA and self-reported OMD. They all suggested an association between OSA and xerostomia but not between OSA and drooling. The association between CPAP and OMD was addressed in 20 articles. The majority of studies have indicated xerostomia as a CPAP side effect; however, some have observed that xerostomia diminishes with CPAP therapy. In 15 papers, the association between MAD and OMD was investigated. In most publications, both xerostomia and drooling have been described as common side effects of MADs. These side effects are often mild and transient, and they improve as patients continue to use their appliance. Most studies found that these OMDs do not cause or are not a strong predictor of non-compliance. CONCLUSION Xerostomia is a common side effect of CPAP and MAD, as well as a significant symptom of OSA. It may be regarded as one of the indicators of sleep apnoea. Moreover, MAD therapy can be associated with OMD. However, it seems that OMD may be mitigated by being adherent to the therapy.
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Affiliation(s)
- Maryam Raoof
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - 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
| | - Razieh Kooshki
- Department of Biology, Faculty of Sciences, Lorestan University, Khorramabad, Iran
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, 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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Demarchi LS, Vogel MT, Haubert G, Rigo L. Impact of xerostomia and the use of dental prosthesis on the quality of life of elderly. BRAZILIAN JOURNAL OF ORAL SCIENCES 2023. [DOI: 10.20396/bjos.v22i00.8667543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Aim: To evaluate the impact of xerostomia, edentulism, use of dental prosthesis, and presence of chronic diseases on quality of life in relation to oral health in institutionalized elderly individuals. Methods: This is a cross-sectional study. A questionnaire was administered containing the following instruments: Oral Health Impact Profile (OHIP-14), which measures the quality of life related to oral health; the Summated Xerostomia Inventory questionnaire (SXI-PL) for evaluation of xerostomia, sociodemographic data, clinical description, and patient-reported factors was assessed (edentulism, use of dental prostheses, and chronic diseases). Results: Most elderly individuals did not have any teeth in their mouths and used dental prosthesis. The impact on quality of life, considering the mean of the OHIP-14 scores, was positive in 58.3% of the elderly. Those who used a dental prosthesis were three times more likely to have their oral health negatively impacted (OR=3.09; 95%CI =1.17 8.11), compared to those who did not use, and individuals with xerostomia were more likely to have their oral health negatively impacted (OR=1.57; 95%CI=1.25-1.98) compared to those without xerostomia. There was no difference in the quality of life of individuals with and without chronic diseases. Conclusions: The feeling of dry mouth and use of dental prostheses negatively impacted the quality of life in relation to oral health of the elderly.
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Cheah H, Gray M, Aboelmagd S, Barmak AB, Arany S. Anticholinergic Medication and Caries Status Predict Xerostomia under 65. Dent J (Basel) 2023; 11:dj11040087. [PMID: 37185465 PMCID: PMC10136720 DOI: 10.3390/dj11040087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/08/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
The use of anticholinergic medications is increasing in younger ages, yet information about xerostomia, the most common anticholinergic side effect, is limited. This case–control retrospective study examines the relationship between anticholinergic medication-induced xerostomia and caries status among adults between 18 and 65 years of age. The study sample comprised 649 cases with xerostomia and 649 age- and gender-matched controls. The anticholinergic burden was estimated using the anticholinergic drug scale (ADS). Caries experience was recorded by calculating the Decayed, Missing, Filled Tooth (DMFT) index. Individuals with xerostomia had a higher mean DMFT index (16.02 ± 9.50), which corresponded with a higher level of anticholinergic exposure from medications (3.26 ± 2.81) compared to their age and gender-matched controls without xerostomia (13.83 + 8.83 and 1.89 ± 2.45, respectively). Logistic regression analysis verified the effects of DMFT, the total number of AC medications, and the ADS burden on xerostomia status. Comparing adults with or without xerostomia revealed statistical differences in several risk factors, such as smoking, diabetes, sleep apnea, and the utilization of anticholinergic medications. A personalized dental care plan should include the evaluation of the anticholinergic burden from medications regardless of the patient’s age to prevent increased caries severity.
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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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Morita I, Morioka H, Abe Y, Nomura T, Nakashima S, Sugiura I, Inagawa Y, Kondo Y, Kameyama C, Kondo K, Kobayashi N. Discordance between hyposalivation and xerostomia among community-dwelling older adults in Japan. PLoS One 2023; 18:e0282740. [PMID: 36867629 PMCID: PMC9983907 DOI: 10.1371/journal.pone.0282740] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/21/2023] [Indexed: 03/04/2023] Open
Abstract
Individuals with an objective decrease in salivary flow (objective dry mouth) may not be aware of subjective dry mouth (xerostomia). However, no clear evidence exists to explain the discordance between subjective and objective dry mouth. Therefore, this cross-sectional study aimed to assess the prevalence of xerostomia and decreased salivary flow among community-dwelling elderly adults. In addition, this study assessed several potential demographic and health status determinants of the discrepancy between xerostomia and reduced salivary flow. The 215 participants in this study were community-dwelling older people aged 70 years and above who underwent dental health examinations between January-February 2019. Symptoms of xerostomia were collected in the form of a questionnaire. The unstimulated salivary flow rate (USFR) was measured by a dentist using visual inspection. The stimulated salivary flow rate (SSFR) was measured using the Saxon test. We identified 19.1% of participants as having mild-severe USFR decline with xerostomia and 19.1% as having mild-severe USFR decline without xerostomia. Additionally, 26.0% of participants had low SSFR and xerostomia, and 40.0% had low SSFR without xerostomia. Except for the age trend, no factors could be associated with the discordance between USFR measurement and xerostomia. Furthermore, no significant factors were associated with the discordance between the SSFR and xerostomia. However, females were significantly associated (OR = 2.608, 95% CI = 1.174-5.791) with low SSFR and xerostomia, as compared to males. Age was a factor that was also significantly associated (OR = 1.105, 95% CI = 1.010-1.209) with low SSFR and xerostomia. Our findings indicate that approximately 20% of the participants had low USFR without xerostomia, and 40% had low SSFR without xerostomia. This study showed that age, sex, and the number of medications may not be factors in the discrepancy between the subjective feeling of dry mouth and reduced salivary flow.
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Affiliation(s)
- Ichizo Morita
- Japanese Red Cross Toyota College of Nursing, Toyota, Aichi, Japan
- * E-mail:
| | - Hisayoshi Morioka
- Department of Public Health, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Tokushima, Japan
| | - Yoshikazu Abe
- Gifu Prefecture Dental Association, Gifu, Gifu, Japan
| | | | | | - Iwane Sugiura
- Gifu Prefecture Dental Association, Gifu, Gifu, Japan
| | - Yujo Inagawa
- Gifu Prefecture Dental Association, Gifu, Gifu, Japan
| | - Yuka Kondo
- Gifu Prefecture Medical Association, Gifu, Gifu, Japan
| | | | - Kanae Kondo
- Japanese Red Cross Toyota College of Nursing, Toyota, Aichi, Japan
| | - Naoji Kobayashi
- Japanese Red Cross Toyota College of Nursing, Toyota, Aichi, Japan
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COVID-19-related stress, exercise, and oral health-related quality of life among community-dwelling older adults who participated in the CHEER Iwamizawa project, Japan. Sci Rep 2022; 12:20347. [PMID: 36437300 PMCID: PMC9701693 DOI: 10.1038/s41598-022-24806-1] [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] [Received: 02/16/2022] [Accepted: 11/18/2022] [Indexed: 11/28/2022] Open
Abstract
This study examined the association between coronavirus disease 2019 (COVID-19)-related stress, exercise habits, and oral health-related quality of life (OHRQoL) in a sample of 215 community-dwelling older adults in Japan (57 men, 158 women; Mage = 74.2 years, SD = 6.0). Data were collected during wellness checkups in October 2020 and included participants' demographic characteristics, measures of instrumental activities of daily living and depressive tendencies, number of teeth, oral hypofunction, OHRQoL, COVID-19-related stress, and exercise habits. Four mutually exclusive groups were created, using the presence or absence of COVID-19-related stress and lack of exercise habits as risk factors for poor OHRQoL (no COVID-19-related stress and no lack of exercise, COVID-19-related stress only, lack of exercise habits only, and both COVID-19-related stress and lack of exercise habits). Poisson regression with robust standard errors provided the prevalence ratio for poor OHRQoL. The presence of both COVID-19-related stress and lack of exercise habits (adjusted prevalence ratio: 2.20, 95% CI: 1.31- 3.69) was associated with poor OHRQoL. The results indicate that COVID-19-related stress and exercise habits should be considered when designing oral health and public health initiatives.
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Sekundo C, Langowski E, Wolff D, Boutin S, Frese C. Maintaining oral health for a hundred years and more? - An analysis of microbial and salivary factors in a cohort of centenarians. J Oral Microbiol 2022; 14:2059891. [PMID: 35401946 PMCID: PMC8986295 DOI: 10.1080/20002297.2022.2059891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/06/2022] [Accepted: 03/24/2022] [Indexed: 11/23/2022] Open
Abstract
Aim To investigate associations between oral health-related conditions and the oral microbiome in a representative study sample of centenarians. Materials and methods Clinical and microbial parameters from 54 centenarians were assessed in the Heidelberg Dental Centenarian Study. Plaque and salivary samples were collected, and the microbiota was characterized by 16S rRNA gene sequencing. Results Diversity and structure of the oral microbiome were mainly influenced by the presence of natural teeth and the number of decayed, missing, and filled teeth (0.028 ≤ p ≤ 0.001 in plaque and salivary samples). Centenarians with less caries experience possessed a more diverse oral microbiome. Moreover, the number of dental visits also showed a significant influence on the microbial composition. Most centenarians presented with hyposalivation (mean stimulated flow rate = 0.84 ± 0.55 ml/min), a low buffering capacity, and an acidic pH. The latter was between 5.0 and 5.8 in 46.3% of cases, and we observed that an increased salivary pH correlated with higher alpha-diversity in both salivary and plaque samples. Conclusion The microbiome diversity correlated significantly with successful oral aging. In addition, regular dental visits were a beneficial factor. However, diversity can be negatively influenced by hyposalivation, associated with pH changes due to aging effects.
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Affiliation(s)
- Caroline Sekundo
- Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Eva Langowski
- Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Diana Wolff
- Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Sébastien Boutin
- Department of Infectious Disease, Medical Microbiology and Hygiene, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
| | - Cornelia Frese
- Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany
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Yüce Sarı S, Yılmaz MT, Elmalı A, Kılıç L, Yüce D, Özyiğit G, Cengiz M, Yazıcı G. Turkish translation and validation of the Xerostomia Inventory. Arch Rheumatol 2022; 37:351-360. [PMID: 36589609 PMCID: PMC9791545 DOI: 10.46497/archrheumatol.2022.8702] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 10/07/2021] [Indexed: 01/04/2023] Open
Abstract
Objectives The Xerostomia Inventory (XI) was developed to assess the severity of dryness in patients with xerostomia. It has a long and a short form with three- and five-point Guttman-type response options. In this study, we aimed to translate the XI into Turkish, to assess the validity and reliability of both response options in patients with head & neck cancer (HNC) or Sjögren syndrome (SS), and to select the optimal version for Turkish patients. Patients and methods Between January 2019 and June 2019, the XI was translated into Turkish (XI-T) and applied to patients aged ≥18 years with HNC and SS. All patients were applied two tests including both the three- and five-point options. The internal consistency was assessed by Cronbach alpha and test-retest reliability by intraclass correlation coefficients (ICCs). Content validity was based on expert opinion and patient reviews. Results A total of 186 patients (109 males, 77 females; median age: 54 years; range, 19 to 78 years) answered the XI-T. The number of patients with HNC and SS was 143 (77%) and 43 (23%), respectively. Median XI-T score was 17 for the three-point, and 24 for the five-point option, respectively. Overall internal consistency was satisfactory for both options (α=0.81 and α=0.89, respectively). Overall test-retest reliability was satisfactory and ICCs ranged between 0.71 and 0.92 for the three-point, and 0.36 and 0.94 for the five-point option, respectively. Assessments based on expert opinions and patient reviews also favored the content validity of the scale. Conclusion The XI-T with both three- and five-point options is a valid and reliable tool to evaluate the presence and severity of dryness in patients with HNC and SS who experience xerostomia. The three-point option is more comprehensible and can be preferred over the five-point option in the Turkish population.
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Affiliation(s)
- Sezin Yüce Sarı
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Melek Tuğce Yılmaz
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Ayşenur Elmalı
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Levent Kılıç
- Department of Internal Medicine, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Deniz Yüce
- Department of Preventive Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Gökhan Özyiğit
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Mustafa Cengiz
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Gözde Yazıcı
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
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13
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Xerostomia as a key predictor of physical frailty among community-dwelling older adults in Japan: a five-year prospective cohort study from The Otassha Study. Arch Gerontol Geriatr 2022; 99:104608. [DOI: 10.1016/j.archger.2021.104608] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/21/2021] [Accepted: 12/07/2021] [Indexed: 11/24/2022]
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14
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Hosseinpour-Moghadam R, Mehryab F, Torshabi M, Haeri A. Applications of Novel and Nanostructured Drug Delivery Systems for the Treatment of Oral Cavity Diseases. Clin Ther 2021; 43:e377-e402. [PMID: 34844769 DOI: 10.1016/j.clinthera.2021.10.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/29/2021] [Accepted: 10/30/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Novel drug delivery systems (DDSs) hold great promise for the treatment of oral cavity diseases. The main objective of this article was to provide a detailed overview regarding recent advances in the use of novel and nanostructured DDSs in alleviating and treating unpleasant conditions of the oral cavity. Strategies to maximize the benefits of these systems in the treatment of oral conditions and future directions to overcome these issues are also discussed. METHODS Publications from the last 10 years investigating novel and nanostructured DDSs for pathologic oral conditions were browsed in a systematic search using the PubMed/MEDLINE, Web of Science, and Scopus databases. Research on applications of novel DDSs for periodontitis, oral carcinomas, oral candidiasis, xerostomia, lichen planus, aphthous stomatitis, and oral mucositis is summarized. A narrative exploratory review of the most recent literature was undertaken. FINDINGS Conventional systemic administration of therapeutic agents could exhibit high clearance of drugs from the bloodstream and low accumulation at the target site. In contrast, conventional topical systems face problems such as short residence time in the affected region and low patient compliance. Novel and nanostructured DDSs are among the most effective and commonly used methods for overcoming the problems of conventional DDSs. The main advantages of these systems are that they possess the ability to protect active agents from systemic and local clearance, enhance bioavailability and cellular uptake, and provide immediate or modified release of therapeutic agents after administration. In the design of local drug delivery devices such as nanofiber mats, films, and patches, components and excipients can significantly affect factors such as drug release rate, residence time in the oral cavity, and taste in the mouth. Choosing appropriate additives is therefore essential. IMPLICATIONS Local drug delivery devices such as nanofiber mats, nanoparticles, liposomes, hydrogels, films, and patches for oral conditions can significantly affect drug efficacy and safety. However, more precise clinical studies should be designed and conducted to confirm promising in vitro and in vivo results. In recent years, novel and nanostructured DDSs increasingly attracted the attention of researchers as a means of treatment and alleviation of oral diseases and unpleasant conditions. However, more clinical studies should be performed to confirm promising in vitro and in vivo results. To transform a successful laboratory model into a marketable product, the long-term stability of prepared formulations is essential. Also, proper scale-up methods with optimum preparation costs should be addressed.
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Affiliation(s)
- Reza Hosseinpour-Moghadam
- Department of Pharmaceutics and Pharmaceutical Nanotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mehryab
- Department of Pharmaceutics and Pharmaceutical Nanotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Torshabi
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Haeri
- Department of Pharmaceutics and Pharmaceutical Nanotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Protein Technology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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15
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Abstract
OBJECTIVE The aim of this study was to describe the prevalence of depressive symptoms and determine the association with oral health variables in older adults belonging to an oral health cohort. METHOD A prospective longitudinal study was conducted between 2009 and 2015. A standardized questionnaire was administered to collect demographic-socioeconomic variables and self-perceived oral health status. The clinical oral examinations were performed by examiners who had undergone training and calibration exercises. Depressive symptoms (outcome) were measured using the Geriatric Depression Scale (GDS-15), with a score of five points or higher considered indicative of the presence of depressive symptoms. RESULTS A total of 439 and 163 older adults (≥60 years of age) were evaluated in 2009 and 2015, respectively. The prevalence of depressive symptoms was 18.3% in 2009 and 28.5% in 2015. In the adjusted Poisson regression model, older adults who experienced tooth loss between 2009 and 2015 (PR = 1.86; 95% CI: 1.01-3.53) and those with a sensation of dry mouth in 2015 but not in 2009 (PR = 3.25 95% CI: 1.56-6.72) were at greater risk of exhibiting depressive symptoms. CONCLUSION In this study, the prevalence of depressive symptoms was considerable. Older adults with tooth loss between 2009 and 2015 and those with a perception of dry mouth were at greater risk of exhibiting depressive symptoms, which underscores the importance of including a dentist as part of the health team for the prevention and treatment of mental health problems.
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Affiliation(s)
- Isabelle Kunrath
- Department of Social and Preventive, School of Dentistry, Federal University of Pelotas, UFPel, Pelotas, Brazil
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16
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Ohara Y, Kawai H, Shirobe M, Iwasaki M, Motokawa K, Edahiro A, Kim H, Fujiwara Y, Ihara K, Watanabe Y, Obuchi S, Hirano H. Association between dry mouth and physical frailty among community-dwelling older adults in Japan: The Otassha Study. Gerodontology 2021; 39:41-48. [PMID: 34762315 DOI: 10.1111/ger.12605] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/22/2021] [Accepted: 10/28/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To elucidate the relationship between physical frailty and dry mouth among community-dwelling older adults in Japan. BACKGROUND Oral hypofunction is associated with physical frailty in older adults. Dry mouth, subjectively evaluated as xerostomia and objectively measured as hyposalivation, is highly prevalent in older adults. However, few reports have used both measures of dry mouth and investigated their association with physical frailty. MATERIALS AND METHODS This cross-sectional study included 643 individuals (mean age, 73.9 years) from the Otassha Study in 2019. Xerostomia was assessed using the 5-item Summated Xerostomia Inventory (SXI). Hyposalivation was assessed by measuring the amount of resting saliva using the modified cotton roll method. Frailty phenotypes were defined by weakness, slowness, weight loss, low physical activity level and exhaustion components, and served as the outcome variable. Participants with three or more components were considered physically frail, and those with one or two components were considered pre-frail. Ordinal logistic regression analyses were performed to evaluate the associations between physical frailty and xerostomia and hyposalivation. RESULTS Among the participants, 4.5% and 49.8% had physical frailty and pre-frailty, respectively. In ordinal logistic regression analysis adjusted for demographic and health characteristics, the SXI score was associated with physical frailty status (adjusted odds ratio for a one-point increase in SXI, 1.12; 95% confidence interval, 1.06-1.19). However, no difference was observed between the amount of resting saliva and severity of physical frailty. CONCLUSION Xerostomia is associated with physical frailty among community-dwelling older adults in Japan. CLINICAL TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Yuki Ohara
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Maki Shirobe
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | | - Keiko Motokawa
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Ayako Edahiro
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hunkyung Kim
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | | - Kazuhige Ihara
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Yutaka Watanabe
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Department of Dental and Oral Surgery, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
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17
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Probiotics, Prebiotics, Synbiotics and Dental Caries. New Perspectives, Suggestions, and Patient Coaching Approach for a Cavity-Free Mouth. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11125472] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Probiotic therapy forms a new strategy for dental caries prevention. Probiotic microorganisms possess the ability to displace cariogenic microorganisms and colonize the oral cavity. They can produce various antimicrobial substances such as bacteriocins, bacteriocin-like peptides, lactic acid, and hydrogen peroxide. Dairy products may be ideal for probiotic administration in dental patients. Many other means have been proposed, primarily for those allergic to dairy components, such as capsules, liquid form, tablets, drops, lozenges, sweetened cakes, and ice creams. The last two forms can be used in a coaching approach for children and elderly patients who find it difficult to avoid sugary beverages in their daily routine and benefit from the suggestion of easy, cheap, and common forms of delicacies. In caries prevention, the concept of the effector strain is already considered an integral part of the contemporary caries cure or prevention strategy in adults. Adults, though, seem not to be favored as much as children at early ages by using probiotics primarily due to their oral microbiome’s stability. In this non-systematic review we describe the modes of action of probiotics, their use in the cariology field, their clinical potential, and propose options to prevent caries through a patient coaching approach for the daily dental practice.
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18
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Marín C, Díaz-de-Valdés L, Conejeros C, Martínez R, Niklander S. Interventions for the treatment of xerostomia: A randomized controlled clinical trial. J Clin Exp Dent 2021; 13:e104-e111. [PMID: 33574994 PMCID: PMC7864369 DOI: 10.4317/jced.57924] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/18/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Xerostomia or dry mouth sensation corresponds to a common clinical problem that can significantly impair the oral health related quality of life (OHRQoL). Currently, there is a large variety of local agents available for the treatment of xerostomia, but there is a lack robust evidence supporting the use of one treatment over another. We aimed to compare the effectiveness of a 1% malic acid salivary stimulant spray with a 1.33% betaine-based saliva substitute mouthwash in the improvement of xerostomia. MATERIAL AND METHODS Fifty-one participants with drug induced or idiopathic xerostomia were randomly allocated into three groups, two intervention and one control group (placebo). OHRQoL and severity of xerostomia were assessed with the OHIP-14sp questionnaire and a visual analogue scale (VAS) respectively. Stimulated and non-stimulated salivary flow rates before and after treatments were also measured. RESULTS All three groups reported a significantly improvement in the dry mouth sensation and non-stimulated salivary flow rates, but only the malic acid spray and the betaine-based mouthwash significantly improved the OHRQoL. There were no significant differences between both intervention groups. CONCLUSIONS This study provides evidence that both tested agents are comparable in improving the dry mouth sensation and OHRQoL of patients with drug induced and idiopathic xerostomia. Key words:Xerostomia, dry mouth, malic acid, betaine, oral-health related quality of life.
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Affiliation(s)
- Constanza Marín
- Departamento de Patología y Cirugía Oral, Facultad de Odontologia, Universidad Andres Bello, Viña del Mar, Chile
| | - Laura Díaz-de-Valdés
- Departamento de Patología y Cirugía Oral, Facultad de Odontologia, Universidad Andres Bello, Viña del Mar, Chile
| | - Catalina Conejeros
- Departamento de Patología y Cirugía Oral, Facultad de Odontologia, Universidad Andres Bello, Viña del Mar, Chile
| | - René Martínez
- Departamento de Patología y Cirugía Oral, Facultad de Odontologia, Universidad Andres Bello, Viña del Mar, Chile
| | - Sven Niklander
- Departamento de Patología y Cirugía Oral, Facultad de Odontologia, Universidad Andres Bello, Viña del Mar, Chile
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Diep MT, Jensen JL, Skudutyte-Rysstad R, Young A, Sødal ATT, Petrovski BÉ, Hove LH. Xerostomia and hyposalivation among a 65-yr-old population living in Oslo, Norway. Eur J Oral Sci 2021; 129:e12757. [PMID: 33501713 PMCID: PMC7986810 DOI: 10.1111/eos.12757] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/11/2020] [Accepted: 11/20/2020] [Indexed: 12/11/2022]
Abstract
This study aimed to describe the prevalence and associated factors for xerostomia and hyposalivation in a young‐elderly population. A random sample of 460 65‐yr‐old people living in Oslo, Norway, answered a questionnaire and underwent a clinical examination (237 men and 223 women; response rate 58%). Ten percent of respondents reported xerostomia. The median Summated Xerostomia Index was 6 (interquartile range [IQR]: 5–7) and the median Clinical Oral Dryness Score was 2 (IQR: 1–3). The median unstimulated whole saliva (UWS) secretion rate was 0.34 (IQR: 0.20–0.53) mL min–1 and the median stimulated whole saliva (SWS) secretion rate was 1.74 (IQR: 1.24–2.38) mL min–1. In 8% of the study participants the UWS secretion rate was ≤0.1 mL min–1 and in 4% the SWS secretion rate was ≤0.7 mL min–1. Three percent of the study participants had both xerostomia and hyposalivation with respect to UWS. Xerostomia was significantly associated with medication use, having rheumatic disease, and having received radiation therapy to the head/neck region. Hyposalivation with respect to UWS and SWS was significantly associated with medication use and type II diabetes. Even though xerostomia and hyposalivation were not prevalent conditions in this population, clinicians should be especially aware of the salivary conditions in patients taking four or more medications, patients diagnosed with type II diabetes, and those who have undergone radiation therapy to the head/neck region.
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Affiliation(s)
- My Tien Diep
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Janicke Liaaen Jensen
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Rasa Skudutyte-Rysstad
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Alix Young
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Anne Thea Tveit Sødal
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | | | - Lene Hystad Hove
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
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20
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Sekiguchi A, Kawashiri SY, Hayashida H, Nagaura Y, Nobusue K, Nonaka F, Yamanashi H, Kitamura M, Kawasaki K, Fukuda H, Iwasaki T, Saito T, Maeda T. Association between high psychological distress and poor oral health-related quality of life (OHQoL) in Japanese community-dwelling people: the Nagasaki Islands Study. Environ Health Prev Med 2020; 25:82. [PMID: 33302863 PMCID: PMC7730733 DOI: 10.1186/s12199-020-00919-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/23/2020] [Indexed: 02/08/2023] Open
Abstract
Background We investigated the association between psychological distress and oral health status/oral health-related quality of life (OHQoL) in Japanese community-dwelling people. Methods We conducted a cross-sectional study using data from the Nagasaki Islands Study. A total of 1183 (455 men and 728 women) has been analyzed in this study. Psychological distress was measured using the Kessler Psychological Distress Scale (K6). Oral health status was measured by dental examination. The OHQoL was measured using the General Oral Health Assessment Index (GOHAI). We defined the total score of ≥5 points on the K6 as high psychological distress (high-K6 group). Results The multiple linear regression analysis to identify the GOHAI showed that gender, K6, the total number of teeth, the number of dental caries, and visiting a dental clinic within the past 6 months significantly associated with the GOHAI. Among all of these variables, high-K6 (≥ 5) was a substantial contributing factor of the GOHAI (β = − 0.23, 95% Cl − 2.31 to −1.41, p < 0.0001). Conclusions It is likely that the individual with high psychological distress was strongly related to poor OHQoL even in the general population.
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Affiliation(s)
- Ai Sekiguchi
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Shin-Ya Kawashiri
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
| | - Hideaki Hayashida
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yuki Nagaura
- Department of General Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Kenichi Nobusue
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Fumiaki Nonaka
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hirotomo Yamanashi
- Department of General Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Masayasu Kitamura
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Koji Kawasaki
- Community Medical Network Center, Nagasaki University Hospital, Nagasaki, Japan
| | | | - Takahiro Iwasaki
- Department of Dentistry for the Disability and Oral Health, Division of Dysphagia Rehabilitation, Asahi University, Gifu, Japan
| | - Toshiyuki Saito
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takahiro Maeda
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.,Department of General Medicine, Nagasaki University Hospital, Nagasaki, Japan
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21
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Ohara Y, Kawai H, Shirobe M, Motokawa K, Fujiwara Y, Kim H, Ihara K, Obuchi S, Edahiro A, Iwasaki M, Watanabe Y, Hirano H. Association between anorexia and hyposalivation in community-dwelling older adults in Japan: a 6-year longitudinal study. BMC Geriatr 2020; 20:504. [PMID: 33238938 PMCID: PMC7691094 DOI: 10.1186/s12877-020-01905-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 11/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hyposalivation is associated with the nutritional status. Anorexia of ageing, defined as an age-related decrease in appetite and food intake, presents even in healthy adults and is considered an independent predictor of malnutrition, frailty, and mortality. However, the relationship between anorexia and hyposalivation of ageing is unclear. Thus, the present longitudinal study aimed to investigate the incidence of hyposalivation and its relationship with anorexia in community-dwelling older people in Japan. METHODS The study population comprised 220 individuals (80 men and 140 women) aged 65-86 years at baseline. The participants underwent comprehensive health check-ups, including dental examinations and anthropometry, and face-to-face interviews in 2013 and 2019. Hyposalivation was determined on the basis of the unstimulated salivary flow rate measured using the modified cotton roll method. Anorexia was defined as a score of ≤29 in the Japanese version of the Council on Nutrition Appetite Questionnaire. Logistic regression analyses were used to test whether the presence of anorexia at baseline was an independent predictor of hyposalivation. RESULTS Hyposalivation developed at a rate of 19.5% during the 6-year observation period. Anorexia was observed in 95 (43.2%) participants at baseline. After adjusting for potential confounding factors, anorexia (adjusted odds ratio [AOR], 2.65; 95% confidence interval [CI], 1.26-5.57) and polypharmacy (AOR, 3.29; CI, 1.06-10.19) were significant predictors of hyposalivation. CONCLUSION Loss of appetite is independently correlated with and a risk factor for hyposalivation in older adults. Anorexia of ageing may have negative effects on the salivary flow rate in such settings. Salivation should be a standard feature in clinical assessments of the older adults.
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Affiliation(s)
- Yuki Ohara
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan.
| | - Hisashi Kawai
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Maki Shirobe
- The Tokyo Metropolitan Support Center for Preventative Long-term and Frail Elderly Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Shuichi Obuchi
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Ayako Edahiro
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Masanori Iwasaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Yutaka Watanabe
- Department of Oral Health Science, Gerodontology, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-Ku, Tokyo, 173-0015, Japan
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22
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Atif S, Syed SA, Sherazi UR, Rana S. Determining the relationship among stress, xerostomia, salivary flow rate, and the quality of life of undergraduate dental students. J Taibah Univ Med Sci 2020; 16:9-15. [PMID: 33603626 PMCID: PMC7858027 DOI: 10.1016/j.jtumed.2020.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/26/2020] [Accepted: 10/30/2020] [Indexed: 11/30/2022] Open
Abstract
Objective Xerostomia may result in several oral conditions, which ultimately affect oral health-related quality of life (OHRQOL). This study aims to evaluate the relationship of stress, xerostomia, salivary flow rate, and OHRQOL among young adults. Method We invited 72 participants to complete three validated questionnaires including the Perceived Stress Scale-10 (PSS-10), a shortened version of the Xerostomia Inventory (SXI), and the shortened Oral Health Impact Profile (S–OHIP). Unstimulated saliva was collected, and flow rate was determined. Based on the SXI scores and hyposalivation, the participants were categorised into four groups: subjective xerostomia, subjective and objective xerostomia, objective xerostomia, and true non-xerostomia. Based on the median PSS score, participants were categorised into high stress and low stress groups. Data were analysed using the Mann–Whitney U test, Kruskal–Wallis H test, and Spearman's correlation coefficient. A p value of 0.05 was set for all tests. Results A significant difference was observed in the unstimulated salivary flow rate (χ2(3) = 26.677, p < 0.001) and PSS scores (X2(3) = 8.552, p = 0.036) between xerostomia groups, while OHIP scores were not statistically different (X2(3) = 5.488, p = 0.139). A significant correlation was observed between SXI and S–OHIP scores (r = 0.348, p = 0.003) and unstimulated salivary flow rate and PSS (r = −0.259, p = 0.028). Conclusion This study shows that perceived stress can influence salivary flow rate. Among the xerostomia groups, stress scores and salivary flow rates varied significantly. Additionally, subjective xerostomia has an impact on OHRQOL.
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Affiliation(s)
- Saira Atif
- Department of Oral Biology, Institute of Dentistry, Combined Military Hospital Lahore Medical College, National University of Medical Sciences, Lahore, Pakistan
- Corresponding address: Institute of Dentistry, Combined Military Hospital Lahore Medical College, Abdur Rehman Road, Lahore Cantt, Lahore, Pakistan.
| | - Sofia A. Syed
- Department of Oral Pathology, Dow Dental College, Dow University of Health Science, Karachi, Pakistan
| | - Ume R. Sherazi
- Department of Operative Dentistry, Institute of Dentistry, Combined Military Hospital Lahore Medical College, National University of Medical Sciences, Lahore, Pakistan
| | - Sadia Rana
- Department of Oral Biology, Sharif Medical & Dental College, Lahore, Pakistan
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23
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Pina GDMS, Mota Carvalho R, Silva BSDF, Almeida FT. Prevalence of hyposalivation in older people: A systematic review and meta-analysis. Gerodontology 2020; 37:317-331. [PMID: 32965067 DOI: 10.1111/ger.12497] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 05/16/2020] [Accepted: 08/21/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The proportion of elders is increasing worldwide, and hyposalivation has been associated with the ageing process. Therefore, there has been growing interest in the frequency of hyposalivation in older people since it can cause transient or permanent problems that could affect oral health. OBJECTIVE To determine the prevalence of hyposalivation in older people (aged ≥ 60 years). METHODS The review was registered at Prospero - International Prospective Register of Systematic Reviews under number CRD42018106322. The search was performed in six electronic databases (Embase, LILACS, Medline, PubMed, Web of Science and Abstracts in Social Gerodontology) and grey literature (Google Scholar) for articles published up to February 2019. The methodology of selected studies was evaluated using the Meta-Analysis of Statistics Assessment and Review (MAStARI) risk of bias checklist. Meta-analyses were performed using Medcalc and Stata 15. RESULTS Thirteen studies totalising 3,885 individuals (≥60 years) were included in this systematic review. The meta-analysis showed an overall hyposalivation prevalence of 33.37% (95% confidence interval [CI] 23.90 - 43.57, P < .0001, n = 3,447). The prevalence of hyposalivation for unstimulated and stimulated methods was 33.39% (95% CI 21.08 - 46.96, P < .0001, n = 2,425 individuals) and 30.47% (95% CI 22.53-39.04, P < .0001, n = 1,495 individuals), respectively. Most of the studies were evaluated as low risk of bias. Some study limitations were related to the observational studies potential risk of bias, and different criteria to measure saliva flow rate. CONCLUSION This study suggests that the overall prevalence of hyposalivation in older people is 33.37%. When considering stimulated methods, the prevalence of hyposalivation was slightly lower (30.47%).
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Kugimiya Y, Watanabe Y, Ueda T, Motokawa K, Shirobe M, Igarashi K, Hoshino D, Takano T, Sakurai K, Taniguchi Y, Kitamura A, Shinkai S, Hirano H. Rate of oral frailty and oral hypofunction in rural community‐dwelling older Japanese individuals. Gerodontology 2020; 37:342-352. [DOI: 10.1111/ger.12468] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 02/04/2020] [Accepted: 02/08/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Yoshihiro Kugimiya
- Removable Prosthodontics and Gerodontology Tokyo Dental College Tokyo Japan
| | - Yutaka Watanabe
- Research Team for Promoting Independence and Mental Health Tokyo Metropolitan Institute of Gerontology Tokyo Japan
- Gerodontology Department of Oral Health Science Faculty of Dental Medicine Hokkaido University Sapporo Japan
| | - Takayuki Ueda
- Removable Prosthodontics and Gerodontology Tokyo Dental College Tokyo Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Maki Shirobe
- Action Research Center for Community Prevention of Frailty Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Kentaro Igarashi
- Removable Prosthodontics Nihon University School of Dentistry at Matsudo Chiba Japan
| | - Daichi Hoshino
- Special Needs Dentistry Division of Community Based Comprehensive Dentistry School of Dentistry Showa University Tokyo Japan
| | - Tomofumi Takano
- Removable Prosthodontics and Gerodontology Tokyo Dental College Tokyo Japan
| | - Kaoru Sakurai
- Removable Prosthodontics and Gerodontology Tokyo Dental College Tokyo Japan
| | - Yu Taniguchi
- Center for Health and Environmental Risk Research National Institute for Environmental Studies Ibaraki Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Health Promotion Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Shoji Shinkai
- Social Sciences and Human Care Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health Tokyo Metropolitan Institute of Gerontology Tokyo Japan
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25
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Tomioka K, Kurumatani N, Saeki K. Regular dental visits may prevent severe functional disability: A community-based prospective study. Arch Gerontol Geriatr 2020; 88:104019. [PMID: 32032835 DOI: 10.1016/j.archger.2020.104019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/09/2020] [Accepted: 01/27/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previous studies have shown that regular dental visits can affect the relationship of tooth loss with mortality and functional disability. However, the independent association between regular dental visits and incident functional disability is unclear. METHODS Our study participants were community-dwelling individuals aged ≥65 years, without disability at baseline. The outcome was the level of incident functional disability, as defined in a new certification of the public long-term care insurance. We defined no disability as no certification at follow-up, mild disability as support levels 1-2 and care level 1 (i.e., independent in basic ADL, but requiring some help in daily activities), and severe disability as care levels 2-5 (i.e., dependent in basic ADL). The exposure variable, based on the questionnaire, was regular dental visits at baseline. Covariates included gender, age, socio-economic status, health status, lifestyle habits, physical and mental functioning, and oral health variables. Using multinomial logistic regression, we calculated adjusted odds ratio (aOR) and 95 % confidence interval (CI) for mild disability and severe disability, with no disability as a reference category. RESULTS Among 8,877 participants, the 33-month cumulative incidence of mild and severe disability was 6.0 % and 1.8 %, respectively. After controlling for all covariates, regular dental visits at baseline were significantly associated with a lower risk of incident severe disability (aOR 0.65; 95 % CI, 0.46-0.91) but not the incidence of mild disability (aOR 0.96; 95 % CI, 0.79-1.17). CONCLUSIONS Encouraging dental visits may contribute to prevention of severe functional disability and extension of healthy life expectancy among community-dwelling older adults.
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Affiliation(s)
- Kimiko Tomioka
- Nara Prefectural Health Research Center, Nara Medical University, Kashihara, Nara, Japan.
| | - Norio Kurumatani
- Nara Prefectural Health Research Center, Nara Medical University, Kashihara, Nara, Japan
| | - Keigo Saeki
- Nara Prefectural Health Research Center, Nara Medical University, Kashihara, Nara, Japan
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26
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Takano T, Kugimiya Y, Morita K, Tazawa S, Ueda T, Sakurai K. Intra- and inter-investigator reliabilities of oral moisture measured using an oral moisture-checking device. J Oral Rehabil 2019; 47:480-484. [PMID: 31803949 DOI: 10.1111/joor.12919] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 11/10/2019] [Accepted: 11/29/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Oral mucosal moisture determined using oral moisture-checking devices is used as a mouth dryness evaluation method. Such devices are capable of evaluating the state of mouth dryness in a simple manner and have applicability in a wide range of subjects; however, their intra- and inter-investigator reliabilities have not yet been clarified. OBJECTIVE This study aims to investigate the intra- and inter-investigator reliabilities of measuring oral moisture using an oral moisture-checking device for a wide range of age groups. METHODS Intra- and inter-investigator reliabilities were investigated in 28 young subjects and 19 older subjects aged ≥65 years. Three trained investigators independently measured oral mucosal moisture values using an oral moisture-checking device. Intra-investigator reliability was assessed using the coefficient of variation (CV) and intraclass correlation coefficient (ICC) (1.1), and inter-investigator reliability was assessed using ICC (2.1). RESULTS Mean CV was 0.015 and 0.016, mean ICC (1.1) was 0.806 and 0.877, and ICC (2.1) was 0.873 and 0.829 in the young and older subjects, respectively. CONCLUSION In young subjects, the mean values of ICC (1.1) and ICC (2.1) of the oral moisture-checking device were 0.806 and 0.873, respectively, whereas in older subjects, these values were 0.877 and 0.829, respectively. Thus, this confirms that the examination of oral mucosal moisture using the oral moisture-checking device has sufficient intra- and inter-investigator reliabilities for a wide range of age groups.
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Affiliation(s)
- Tomofumi Takano
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Yoshihiro Kugimiya
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Kuniko Morita
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Shiho Tazawa
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Takayuki Ueda
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Kaoru Sakurai
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
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27
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Lee KA, Park JC, Park YK. Nutrient intakes and medication use in elderly individuals with and without dry mouths. Nutr Res Pract 2019; 14:143-151. [PMID: 32256989 PMCID: PMC7075737 DOI: 10.4162/nrp.2020.14.2.143] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/15/2019] [Accepted: 12/05/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/OBJECTIVES The nutrition of the elderly depends on various factors. Oral health, especially oral dryness, can be an important risk factor. In this study, we attempted to determine whether dry mouth is associated with compromised nutrient intakes. SUBJECTS/METHODS A total of 120 participants aged 65–86 yrs (mean age: 69 ± 1 y) were included in this study. Demographic and health-related characteristics, living status, meals, number of medications, medical conditions, chewing ability, and quality of life, the Oral Health Impact Profile (the OHIP-14) were assessed. We performed one day 24-hr recall assessment for nutrient analyses. The differences of the means between the dry-mouth and non-dry-mouth groups were analyzed. Elderly subjects with xerostomia-induced dry mouth were classified as those who reported at least one dryness symptom on a questionnaire. RESULTS A significant difference in population distribution was observed among the elderly who took medications for hypertension, diabetes and osteoporosis and was significantly higher in the dry-mouth group (70.2%) than in the non-dry-mouth group (44.4%) (P = 0.005). Compared with the non-dry-mouth group (50.8%), a significantly higher proportion (73.7%) of participants in the dry-mouth group took multiple medicines (≥ 4 medications) (P = 0.019). The intakes of vegetable fat, vitamin E, folate and water in the dry-mouth group were lower than in the non-dry-mouth group. The intakes of fluoride and ω-3 fatty acids were significantly lower in the dry-mouth group than in the non-dry-mouth group. CONCLUSION The participants in the dry-mouth group exhibited low nutrient and water intakes. It is recommended that the elderly with dry mouth should drink sufficient water and receive targeted and specific nutritional guidance to prevent malnutrition.
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Affiliation(s)
- Kyung Ah Lee
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, Gyeonggi 17104, Korea
| | - Jung-Chul Park
- Department of Periodontology, Dankook University College of Dentistry, Cheonan, Chungnam 31116, Korea
| | - Yoo Kyoung Park
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, Gyeonggi 17104, Korea
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28
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Rao RS, Akula R, Satyanarayana TSV, Indugu V. Recent Advances of Pacemakers in Treatment of Xerostomia: A Systematic Review. J Int Soc Prev Community Dent 2019; 9:311-315. [PMID: 31516864 PMCID: PMC6714424 DOI: 10.4103/jispcd.jispcd_389_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 05/01/2019] [Indexed: 12/31/2022] Open
Abstract
Objectives: Treatment of dry mouth is the most common clinical challenge in the dental field. Although some remedies have been used to improve the signs and symptoms of xerostomia, none of them are absolutely satisfactory for the patients who have this alteration. In the current years, non-pharmacological treatments based on neuro-electro-stimulation for the treatment of xerostomia were developed. This review aimed at presenting recent developments for the treatment of xerostomia, applying neuro-electro-stimulation by miniaturized intraoral electrostimulators. Materials and Methods: A thorough literature search between 1986 and 2018 was carried out using PubMed Central, Scopus, National Science Library, ProQuest, and Google Scholar databases; the results were reviewed, prioritized, and the findings were compiled. Twenty-two studies were evaluated for the review. Results: This tool increases salivary secretion and improves xerostomia symptoms. Scientific trials have been carried out, which have revealed the wetting effect of the method described in this text. Conclusion: Neuro-electro-stimulation of the salivary gland plays an important role in the stimulation of saliva in patients who need further therapy and have poor quality of life. Intraoral electrostimulator offers a new non-pharmacological method for treating dry mouth.
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Affiliation(s)
- Rayapati Srinivasa Rao
- Department of Prosthodontics, Teerthanker Mahaveer University Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Rajesh Akula
- Dental department, Ex-servicemen contributory health Scheme, Srikakulam, Andhra Pradesh, India
| | - Tammineedi S V Satyanarayana
- Department of Prosthodontics and Crown and Bridge, KLR's Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India
| | - Venkatagiri Indugu
- Department of Orthodontics and Dentofacial Orthopedics, St. Joseph Dental College, Eluru, Andhra Pradesh, India
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29
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Łysik D, Niemirowicz-Laskowska K, Bucki R, Tokajuk G, Mystkowska J. Artificial Saliva: Challenges and Future Perspectives for the Treatment of Xerostomia. Int J Mol Sci 2019; 20:E3199. [PMID: 31261876 PMCID: PMC6651665 DOI: 10.3390/ijms20133199] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/21/2019] [Accepted: 06/28/2019] [Indexed: 12/16/2022] Open
Abstract
The chronic sensation of a dry mouth is a disease condition called xerostomia and affects a large part of the population. Xerostomia is associated with decreased secretion, or more often, qualitative changes in saliva proteins and immunoglobulin concentrations that develop as a result of salivary gland dysfunction. Several reasons causing dry mouth were described, and usually, they include taking medications, diseases or radiotherapy. In some situations, when it is difficult to use salivary stimulants or salivary gland damage is irreversible, the only option might seem to be saliva substitutes. The paper presents the most important aspects considering saliva preparations. The rheological and lubricating properties and the reconstruction of the complex saliva structure has been the main purpose of research. The biological properties of saliva preparations were also widely discussed. As part of the work, the antimicrobial effect of three commercial saliva preparations was tested. Finally, inadequate antimicrobial properties against the strains isolated from the oral cavity were demonstrated. The development of salivary substitutes, in particular, the improvement of antimicrobial properties, can be achieved using nanotechnology, including drug delivery systems containing nanocarriers.
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Affiliation(s)
- Dawid Łysik
- Department of Materials Engineering and Production, Bialystok University of Technology, Wiejska 45C, 15-351 Bialystok, Poland
| | | | - Robert Bucki
- Department of Microbiological and Nanobiomedical Engineering, Medical University of Bialystok, Mickiewicza 2C, 15-222 Bialystok, Poland
| | - Grażyna Tokajuk
- Department of Integrated Dentistry, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276 Bialystok, Poland
| | - Joanna Mystkowska
- Department of Materials Engineering and Production, Bialystok University of Technology, Wiejska 45C, 15-351 Bialystok, Poland.
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30
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Cheng YM, Lan SH, Hsieh YP, Lan SJ, Hsu SW. Evaluate five different diagnostic tests for dry mouth assessment in geriatric residents in long-term institutions in Taiwan. BMC Oral Health 2019; 19:106. [PMID: 31196048 PMCID: PMC6567641 DOI: 10.1186/s12903-019-0797-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 05/24/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Residents in long-term care (LTC) institutions require care plans to effectively resolve dry mouth. Simple and easily comprehensible dry mouth indices must be developed to assist care professionals in determining dry mouth among residents. Therefore, this study aim of the study was to evaluate five different diagnostic tests for dry mouth assessment. METHODS A total of 568 residents were recruited from several LTC institutions in central Taiwan. The research instruments and tools comprised of the characteristics of the residents, state of oral health care, self-perceived ability to chew food, Taiwanese short-form of the Oral Health Impact Profile (OHIP-7 T), self-perceived levels of dry mouth, oral moisture checking, and a repetitive saliva swallowing test (RSST). The data collected were analyzed through demographic analysis, Correlation coefficient and chi-squared automatic interaction detection. RESULTS Results of the decision tree analysis indicated that RSST results, tooth brushing frequency, and age were the three indices that exerted the greatest influence on oral moisture levels. Specifically, in residents with relatively high RSST results, a daily tooth brushing frequency > 1, and an age < 68 years exhibited more favorable oral moisture levels. The results indicated that residents' self-perceived oral status was not associated with their oral moisture levels. CONCLUSION The three indices can be provided to LTC institutions for on-site assessment of dry mouth among residents to facilitate early detection of those with dry mouth.
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Affiliation(s)
- Yao-Ming Cheng
- Department of Healthcare Administration, Asia University, Taichung City, Taiwan
| | - Shao-Huan Lan
- School of Pharmaceutical Sciences and Medical Technology, Putian University, Putian City, China
| | - Yen-Ping Hsieh
- Department of Long-term Care, National Quemoy University, No. 1 University Rd., Jinning Township, Kinmen County 89250 Taiwan
| | - Shou-Jen Lan
- Department of Healthcare Administration, Asia University, Taichung City, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Shang-Wei Hsu
- Department of Healthcare Administration, Asia University, Taichung City, Taiwan
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31
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Rech RS, Hugo FN, Tôrres LHDN, Hilgert JB. Factors associated with hyposalivation and xerostomia in older persons in South Brazil. Gerodontology 2019; 36:338-344. [PMID: 31148246 DOI: 10.1111/ger.12415] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- Rafaela Soares Rech
- Graduate Studies Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Neves Hugo
- Graduate Studies Program in Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Juliana Balbinot Hilgert
- Graduate Studies Program in Dentistry, Graduate Studies Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Agostini BA, Cericato GO, Silveira ERD, Nascimento GG, Costa FDS, Thomson WM, Demarco FF. How Common is Dry Mouth? Systematic Review and Meta-Regression Analysis of Prevalence Estimates. Braz Dent J 2019; 29:606-618. [PMID: 30517485 DOI: 10.1590/0103-6440201802302] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 06/06/2018] [Indexed: 12/16/2022] Open
Abstract
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.
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Affiliation(s)
| | - Graziela Oro Cericato
- School of Dentistry, IMED - Instituto de Desenvolvimento Humano, Passo Fundo, RS, Brazil
| | | | | | - Francine Dos Santos Costa
- Post-Graduate Program in Epidemiology, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Post-Graduate Program in Dentistry, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Flavio Fernando Demarco
- Post-Graduate Program in Epidemiology, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Post-Graduate Program in Dentistry, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil
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Åstrøm AN, Lie SA, Ekback G, Gülcan F, Ordell S. Self-reported dry mouth among ageing people: a longitudinal, cross-national study. Eur J Oral Sci 2018; 127:130-138. [PMID: 30584805 DOI: 10.1111/eos.12601] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Focusing on Swedish and Norwegian cohorts of community-dwelling older adults between age 65 and 70, this study aimed to identify predictors of the prevalence and incident cases of daytime and night-time xerostomia. It was hypothesized that the prevalence increases with increasing age and is higher in women than in men and that the prevalence of persistent xerostomia and the 5-yr-incident cases are higher in people with consistent use of medication and need for health care. Of the Norwegian participants who completed the 2007 survey (age 65 yr), 70% (n = 2,947) participated in 2012. Individuals participating in both 2007 and 2012 constituted the Swedish panel (80%, n = 4,862). The prevalence of xerostomia was higher in women than in men and increased from age 65 to age 70, most markedly in the Swedish cohort. The risk of persistent xerostomia was greatest for participants with consistent use of medication (OR = 1.3) and contact with a physician (OR = 2.3). The risk of incident cases of xerostomia during daytime was greatest for participants with recent and consistent use of medication and recent contact with a physician. Dental professionals should identify patients with xerostomia, emphasize early prevention, and alleviate oral symptoms in collaboration with physicians.
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Affiliation(s)
- Anne N Åstrøm
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Stein A Lie
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Gunnar Ekback
- Örebro County Council, Örebro, Sweden.,School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Ferda Gülcan
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Sven Ordell
- Dental Commissioning Unit, Östergötland County Council, Linköping University, Linköping, Sweden
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Iwasaki M, Borgnakke WS, Yoshihara A, Ito K, Ogawa H, Nohno K, Sato M, Minagawa K, Ansai T, Miyazaki H. Hyposalivation and 10-year all-cause mortality in an elderly Japanese population. Gerodontology 2018; 35:87-94. [PMID: 29322550 DOI: 10.1111/ger.12319] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the association of salivary flow rate with all-cause mortality among older Japanese adults. We hypothesised that hyposalivation would be a marker for mortality. BACKGROUND Hyposalivation, which is an objectively measurable decrease in salivary flow, is highly prevalent among older adults. It is associated with malnutrition and poor general health. METHODS The study population comprised 600 community-dwelling Japanese adults (306 men and 294 women), who were 70 years old at baseline. They underwent stimulated salivary flow rate (SSFR) measurements and were followed up during a 10-year study period. After stratification by sex, the hazard ratios of all-cause mortality were estimated using Cox proportional hazards regression analysis comparing groups with and without hyposalivation (ie, SSFR < 0.7 mL/min). RESULTS The baseline prevalence of hyposalivation was 27.8% (85/306) among men and 47.3% (139/294) among women. During a mean (standard deviation) follow-up period of 104 (27) months, 80 deaths occurred: 60 (75.0%) deaths among men and 20 (25.0%) deaths among women. After adjusting for the number of remaining teeth, smoking status, exercise, hypoalbuminemia, diabetes and cardiovascular disease, hyposalivation at baseline was significantly associated with all-cause mortality among men (adjusted hazard ratio, 1.71; 95% confidence interval, 1.01-2.89). In contrast, no association between SSFR and all-cause mortality existed among women. CONCLUSION Hyposalivation could be a marker for all-cause mortality among older community-dwelling Japanese men. Future studies investigating the association between SSFR and cause-specific mortality are warranted.
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Affiliation(s)
- Masanori Iwasaki
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Division of Community, Oral Health Development, Kyushu Dental University, Kitakyushu, Japan
| | - Wenche S Borgnakke
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Akihiro Yoshihara
- Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kayoko Ito
- Oral Rehabilitation, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Hiroshi Ogawa
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kaname Nohno
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Misuzu Sato
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kumiko Minagawa
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Toshihiro Ansai
- Division of Community, Oral Health Development, Kyushu Dental University, Kitakyushu, Japan
| | - Hideo Miyazaki
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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35
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Muñoz-González C, Vandenberghe-Descamps M, Feron G, Canon F, Labouré H, Sulmont-Rossé C. Association between Salivary Hypofunction and Food Consumption in the Elderlies. A Systematic Literature Review. J Nutr Health Aging 2018; 22:407-419. [PMID: 29484355 DOI: 10.1007/s12603-017-0960-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This systematic literature review aims to summarize the existing scientific evidence about the association between a reduced salivary function and food consumption in elderly people. METHODS A validated search strategy in two databases (PubMed and ISI Web of Knowledge) was carried out and retrieved papers together with their reference lists were screened by two independent reviewers. The quality of the included studies was critically appraised via the Quality Assessment Criteria for Evaluating Primary Research Papers. RESULTS From the originally identified studies (n=391), only 15 articles (all cross-sectional studies) met the pre-fixed inclusion/exclusion criteria. The methodological quality of the included studies was in general good, although only 3 from 15 obtained the maximum score. The control of confounding factors was the quality variable more poorly rated in the selected studies. Salivary hypofunction was associated with a decrease of the objective chewing and swallowing abilities and taste perception. Moreover, most of the selected studies showed a relationship between salivary hypofunction and food consumption (in terms of appetite loss, unbalanced dietary intake and malnutrition), although no causality could be established. CONCLUSIONS This study highlights the fact that salivary hypofunction definition and measurements are different across the studies. Therefore, future research efforts should focus on establishing a gold standard to define and identify salivary hypofunction throughout life and on performing longitudinal studies controlling for confounding factors to establish causality.
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Affiliation(s)
- C Muñoz-González
- Claire Sulmont-Rossé, INRA, CSGA, 17 rue Sully, F-21000 Dijon, France, Telephone: +33 380 69 32 71, E-mail address:
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Choi JS, Kim HE, Donnelly LR. Relationship between salivary haemoglobin and number of remaining teeth in older Koreans. Gerodontology 2017; 35:25-32. [DOI: 10.1111/ger.12312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2017] [Indexed: 12/23/2022]
Affiliation(s)
- Jun-Seon Choi
- Department of Dental Hygiene; College of Health Science; Gachon University; Incheon Korea
| | - Hee-Eun Kim
- Department of Dental Hygiene; College of Health Science; Gachon University; Incheon Korea
| | - Leeann R. Donnelly
- Faculty of Dentistry; University of British Columbia; Vancouver BC Canada
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Islas-Granillo H, Borges-Yáñez A, Fernández-Barrera MÁ, Ávila-Burgos L, Patiño-Marín N, Márquez-Corona MDL, Mendoza-Rodríguez M, Medina-Solís CE. Relationship of hyposalivation and xerostomia in Mexican elderly with socioeconomic, sociodemographic and dental factors. Sci Rep 2017; 7:40686. [PMID: 28094800 PMCID: PMC5240562 DOI: 10.1038/srep40686] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 11/29/2016] [Indexed: 11/09/2022] Open
Abstract
We determined the prevalence of hyposalivation and xerostomia in older Mexicans (≥60 years), and its relationship with diverse factors. A cross-sectional study was realized in elderly subjects from Pachuca, Mexico. Chewing-stimulated saliva was collected under standardized conditions and salivary flow was measured; subjects were considered to have hyposalivation if their stimulated salivary flow was less than 0.7 mL per minute. Xerostomia was evaluated by asking subjects 'Does your mouth feel dry?'. Hyposalivation was present in 59.7%, and xerostomia in 25.2% of subjects. 16.5% of subjects had both conditions. Xerostomia was present in 27.7% of subjects with hyposalivation and 21.4% of subjects without hyposalivation, but the difference was not significant (p > 0.05). Thus, 68.3% of older Mexicans had xerostomia and/or hyposalivation. Factors associated with hyposalivation were: using fewer devices in oral hygiene, lacking social benefits for retirement/pension, living in a public retirement home, brushing teeth less than twice a day and lacking teeth without dentures. None of the factors included in this study were associated with xerostomia. We concluded that several variables studied were associated with hyposalivation, but none for xerostomia. Additional research should examine the amount of hyposalivation and factors associated with hyposalivation especially in elderly with increased risk for hyposalivation.
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Affiliation(s)
- Horacio Islas-Granillo
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Mexico
| | - Aida Borges-Yáñez
- DEPeI Faculty of Dentistry of National Autonomous University of Mexico, Ciudad de Mexico, Mexico
| | | | - Leticia Ávila-Burgos
- Health Systems Research Centre at National Institute of Public Health, Cuernavaca, Mexico
| | - Nuria Patiño-Marín
- Clinical Research Laboratory of Dental Sciences Doctorate Program at Autonomous University of San Luis Potosí, San Luis Potosí, Mexico
| | | | - Martha Mendoza-Rodríguez
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Mexico
| | - Carlo Eduardo Medina-Solís
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Mexico.,Advanced Studies and Research Center in Dentistry "Dr. Keisaburo Miyata" of School of Dentistry at Autonomous University State of Mexico, Toluca, México
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Niklander S, Veas L, Barrera C, Fuentes F, Chiappini G, Marshall M. Risk factors, hyposalivation and impact of xerostomia on oral health-related quality of life. Braz Oral Res 2017; 31:e14. [PMID: 28099580 DOI: 10.1590/1807-3107bor-2017.vol31.0014] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 12/06/2016] [Indexed: 12/24/2022] Open
Abstract
To determine xerostomia-related frequency, factors, salivary flow rates and Oral Health-Related Quality of Life (OHRQoL) of patients attending the Universidad Andrés Bello Dental School Clinic, in the city of Viña del Mar, Chile. The study involved 566 patients assessed with xerostomia, based on a single standardized questionnaire. The severity and impact of xerostomia on OHRQoL was assessed using a visual analogue scale (VAS) and the short version of the Oral Health Impact Profile Questionnaire (OHIP-14sp), respectively. Stimulated and non-stimulated salivary flow rates were obtained from a sample of patients. Xerostomia was reported in 61 patients (10.8%), comprising 50 women (83.3%) and 11 men (16.7%) (p < 0.013). The prevalence was 13% among the women and 6.1% among the men. Gender, age and medication were found to be independent risk factors for the development of xerostomia. Hyposalivation was found in 10 of the 35 patients with xerostomia (28.6%) and in 2 patients without it (p < 0.011). Patients with xerostomia had a reduced OHRQoL, compared with patients without xerostomia, as shown by the total OHIP-14sp score (p < 0.001). Xerostomia was a common, potentially debilitating condition with a major impact on the OHRQoL of a patient population attending a university-based dental clinic. Hyposalivation was present in almost 30% of the patients who complained of xerostomia. It is important that general dentists be aware of this condition, so that they can provide patients with a good diagnosis, treatment and follow-up.
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Affiliation(s)
- Sven Niklander
- Universidad Andres Bello, Dentistry Faculty, Viña del Mar, Chile
| | - Laura Veas
- Universidad Andres Bello, Dentistry Faculty, Viña del Mar, Chile
| | - Cristina Barrera
- Universidad Andres Bello, Dentistry Faculty, Viña del Mar, Chile
| | - Flavio Fuentes
- Universidad Andres Bello, Dentistry Faculty, Viña del Mar, Chile
| | | | - Maureen Marshall
- Universidad Andres Bello, Dentistry Faculty, Viña del Mar, Chile
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Sato Y, Aida J, Kondo K, Tsuboya T, Watt RG, Yamamoto T, Koyama S, Matsuyama Y, Osaka K. Tooth Loss and Decline in Functional Capacity: A Prospective Cohort Study from the Japan Gerontological Evaluation Study. J Am Geriatr Soc 2016; 64:2336-2342. [DOI: 10.1111/jgs.14324] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 03/03/2016] [Accepted: 04/20/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Yukihiro Sato
- Department of International and Community Oral Health; Graduate School of Dentistry; Tohoku University; Sendai Japan
| | - Jun Aida
- Department of International and Community Oral Health; Graduate School of Dentistry; Tohoku University; Sendai Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences; Chiba University; Chiba Japan
- Department of Gerontological Evaluation; Center for Gerontology and Social Science; National Center for Geriatrics and Gerontology; Obu City Japan
| | - Toru Tsuboya
- Department of International and Community Oral Health; Graduate School of Dentistry; Tohoku University; Sendai Japan
| | - Richard G. Watt
- Department of Epidemiology and Public Health; University College London; London United Kingdom
| | - Tatsuo Yamamoto
- Division of Dental Sociology; Department of Oral Science; Graduate School of Dentistry; Kanagawa Dental University; Kanagawa Japan
| | - Shihoko Koyama
- Department of International and Community Oral Health; Graduate School of Dentistry; Tohoku University; Sendai Japan
| | - Yusuke Matsuyama
- Department of International and Community Oral Health; Graduate School of Dentistry; Tohoku University; Sendai Japan
| | - Ken Osaka
- Department of International and Community Oral Health; Graduate School of Dentistry; Tohoku University; Sendai Japan
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Tanaka H, Ogata S, Ikebe K, Kurushima Y, Matsuda K, Enoki K, Omura K, Honda C, Hayakawa K. Association between salivary flow rate and depressive symptoms with adjustment for genetic and family environmental factors in Japanese twin study. Clin Oral Investig 2016; 21:1291-1297. [PMID: 27318473 DOI: 10.1007/s00784-016-1883-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 06/13/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The association between salivary flow rate (SFR) and depressive symptoms have been inconclusive. The present study aimed to investigate the association between SFR and depressive symptoms with and without adjustment for genetic and family environmental factors. MATERIALS AND METHODS We conducted a cross-sectional study using twins and measured SFR and depressive symptoms as the outcome and explanatory variables, respectively. We also performed three-step regression analyses by first analysing the association between SFR and depressive symptoms without adjustment for genetic and family environmental factors (individual-level analyses). We then performed between-within analyses using monozygotic (MZ) and same-sex dizygotic (DZ) twin pairs, and finally using only MZ twin pairs. These between-within analyses estimated the coefficients adjusted for genetic and family environmental factors. Furthermore, differences in the associations between individual-level and between-within suggest confounding by genetic and family environmental factors. RESULTS We conducted 448 twins aged ≥20 years. In individual-level analyses in males and between-within analyses using MZ and same-sex DZ male twin pairs, SFR associated with depressive symptoms. In between-within analyses using only MZ male twin pairs, SFR did not associate with depressive symptoms. In females, SFR did not associate with depressive symptoms in both individual-level and between-within analyses. CONCLUSIONS The present study revealed that the association between SFR and depressive symptoms was affected by common genetic factors in males. CLINICAL RELEVANCE Understanding this association between SFR and depressive symptoms with adjustment for genetic and family environmental factors could lead to an important consideration for the prevention and treatment of hyposalivation.
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Affiliation(s)
- Haruka Tanaka
- Department of Health Promotion Science, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan. .,Mie Prefectural College of Nursing, 1-1-1 Yumegaoka, Tsu, Mie, 514-0116, Japan.
| | - Soshiro Ogata
- Department of Health Promotion Science, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan.,Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yuko Kurushima
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kenichi Matsuda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kaori Enoki
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kayoko Omura
- Mie Prefectural College of Nursing, 1-1-1 Yumegaoka, Tsu, Mie, 514-0116, Japan
| | - Chika Honda
- Center for Twin Research, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | | | - Kazuo Hayakawa
- Mie Prefectural College of Nursing, 1-1-1 Yumegaoka, Tsu, Mie, 514-0116, Japan
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Torimoto K, Matsushita C, Yamada A, Goto D, Matsumoto Y, Hosokawa Y, Miyake M, Aoki K, Hirayama A, Tanaka N, Fujimoto K. Clinical efficacy and safety of mirabegron and imidafenacin in women with overactive bladder: A randomized crossover study (the MICRO study). Neurourol Urodyn 2016; 36:1097-1103. [DOI: 10.1002/nau.23050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 05/25/2016] [Indexed: 11/07/2022]
Affiliation(s)
| | - Chie Matsushita
- Saiseikai-Chuwa Hospital; Nara Japan
- Tane General Hospital; Osaka Japan
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Iwasaki M, Yoshihara A, Ito K, Sato M, Minagawa K, Muramatsu K, Watanabe R, Manz MC, Ansai T, Miyazaki H. Hyposalivation and dietary nutrient intake among community-based older Japanese. Geriatr Gerontol Int 2015; 16:500-7. [DOI: 10.1111/ggi.12500] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Masanori Iwasaki
- Division of Preventive Dentistry, Department of Oral Health Science; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
- Division of Community Oral Health Development; Kyushu Dental University; Kitakyushu Japan
| | - Akihiro Yoshihara
- Division of Oral Science for Health Promotion, Department of Oral Health and Welfare; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Kayoko Ito
- Oral Rehabilitation; Niigata University Medical and Dental Hospital; Niigata Japan
| | - Misuzu Sato
- Division of Preventive Dentistry, Department of Oral Health Science; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Kumiko Minagawa
- Division of Preventive Dentistry, Department of Oral Health Science; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Kanako Muramatsu
- Department of Health and Nutrition, Faculty of Human Life Studies; University of Niigata Prefecture; Niigata Japan
| | - Reiko Watanabe
- Department of Health and Nutrition, Faculty of Human Life Studies; University of Niigata Prefecture; Niigata Japan
| | - Michael C. Manz
- Department of Cariology, Restorative Sciences, and Endodontics; School of Dentistry, University of Michigan; Ann Arbor Michigan USA
| | - Toshihiro Ansai
- Division of Community Oral Health Development; Kyushu Dental University; Kitakyushu Japan
| | - Hideo Miyazaki
- Division of Preventive Dentistry, Department of Oral Health Science; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
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Takeuchi K, Furuta M, Takeshita T, Shibata Y, Shimazaki Y, Akifusa S, Ninomiya T, Kiyohara Y, Yamashita Y. Risk factors for reduced salivary flow rate in a Japanese population: the Hisayama Study. BIOMED RESEARCH INTERNATIONAL 2015; 2015:381821. [PMID: 25705657 PMCID: PMC4332456 DOI: 10.1155/2015/381821] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 01/20/2015] [Accepted: 01/23/2015] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to determine distinct risk factors causing reduced salivary flow rate in a community-dwelling population using a prospective cohort study design. This was a 5-year follow-up survey of 1,377 community-dwelling Japanese individuals aged ≥40 years. The salivary flow rate was evaluated at baseline and follow-up by collecting stimulated saliva. Data on demographic characteristics, use of medication, and general and oral health status were obtained at baseline. The relationship between reduced salivary flow rate during the follow-up period and its predictors was evaluated after adjustment for confounding factors. In a multivariate logistic regression model, higher age and plaque score and lower serum albumin levels were significantly associated with greater odds of an obvious reduction in salivary flow rate (age per decade, odds ratio [OR] = 1.25, 95% confidence interval [CI] = 1.03-1.51; serum albumin levels <4 g/dL, OR = 1.60, 95% CI = 1.04-2.46; plaque score ≥1, OR = 1.53, 95% CI = 1.04-2.24). In a multivariate linear regression model, age and plaque score remained independently associated with the increased rate of reduced salivary flow. These results suggest that aging and plaque score are important predictors of reduced salivary flow rate in Japanese adults.
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Affiliation(s)
- Kenji Takeuchi
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Michiko Furuta
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Toru Takeshita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Yukie Shibata
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
| | - Yoshihiro Shimazaki
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University, Aichi 464-8650, Japan
| | - Sumio Akifusa
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
- Department of Health Management, School of Oral Health Science, Kyushu Dental College, Kitakyushu 803-8580, Japan
| | - Toshiharu Ninomiya
- Division of Research Management, Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Yutaka Kiyohara
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Yoshihisa Yamashita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
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Hahnel S, Schwarz S, Zeman F, Schäfer L, Behr M. Prevalence of xerostomia and hyposalivation and their association with quality of life in elderly patients in dependence on dental status and prosthetic rehabilitation: a pilot study. J Dent 2014; 42:664-70. [PMID: 24632475 DOI: 10.1016/j.jdent.2014.03.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 02/04/2014] [Accepted: 03/06/2014] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES The aims of this pilot study were to investigate the prevalence of xerostomia and hyposalivation and their impact on quality of life in a cohort of elderly patients including dental status and the character of potential prosthetic restorations as independent variables. METHODS Patients aged 60 years or older without any objective or subjective need for prosthodontic treatment taking part in a regular recall programme were included in the trial. Quality of life was assessed using the German version of the GOHAI; prevalence and severity of xerostomia was investigated using the shortened version of the Xerostomia Inventory (XI). Stimulated salivary flow rate was determined using a sialometric approach. Dental status and the character of prosthetic restorations (no/fixed restorations and removable but tooth-supported dentures vs. gum-supported dentures) were assessed in a clinical examination by experienced dentists specialized in prosthodontic treatment. RESULTS A total of 68 patients were included in the trial; a prevalence of xerostomia of 16% and a prevalence of hyposalivation of 31% were identified. The quality of life in the study cohort decreased significantly as a function of xerostomia severity but not salivary flow; moreover, a significant impact of the number of teeth/implants in the upper jaw and the presence of gum-supported dentures in both jaws on GOHAI scores could be identified. CONCLUSIONS Within the limitations of a pilot study, the results support the assumption that the quality of life in elderly patients is particularly related to their subjective perception of xerostomia. A decline in salivary flow, the dental status and the character of prosthetic restorations appear to play a subordinate role for the quality of life in elderly patients. CLINICAL SIGNIFICANCE The quality of life in elderly patients may be severely diminished due to an increased subjective perception of dry mouth. Dental treatment should focus on alleviating xerostomia, whereas the impact of dental status and prosthetic restoration appear to be subordinate.
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Affiliation(s)
- Sebastian Hahnel
- Department of Prosthodontics, Regensburg University Medical Center, Regensburg, Germany.
| | - Simone Schwarz
- Department of Prosthodontics, Regensburg University Medical Center, Regensburg, Germany
| | - Florian Zeman
- Centre for Clinical Trials, Regensburg University Medical Center, Regensburg, Germany
| | - Lina Schäfer
- Department of Prosthodontics, Regensburg University Medical Center, Regensburg, Germany
| | - Michael Behr
- Department of Prosthodontics, Regensburg University Medical Center, Regensburg, Germany
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