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Desai JP, Nair RU. Oral Health Factors Related to Rapid Oral Health Deterioration among Older Adults: A Narrative Review. J Clin Med 2023; 12:jcm12093202. [PMID: 37176641 PMCID: PMC10179735 DOI: 10.3390/jcm12093202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/11/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
Older adults who face systemic health issues and lack adequate social support are at risk for oral health deterioration. How rapidly such changes take place depends on the severity of their medical condition and their ability to access oral health services in a timely manner. The management of dental caries and periodontal disease in this cohort is made complex by the interaction of local and host factors such as the presence of dry mouth, involvement of root surfaces, and altered wound healing. in addition to enhanced maintenance needs to avoid recurrence or progression. Tooth replacement can be beneficial in restoring oral function, allowing patients to enjoy a healthy and nutritious diet but requires careful consideration to avoid further damage to remaining dental units. Establishing a dental home for the older adult can facilitate routine surveillance, disease prevention, and patient/caregiver education to achieve oral health goals commensurate with overall health. This narrative review details oral health factors that are related to rapid oral health deterioration among older adults.
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Affiliation(s)
- Jhanvi P Desai
- Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA
| | - Rohit U Nair
- Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA
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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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Jayasinghe TN, Harrass S, Erdrich S, King S, Eberhard J. Protein Intake and Oral Health in Older Adults-A Narrative Review. Nutrients 2022; 14:4478. [PMID: 36364741 PMCID: PMC9653899 DOI: 10.3390/nu14214478] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 08/31/2023] Open
Abstract
Oral health is vital to general health and well-being for all ages, and as with other chronic conditions, oral health problems increase with age. There is a bi-directional link between nutrition and oral health, in that nutrition affects the health of oral tissues and saliva, and the health of the mouth may affect the foods consumed. Evidence suggests that a healthy diet generally has a positive impact on oral health in older adults. Although studies examining the direct link between oral health and protein intake in older adults are limited, some have explored the relationship via malnutrition, which is also prevalent among older adults. Protein-energy malnutrition (PEM) may be associated with poor oral health, dental caries, enamel hypoplasia, and salivary gland atrophy. This narrative review presents the theoretical evidence on the impact of dietary protein and amino acid composition on oral health, and their combined impact on overall health in older adults.
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Affiliation(s)
- Thilini N. Jayasinghe
- The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Sanaa Harrass
- School of Life Sciences, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Sharon Erdrich
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Shalinie King
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Joerg Eberhard
- The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
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Montez De Sousa ÍR, Bergheim I, Brombach C. Beyond the Individual -A Scoping Review and Bibliometric Mapping of Ecological Determinants of Eating Behavior in Older Adults. Public Health Rev 2022; 43:1604967. [PMID: 35992753 PMCID: PMC9381692 DOI: 10.3389/phrs.2022.1604967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/27/2022] [Indexed: 11/20/2022] Open
Abstract
Objectives: The objective of this scoping review was to summarize and provide a visual overview of the present-day knowledge on ecological determinants of eating behavior in community-dwelling elderly persons in relation with nutrition communication, considering the evolution of the field. The second objective was to integrate results in recommendations for the development of nutrition communication strategies. Methods: A literature review was performed on Medline, PubMed and Google Scholar, according with the PRISMA protocol for scoping reviews. An a-priori analysis was executed by categorizing determinants from the literature according with the different levels represented in the ecological framework and an a-posteriori analysis by using VosViewer for a chronological bibliometric mapping analysis. Results: Of 4029 articles retrieved, 77 were selected for analysis. Initial publications focused more on individual determinants of eating behavior. Over time, there was a shift towards a holistic view of eating behavior considering the “food environment”, including social networks, physical settings and public policy. Conclusion: Beyond the individual, all ecological levels are relevant when targeting eating behavior in the elderly. Nutrition communication strategies should be structured considering these influences.
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Affiliation(s)
- Íris Rafaela Montez De Sousa
- Institute of Food and Beverage Innovation, Life Sciences and Facility Management, Zurich University of Applied Sciences, Wädenswil, Switzerland
- Molecular Nutritional Science, Department of Nutritional Sciences, University of Vienna, Vienna, Austria
- *Correspondence: Íris Rafaela Montez De Sousa,
| | - Ina Bergheim
- Molecular Nutritional Science, Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Christine Brombach
- Institute of Food and Beverage Innovation, Life Sciences and Facility Management, Zurich University of Applied Sciences, Wädenswil, Switzerland
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Johansson AK, Omar R, Mastrovito B, Sannevik J, Carlsson GE, Johansson A. Prediction of xerostomia in a 75-year-old population: A 25-year longitudinal study. J Dent 2022; 118:104056. [PMID: 35121136 DOI: 10.1016/j.jdent.2022.104056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES To follow the same individuals from age 50 up to 75 years to report on prevalence, persistence, progression, remission, incidence and predictors for xerostomia. METHODS A questionnaire was distributed to all 50-years-olds (1992) in two Swedish counties (N=8888) and repeated at the age of 65 (2007) and 75 years (2017). 3060 individuals responded on all three occasions (response rate 42.5%). Xerostomia was assessed with two questions. Additional questions addressed inter alia general/oral health and oral function. RESULTS Reported prevalence of daytime xerostomia were 23.3% and 14.7%, and 39.5% and 27.5% in women and men, age 50 and 75, respectively. Night-time prevalence was higher. At age 50, 27.4% women and 24.0% men reported having dry mouth, and at age 75, 61.0% and 53.8%, respectively. At all time points, women reported significantly more xerostomia than men. Progression (deterioration) was common, and persistence (continuing presence) was high, while 25-year incidence for daytime xerostomia was 16.2% and 12.8%, and 33.6% and 29.8% at night-time, for women and men, respectively. Based on reports at age 50, regression analyses showed that prediction for developing xerostomia during the observation period, and reporting xerostomia at age 75 years, were female gender, impaired general health, chewing, jaw opening and intraoral problems, dissatisfaction with dental appearance, low education and having white/plastic filling. CONCLUSIONS Xerostomia is common in older people, especially at night and in women. It can be predicted by diverse factors reported earlier in life. CLINICAL SIGNIFICANCE Clinicians need to be made aware of that elderly often suffers from dry mouth so that they can recommend effective measures to eliminate or ease the patients accompanying symptoms and also exclude or lessen possible negative impact on oral health related to xerostomia.
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Affiliation(s)
- Ann-Katrin Johansson
- Department of Clinical Dentistry - Cariology, Faculty of Medicine, University of Bergen, Bergen, Norway.
| | - Ridwaan Omar
- Department of Restorative Sciences - Prosthodontics, Faculty of Dentistry, Kuwait University, Safat, Kuwait
| | - Berit Mastrovito
- Dental Commissioning Unit, Östergötland County Council, Linköping, Sweden
| | | | - Gunnar E Carlsson
- Department of Prosthetic Dentistry, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
| | - Anders Johansson
- Department of Clinical Dentistry - Prosthodontics, Faculty of Medicine, University of Bergen, Bergen, Norway
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Naharci MI, Katipoglu B, Tasci I. Association of anticholinergic burden with undernutrition in older adults: A cross-sectional study. Nutr Clin Pract 2022; 37:1215-1224. [PMID: 34994474 DOI: 10.1002/ncp.10821] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Limited data are available concerning the contribution of drugs with anticholinergic properties (DAPs) to undernutrition among older adults. This study aimed to determine the potential association of anticholinergic burden (ACB) to nutrition status in older people. METHODS We prospectively enrolled participants aged over 65 who underwent a comprehensive geriatric assessment between January 2017 and June 2020. Nutrition status was assessed by the Mini Nutritional Assessment-Short Form (MNA-SF). The ACB was assessed using the ACB scale. RESULTS A total of 615 participants were included in the analysis (mean age ± SD, 78.5 ± 6.6 years; male, 55.3%). The prevalence of undernutrition (MNA-SF score <12) was 22.6% (n = 139). Participants with undernutrition were predominantly older (P < 0.001), had lower mean body mass index scores (undernutrition, 27.3 ± 5.4 vs healthy, 29.5 ± 8.0; P = 0.007), had a lower educational level (P = 0.016), had higher cardiovascular disease morbidity (P < 0.001), and had a higher ACB (P < 0.001) when compared with those with normal nutrition status. In adjusted analysis, the odds of having undernutrition were higher among participants with an ACB score >1 (odds ratio, 1.20; 95% CI, 1.01-1.43; P = 0.044). The weighted multivariate linear regression analysis showed a significant inverse association between the total ACB score and MNA-SF score controlling for multiple confounders. CONCLUSION ACB appears to be inversely correlated with nutrition status among older adults. Undernutrition may be considered an additional reason to consider deprescribing DAPs in this population.
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Affiliation(s)
- Mehmet Ilkin Naharci
- Division of Geriatrics, Gulhane Faculty of Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Bilal Katipoglu
- Division of Geriatrics, Gulhane Faculty of Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ilker Tasci
- Department of Internal Medicine, Gulhane Faculty of Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Association between Diet and Xerostomia: Is Xerostomia a Barrier to a Healthy Eating Pattern? Nutrients 2021; 13:nu13124235. [PMID: 34959787 PMCID: PMC8703915 DOI: 10.3390/nu13124235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/16/2021] [Accepted: 11/23/2021] [Indexed: 01/11/2023] Open
Abstract
Objective. Xerostomia is a subjective feeling of dry mouth and is commonly observed in patients with autoimmune diseases. Our study examines the association between xerostomia and diet. Materials and Methods. The cross-sectional study includes 1405 adults from 15 Lithuanian geographical areas (52% response rate). A self-reported questionnaire inquired about xerostomia, sex, age, education, residence, and consumption of selected 23 diet items. For the multivariable analysis, 23 diet items were categorized into eight major diet groups. The data were analyzed by bivariate and multivariable analyses. Results. When comparing participants with and without xerostomia, there were significant differences in consumption frequencies concerning cold-pressed oil (p = 0.013), bread (p = 0.029), processed meat products (p = 0.016), fat and lean fish (p = 0.009), and probiotic supplements (p = 0.002). In the multivariable binary logistic regression model, when controlled for other determinants, the higher consumption of carbohydrates (OR 0.39, 95% CI 0.23–0.65), proteins (OR 0.56, 95% CI 0.32–0.99), and oils (OR 0.58, 95% CI 0.34–1.00) was associated with a lower likelihood of xerostomia. Conclusions. The association between xerostomia and the consumption of the six diet items—cold-pressed oils, lean and fat fish, bread, processed meat, and probiotic supplements— and the three major diet groups—carbohydrates, proteins, and oils—was observed. Longitudinal studies are needed to validate the observed associations.
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The Effects of Sorbet Drinking Before Meal on Food Intake and Body Mass Index Among Elderly People With Xerostomia. TOP CLIN NUTR 2021. [DOI: 10.1097/tin.0000000000000263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Older age, smoking, tooth loss and denture-wearing but neither xerostomia nor salivary gland hypofunction are associated with low intakes of fruit and vegetables in older Danish adults. J Nutr Sci 2021; 10:e47. [PMID: 34267893 PMCID: PMC8256315 DOI: 10.1017/jns.2021.38] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/14/2021] [Accepted: 06/01/2021] [Indexed: 11/07/2022] Open
Abstract
Xerostomia and salivary gland hypofunction are prevalent conditions in older people and may adversely influence the intake of certain foods, notably fruit and vegetables. Here, we aimed to investigate whether xerostomia and salivary gland hypofunction were associated with a lower intake of fruit and vegetables. The study included 621 community-dwelling adults, mean age 75⋅2 ± 6⋅4 years, 58⋅9 % female, who had participated in the Copenhagen City Heart Study follow-up, and undergone interviews regarding food intake (preceding month), oral and general health (xerostomia, taste alterations, diseases, medication, alcohol consumption and smoking), clinical oral examination and measurements of unstimulated and chewing-stimulated whole saliva flow rates. The average total energy intake (8⋅4 ± 2⋅7 MJ) and protein energy percentage (14⋅8 ± 3⋅1 %) were slightly below recommendations. The average fruit (234⋅7 ± 201⋅2 g/d) and vegetables (317⋅3 ± 157⋅4 g/d) intakes were within recommendations. Xerostomia and hyposalivation were more prevalent in women than in men (16⋅4 v. 7⋅1 %, P < 0⋅001 and 40⋅7 v. 27⋅5 %, P < 0⋅001). Multiple linear regression analyses revealed that older age (β -0⋅009, se 0⋅003, P = 0⋅005), smoking (β -0⋅212, se 0⋅060, P = 0⋅0005) and wearing complete dentures/being partially or fully edentulous (β -0⋅141, se 0⋅048, P = 0⋅003), but neither xerostomia nor salivary flow rates were associated with an inadequate fruit and vegetable intake, after adjustment for covariates. Older age, smoking, tooth loss and denture-wearing were stronger determinants of low fruit and vegetable intakes than xerostomia and salivary hypofunction supporting the importance of dietary counselling and maintenance of oral health and an adequate masticatory performance.
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Nakayama E, Tohara H, Sato M, Abe K, Kimura M, Watanabe M, Iida M, Ueda K. Relationship between oral intake level and oral health assessment tool scores in the convalescent ward. J Oral Sci 2020; 63:79-82. [PMID: 33281145 DOI: 10.2334/josnusd.20-0414] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE To examine the relationship between oral intake function and oral health status in convalescent inpatients. METHODS Subjects were 222 patients admitted to a convalescent hospital between 1 January and 30 June 2018. Investigation items were age, sex, causative disease, body mass index, functional oral intake scale (FOIS), functional independence measure, occlusal contact, assistance with oral cleaning, and oral health assessment tool (OHAT) scores. Multiple regression analysis was performed with FOIS as the dependent variable, and investigation items were related to FOIS as independent variables. RESULTS Results of multiple regression analysis for all patients suggested that saliva and denture scores were significantly associated with FOIS. However, analysis excluding non-oral feeding patients did not show a significant association between FOIS and OHAT scores. CONCLUSION The results of this study suggest that oral health status is associated with oral intake function. In addition, the oral health status of inpatients may be strongly related to whether or not they are eating orally. Therefore, it is necessary to take good care of oral health in non-oral feeding patients in the convalescent ward.
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Affiliation(s)
- Enri Nakayama
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry.,Shin-yachiyo Hospital
| | - Haruka Tohara
- Shin-yachiyo Hospital.,Dysphagia Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Mitsuyasu Sato
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
| | - Kimiko Abe
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
| | - Masanori Kimura
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
| | - Mao Watanabe
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
| | - Masato Iida
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
| | - Koichiro Ueda
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
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Mao W, Chen Y, Wu B, Ge S, Yang W, Chi I, Dong X. Perceived Stress, Social Support, and Dry Mouth Among US Older Chinese Adults. J Am Geriatr Soc 2020; 67:S551-S556. [PMID: 31403193 DOI: 10.1111/jgs.15890] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/18/2019] [Accepted: 02/22/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Dry mouth is a common condition among older adults that negatively influences oral health, general health, and quality of life. The role of psychosocial factors in oral health conditions and diseases remains largely unknown. We conducted a study to examine the relationship between perceived stress and dry mouth among US older Chinese adults and further investigated the potential moderating role of social support and social strain from different sources in the relationship. DESIGN Cross-sectional analysis. SETTING Baseline of the Population Study of Chinese Elderly in Chicago, a community-engaged, population-based longitudinal study of health and well-being among community-dwelling US older Chinese adults. PARTICIPANTS Individuals 60 years or older (N = 3157). MEASUREMENTS Perceived stress was measured by the 10-item Chinese Perceived Stress Scale to evaluate the degree to which life situations were perceived as stressful during the preceding month on a 5-point scale, ranging from 0 ("never") to 4 ("very often"). Dry mouth was a binary self-reported outcome variable (1 = "dry mouth"). Social support was measured by the Health and Retirement Study's social support and strain scale from sources including spouse, other family members, and friends with a 3-point response set, ranging from 0 ("hardly ever") to 2 ("often"). Sociodemographics and disease processes were assessed as covariates. We conducted stepwise logistic regressions with interaction terms. RESULTS Having higher levels of perceived stress was significantly associated with a higher likelihood of reporting dry mouth (odds ratio = 1.03; 95% confidence interval = 1.02-1.04). The effect of perceived stress on dry mouth may vary by levels of family and friend support. CONCLUSION Perceived stress may influence dry mouth either directly or indirectly. To prevent or reduce dry mouth, in addition to disease processes, interventions need to consider psychosocial factors in dry mouth, especially perceived stress and social support, in this growing population. J Am Geriatr Soc 67:S551-S556, 2019.
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Affiliation(s)
- Weiyu Mao
- School of Social Work, University of Nevada, Reno, Nevada
| | - Yiwei Chen
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, New York
| | - Shaoqing Ge
- School of Nursing, Duke University, Durham, North Carolina
| | - Wei Yang
- School of Community Health Sciences, University of Nevada, Reno, Nevada
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey
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Hakeem FF, Bernabé E, Sabbah W. Association between oral health and frailty: A systematic review of longitudinal studies. Gerodontology 2019; 36:205-215. [DOI: 10.1111/ger.12406] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 02/26/2019] [Accepted: 03/02/2019] [Indexed: 12/23/2022]
Affiliation(s)
- Faisal F. Hakeem
- Faculty of Dentistry, Oral & Craniofacial Sciences King's College London London UK
- Department of Preventive Dental Sciences, College of Dentistry Taibah University Dental College & Hospital Madinah Saudi Arabia
| | - Eduardo Bernabé
- Faculty of Dentistry, Oral & Craniofacial Sciences King's College London London UK
| | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences King's College London London UK
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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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Saliba TA, Ortega MM, Goya KK, Moimaz SAS, Garbin CAS. Influence of oral health on the quality of life of institutionalized and noninstitutionalized elderly people. Dent Res J (Isfahan) 2018; 15:256-263. [PMID: 30123302 PMCID: PMC6073941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND This study aimed to determine the perception of institutionalized (G1) and noninstitutionalized (G2) elderly people on oral health and quality of life (QOL). MATERIALS AND METHODS This cross-sectional, exploratory study applied two instruments - the Geriatric Oral Health Assessment Index (GOHAI) and the World Health Organization QOL-Bref (WHOQOL-BREF) - in two cities of the state of Sao Paulo, Brazil. Among the institutionalized elderly, G1 (n = 150), 50% were not mentally able to answer the questions correctly, 12% did not answer all the questions, and 7.34% refused to take part in the research or were too frail or dependent, resulting in 31 institutionalized participants. In the noninstitutionalized group, G2 (n = 80), 52.50% refused to take part in the research, resulting in 38 noninstitutionalized participants. The elderly individuals (i) who did not respond to three or more questions of the GOHAI, (ii) those who did not answer all the questions of the WHOQOL-Bref, and (iii) those who did not consent to participate in the research study were excluded from the study population (P < 0.05 consider significant). RESULTS The oral health of both groups minimally affected the QOL of the elderly. The WHOQOL-Bref score varied between the two study groups mainly in terms of physical domain and self-perception of QOL. The study groups showed differences in some variables: self-perception of QOL (P = 0.0209), mobility (P = 0.0057), and access to health services (P = 0.0252). G2 presented the best conditions. CONCLUSION The oral health condition of both groups minimally affected the QOL of the participants; however, differences in the self-perception of QOL were significant, mainly in the physical domain.
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Affiliation(s)
- Tânia Adas Saliba
- Department of Child and Social Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil,Address for correspondence: Dr. Tânia Adas Saliba, Department of Child and Social Dentistry, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, Brazil. E-mail:
| | - Mariana Martins Ortega
- Department of Child and Social Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Karimy Kassem Goya
- Department of Child and Social Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Suzely Adas Saliba Moimaz
- Department of Child and Social Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Cléa Adas Saliba Garbin
- Department of Child and Social Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
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15
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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: 28] [Impact Index Per Article: 4.7] [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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16
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17
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Kubota C, Kanazawa M, Hama Y, Komagamine Y, Minakuchi S. Association between chewing-stimulated salivary flow under the effects of atropine and mixing ability assessed using a color-changeable chewing gum. J Prosthodont Res 2017; 61:387-392. [PMID: 28126244 DOI: 10.1016/j.jpor.2016.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 12/26/2016] [Accepted: 12/26/2016] [Indexed: 11/17/2022]
Abstract
PURPOSE To assess the time course of chewing-stimulated salivary flow after oral atropine administration, and determine the association between chewing-stimulated salivary flow and mixing ability using color-changeable chewing gum in dentate adults. METHODS Ten healthy dentate adults were administered 1mg oral atropine to induce mouth dryness. The subjects' chewing-stimulated salivary flow was assessed using the Saxon test. They were then asked to rinse their mouth with tap water for 15s, and to chew on color-changeable chewing gum for 60s at a constant rate of 60 cycles per min. This procedure was performed before, and at 10-min intervals for up to 120min after the atropine administration. The experiment was repeated after 1 week. Steel's test was used to compare the chewing-stimulated salivary flow rates at each time point after atropine administration with the baseline value. The effect of the stimulated salivary flow rates on the degree of color change was analyzed using linear mixed effects models, with the stimulated salivary flow rates as fixed factors and subjects as the random factor. RESULTS Chewing-stimulated salivary flow showed a significant decrease from 50 to 120min after oral atropine administration (P<0.05) and the amount of chewing-stimulated salivary flow had a significant effect on the color change of the color-changeable chewing gum (P<0.001). CONCLUSIONS We observed a decrease in stimulated salivary flow after orally administering 1mg atropine, and a positive association between mixing ability using color-changeable chewing gum and chewing-stimulated salivary flow in dentate subjects.
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Affiliation(s)
- Chieko Kubota
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Manabu Kanazawa
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Yohei Hama
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuriko Komagamine
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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18
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da Silva L, Kupek E, Peres KG. General health influences episodes of xerostomia: a prospective population-based study. Community Dent Oral Epidemiol 2016; 45:153-159. [DOI: 10.1111/cdoe.12271] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 11/14/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Luciana da Silva
- Department of Public Health; Federal University of Santa Catarina; Florianópolis Santa Catarina Brazil
| | - Emil Kupek
- Department of Public Health; Federal University of Santa Catarina; Florianópolis Santa Catarina Brazil
| | - Karen G. Peres
- Department of Public Health; Federal University of Santa Catarina; Florianópolis Santa Catarina Brazil
- Australian Research Centre for Population Oral Health; Adelaide Dental School; The University of Adelaide; Adelaide Australia
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19
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Associations Between Tooth Loss, With or Without Dental Prostheses, and Malnutrition Risk in Older Adults. TOP CLIN NUTR 2016. [DOI: 10.1097/tin.0000000000000077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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20
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Kaur M, Himadi E, Chi DL. Prevalence of xerostomia in an adolescent inpatient psychiatric clinic: a preliminary study. SPECIAL CARE IN DENTISTRY 2015; 36:60-5. [PMID: 26687928 DOI: 10.1111/scd.12154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Adolescents with psychiatric conditions may be at risk for xerostomia. In this preliminary study, we estimated xerostomia prevalence in adolescents ages 9 to 17 years from an inpatient psychiatric clinic (N = 25) and examined whether: (1) gender and age were associated with xerostomia and (2) xerostomia was associated with self-reported cavities. METHODS We used a modified 11-item Xerostomia Index to identify xerostomia (no/yes) and asked if adolescents ever had or currently have cavities (no/yes). RESULTS The mean age was 14 years (SD = 2.3) and 72% were male. Sixty percent reported xerostomia (SD = 50). There were no significant associations between xerostomia and gender (p = 0.99) or age (p = 0.66), or between xerostomia and past (p = 0.26) or current cavities (p = 0.11). Larger proportions of adolescents with xerostomia reported previous and current cavities. CONCLUSIONS Sixty percent of adolescents from an inpatient psychiatric clinic reported having xerostomia, which may lead to increased caries risk over time. Additional research should examine the prevalence and consequences of xerostomia in high-risk adolescents.
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Affiliation(s)
- Manvir Kaur
- Research Assistant, University of Washington, Seattle, Washington
| | - Elaine Himadi
- Clinical Assistant Professor, School of Medicine, Department of Psychiatry, University of Iowa, Iowa City, IA
| | - Donald L Chi
- Associate Professor, University of Washington, Seattle, Washington
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21
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Huang YC, Chu CL, Ho CS, Lan SJ, Chen WY, Liang YW, Hsieh YP. Factors affecting institutionalized older peoples' self-perceived dry mouth. Qual Life Res 2014; 24:685-91. [PMID: 25150709 PMCID: PMC4349962 DOI: 10.1007/s11136-014-0792-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2014] [Indexed: 11/29/2022]
Abstract
Purpose The purpose of this study was to determine the factors affecting institutionalized older peoples’ self-perceived dry mouth. Methods This cross-sectional study was conducted on elderly residents at 22 long-term care facilities. A total of 165 questionnaires were returned from 13 senior citizen welfare institutions (SCWIs) and nine nursing homes. Multiple logistic regression analysis was used to analyze the data obtained. Results The results showed that the type of long-term care (LTC) facility, regular oral examinations, wearing dentures, and the ability to chew sticky foods affected self-perceived dry mouth. This study determined an association between the type of LTC facility where the participants lived and self-perceived dry mouth. Conclusions The results indicated the importance of providing oral care in order to improve and prevent dry mouth among institutionalized older people living in SCWIs who do not undergo regular oral examinations, wear dentures, and have difficulty chewing sticky foods.
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Affiliation(s)
- Ying-Chia Huang
- Department of Healthcare Administration, Asia University, Taichung City, Taiwan, ROC,
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22
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Eckerblad J, Tödt K, Jakobsson P, Unosson M, Skargren E, Kentsson M, Theander K. Symptom burden in stable COPD patients with moderate or severe airflow limitation. Heart Lung 2014; 43:351-7. [PMID: 24856227 DOI: 10.1016/j.hrtlng.2014.04.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 04/02/2014] [Accepted: 04/03/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To describe a multidimensional symptom profile in patients with stable chronic obstructive pulmonary disease (COPD) and determine whether symptom experience differed between patients with moderate or severe airflow limitations. BACKGROUND Patients with severe airflow limitation experience numerous symptoms, but little is known regarding patients with moderate airflow limitation. METHODS A multidimensional symptom profile (Memorial Symptom Assessment Scale) was assessed in 42 outpatients with moderate and 49 with severe airflow limitations. RESULTS The mean number of symptoms in the total sample was 7.9 (±4.3) with no difference between patients with moderate and severe airflow limitations. The most prevalent symptoms with the highest MSAS symptom burden scores were shortness of breath, dry mouth, cough, sleep problems, and lack of energy in both groups. CONCLUSIONS Patients with moderate or severe airflow limitations experience multiple symptoms with high severity and distress. An assessment of their multidimensional symptom profile might contribute to better symptom management.
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Affiliation(s)
- J Eckerblad
- Department of Social and Welfare Studies, Faculty of Health Sciences, Linkoping University, 581 85 Linkoping, Sweden.
| | - K Tödt
- Department of Social and Welfare Studies, Faculty of Health Sciences, Linkoping University, 581 85 Linkoping, Sweden; Department of Pulmonary Medicine, University Hospital, 581 85 Linkoping, Sweden
| | - P Jakobsson
- Department of Pulmonary Medicine, University Hospital, 581 85 Linkoping, Sweden
| | - M Unosson
- Department of Social and Welfare Studies, Faculty of Health Sciences, Linkoping University, 581 85 Linkoping, Sweden
| | - E Skargren
- Department of Medicine and Health Sciences, Faculty of Health Sciences, Linkoping University, 581 85 Linkoping Sweden
| | - M Kentsson
- Department of Pulmonary Medicine, Ryhov Hospital, Jonkoping S-551 85, Sweden
| | - K Theander
- Faculty of Health, Science and Technology, Department of Health Sciences, Nursing, Karlstad University, 656 37 Karlstad, Sweden; Primary Care Research Unit, Varmland County Council, Karlstad, Sweden
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23
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Hildebrandt GH, Tantbirojn D, Augustson DG, Guo H. Effect of Caffeinated Soft Drinks on Salivary Flow. JOURNAL OF CAFFEINE RESEARCH 2014; 3:138-142. [PMID: 24761280 DOI: 10.1089/jcr.2013.0012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Soft drinks containing caffeine have been associated with more aggressive forms of dental decay. Cariogenicity of caffeinated soft drinks may be attributed to the effect of caffeine on salivary flow. This study assessed whether caffeinated soft drinks produced short-term oral dryness in healthy adults. METHODS The authors collected saliva on two separate days from 35 participants before and one hour after drinking a soft drink. On one of the days the soft drink was caffeinated and on the other day it was not. Saliva collection involved 15 minutes unstimulated whole saliva, 5 minutes paraffin-stimulated whole saliva, and 10 seconds labial minor salivary gland output. RESULTS Unstimulated and stimulated flow rates slightly increased and minor gland output slightly decreased one hour after the soft drink consumption regardless of caffeine content. These changes were not statistically significant (two-period two-treatment crossover trial using two-stage Grizzle model, p>0.05). A linear mixed model statistic did not show the caffeine effect on salivary flow rate. CONCLUSIONS Caffeinated soft drink consumption had no significant effect on salivary flow rate after one hour by any of the three measures employed in this study. Caffeine's contribution to the cariogenicity of soft drinks is likely by centrally-mediated effects on consumption patterns.
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Affiliation(s)
- Gary H Hildebrandt
- Division of Operative Dentistry, Department of Restorative Sciences, School of Dentistry, University of Minnesota , Minneapolis, Minnesota
| | - Daranee Tantbirojn
- Department of Restorative Sciences, School of Dentistry, University of Minnesota , Minneapolis, Minnesota
| | - David G Augustson
- School of Dentistry, University of Minnesota , Minneapolis, Minnesota
| | - Hongfei Guo
- Division of Biostatistics and Clinical and Translational Science Institute, University of Minnesota , Minneapolis, Minnesota
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24
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Mizutani S, Ekuni D, Tomofuji T, Azuma T, Kataoka K, Yamane M, Iwasaki Y, Morita M. Relationship between xerostomia and gingival condition in young adults. J Periodontal Res 2014; 50:74-9. [PMID: 24697562 DOI: 10.1111/jre.12183] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Xerostomia is a subjective symptom of dryness in the mouth. Although a correlation between xerostomia and oral conditions in the elderly has been reported, there are few such studies in the young adults. The aim of this study was to examine the relationship of xerostomia with the gingival condition in university students. MATERIAL AND METHODS A total of 2077 students (1202 male subjects and 875 female subjects), 18-24 years of age, were examined. The disease activity and severity of the gingival condition were assessed as the percentage of teeth with bleeding on probing (%BOP) and the presence of teeth with probing pocket depth of ≥ 4 mm, respectively. Additional information on xerostomia, oral health behaviors, coffee/tea intake and nasal congestion was collected via a questionnaire. Path analysis was used to test pathways from xerostomia to the gingival condition. RESULTS One-hundred and eighty-three (8.8%) students responded that their mouths frequently or always felt dry. Xerostomia was related to %BOP and dental plaque formation, but was not related to the presence of probing pocket depth ≥ 4 mm. In the structural model, xerostomia was related to dental plaque formation (p < 0.01), and a lower level of dental plaque formation was associated with a lower %BOP. Xerostomia was associated with coffee/tea intake (p < 0.01) and nasal congestion (p < 0.001). CONCLUSION Xerostomia was indirectly related to gingival disease activity through the accumulation of dental plaque. Nasal congestion and coffee/tea intake also affected xerostomia. These findings suggest that xerostomia should be considered in screening for gingivitis risk in young adults.
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Affiliation(s)
- S Mizutani
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kita-ku, Okayama, 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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26
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Chi DL, Tucker-Seeley R. Gender-stratified models to examine the relationship between financial hardship and self-reported oral health for older US men and women. Am J Public Health 2013; 103:1507-15. [PMID: 23327271 DOI: 10.2105/ajph.2012.301145] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES We evaluated the relationship between financial hardship and self-reported oral health for older men and women. METHODS We focused on adults in the 2008 Health and Retirement Study (n = 1,359). The predictor variables were 4 financial hardship indicators. We used Poisson regression models to estimate the prevalence ratio of poor self-reported oral health. RESULTS In the non-gender-stratified model, number of financial hardships was not significantly associated with self-reported oral health. Food insecurity was associated with a 12% greater prevalence of poor self-reported oral health (95% confidence interval [CI] = 1.04, 1.21). In the gender-stratified models, women with 3 or more financial hardships had a 24% greater prevalence of poor self-reported oral health than women with zero (95% CI = 1.09, 1.40). Number of hardships was not associated with self-reported oral health for men. For men, skipping medications was associated with 50% lower prevalence of poor self-reported oral health (95% CI = 0.32, 0.76). CONCLUSIONS Number of financial hardships was differentially associated with self-reported oral health for older men and women. Most financial hardship indicators affected both genders similarly. Future interventions to improve vulnerable older adults' oral health should account for gender-based heterogeneity in financial hardship experiences.
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Affiliation(s)
- Donald L Chi
- University of Washington, School of Dentistry, Department of Oral Health Sciences, Box 357475, Seattle, WA 98195-7475, USA.
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27
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Aida J, Kondo K, Yamamoto T, Hirai H, Nakade M, Osaka K, Sheiham A, Tsakos G, Watt RG. Oral health and cancer, cardiovascular, and respiratory mortality of Japanese. J Dent Res 2011; 90:1129-35. [PMID: 21730255 DOI: 10.1177/0022034511414423] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Cardiovascular diseases, cancer, and respiratory disease are major causes of death in developed countries. No study has simultaneously compared the contribution of oral health with these major causes of death. This study examined the association between oral health and cardiovascular diseases, cancer, and respiratory mortality among older Japanese. Self-administered questionnaires were mailed to participants in the Aichi Gerontological Evaluation Study (AGES) Project in 2003. Mortality data were analyzed for 4425 respondents. Three categories of oral health were used: 20 or more teeth, 19 or fewer teeth and eat everything, 19 or fewer teeth and eating difficulty. Sex, age, body mass index (BMI), self-rated health, present illness, exercise, smoking, alcohol, education, and income were used as covariates. During 4.28 years' follow-up, 410 people died, 159 from cancer, 108 of cardiovascular diseases, and 58 of respiratory disease. Multivariate adjusted Cox proportional hazard models showed that, compared with the respondents with 20 or more teeth, respondents with 19 or fewer teeth and with eating difficulty had a 1.83 and 1.85 times higher hazard ratio for cardiovascular disease mortality and respiratory disease mortality, respectively. There was no significant association with cancer mortality. Oral health predicted cardiovascular and respiratory disease mortality but not cancer mortality in older Japanese.
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Affiliation(s)
- J Aida
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
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