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van der Meulen AI, Neis EPJG, de Nijs EJM, Coenegracht BJEG, Stoppelenburg A, van den Beuken-van Everdingen MHJ, van der Linden YM. Dry mouth in patients with a life-limiting condition or frailty: a study protocol for two intervention studies and a nested qualitative sub-study (the Dry mOuth Project, DROP). BMC Palliat Care 2023; 22:120. [PMID: 37612654 PMCID: PMC10463805 DOI: 10.1186/s12904-023-01242-0] [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: 07/31/2023] [Accepted: 08/08/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Despite its prevalent and impactful nature, dry mouth remains an underexposed and undertreated symptom in patients with a life-limiting condition or frailty. The main contributing factors are a lack of awareness and knowledge amongst both healthcare professionals and patients, and a scarcity of effective, evidence-based interventions. In the DRy mOuth Project (DROP), we address these factors by investigating both a non-pharmacological and a pharmacological intervention: a nurse-led patient education program and locally applied pilocarpine. METHODS This intervention-based research project consists of two parallel studies. The non-pharmacological study is a cluster non-randomized controlled trial in 228 palliative nursing home and hospital patients, investigating the effect of structured use of guidelines and of patient education on dry mouth symptoms. This intervention, a nurse-led patient education program (the Mouth Education Program, MEP), will be compared to care as usual, the control. The pharmacological study is a double-blind placebo-controlled randomized trial that examines the effect of locally applied pilocarpine drops in 120 patients with dry mouth symptoms. Both studies use the same mixed-methods study design, in which the primary outcome is the clinical response to the intervention at 4 weeks, as measured by a dry mouth severity score (numeric rating scale from 0 to 10). Other outcomes, as measured by questionnaires over a 12-week follow-up period, include durability of the effect, impact on quality of life and, adherence and acceptability of the intervention. In addition, the feasibility and cost-effectiveness are evaluated by means of questionnaires and focus groups with healthcare professionals, and interviews with patients. DISCUSSION This study investigates the effectiveness and feasibility of two interventions for dry mouth symptoms in patients with life-limiting conditions or frailty. Due to the large-scale and mixed-method nature of the study, this study will also improve our understanding of dry mouth and its relating factors and of the patients' and healthcare professionals' experiences with symptoms, care and guidelines of dry mouth, including any perceived barriers and facilitators. TRIAL REGISTRATION NCT05964959 & NCT05506137.
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Affiliation(s)
| | - Evelien P J G Neis
- Center of Expertise in Palliative Care, Maastricht University Medical Center, Maastricht, Netherlands
| | - Ellen J M de Nijs
- Center of Expertise in Palliative Care, Leiden University Medical Center, Leiden, Netherlands
| | | | - Arianne Stoppelenburg
- Center of Expertise in Palliative Care, Leiden University Medical Center, Leiden, Netherlands
- Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands
| | | | - Yvette M van der Linden
- Center of Expertise in Palliative Care, Leiden University Medical Center, Leiden, Netherlands
- Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands
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2
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Pérez-Jardón A, Pérez-Sayáns M, Peñamaría-Mallón M, Otero-Rey E, Velasco-Ortega E, López-López J, Martínez-González JM, Blanco-Carrión A. Xerostomia, the perception of general and oral health and health risk behaviours in people over 65 years of age. BMC Geriatr 2022; 22:982. [PMID: 36536323 PMCID: PMC9764469 DOI: 10.1186/s12877-022-03667-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This study investigated the association between xerostomia and health risk behaviours, general and oral health and quality of life. METHODS A cross-sectional study involving 800 adults over 65 years of age residing in Spain using a computer-assisted telephone questionnaire. The severity of xerostomia was assessed through the Xerostomia Inventory (XI). Both univariate and adjusted multinomial logistic regression were used to determine the risk (OR) of xerostomia. RESULTS The sample comprised of 492 females (61.5%) and 308 males, with a mean age of 73.7 ± 5.8 years. Some, 30.7% had xerostomia: 25.6% mild, 4.8% moderate and 0.3% severe, the majority being female (34.8% vs 24%; p = 0.003). The mean XI was 24.6 ± 6.3 (95% CI 19.2-24.8) for those with poor health, whereas it was 17.4 ± 6.3 (95%CI 16.1-18.6) in those reporting very good health (p < 0.001). This difference was also observed in terms of oral health, with the XI mean recorded as 14.7 ± 10.7 for very poor oral health and 6.4 ± 5.4 for those with very good health (p = 0.002). Logistic regression showed that the highest OR for xerostomia was observed among adults with poor general health (2.81; 95%CI 1.8-4.3; p < 0.001) and for adjusted model the OR was still significant (2.18; 95%CI 1.4-3.4; p = 0.001). Those who needed help with household chores had 2.16 higher OR (95%CI 1.4-3.4; p = 0.001) and 1.69 (95%CI 1.1-2.7; p = 0.03) in the adjusted model. Females had a higher risk of suffering from xerostomia than males. CONCLUSION The strong association between xerostomia and the general and oral health status of older adults justifies the need for early assessment and regular follow-up.
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Affiliation(s)
- Alba Pérez-Jardón
- grid.11794.3a0000000109410645Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes). Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, 15705 A Coruña, Spain ,grid.488911.d0000 0004 0408 4897ORALRES group. Instituto de Investigación Sanitaria de Santiago (IDIS), 15706 Santiago de Compostela, Spain
| | - Mario Pérez-Sayáns
- grid.11794.3a0000000109410645Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes). Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, 15705 A Coruña, Spain ,grid.488911.d0000 0004 0408 4897ORALRES group. Instituto de Investigación Sanitaria de Santiago (IDIS), 15706 Santiago de Compostela, Spain
| | - Manuel Peñamaría-Mallón
- grid.11794.3a0000000109410645Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes). Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, 15705 A Coruña, Spain
| | - Eva Otero-Rey
- grid.11794.3a0000000109410645Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes). Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, 15705 A Coruña, Spain ,grid.488911.d0000 0004 0408 4897ORALRES group. Instituto de Investigación Sanitaria de Santiago (IDIS), 15706 Santiago de Compostela, Spain
| | - Eugenio Velasco-Ortega
- grid.9224.d0000 0001 2168 1229Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 41009 Seville, Spain
| | - José López-López
- grid.5841.80000 0004 1937 0247Oral Health and Masticatory System Group-IDIBELL, Faculty of Medicine and Health Sciences, Odontological Hospital University of Barcelona, University of Barcelona, 08907 Barcelona, Spain
| | - José María Martínez-González
- grid.4795.f0000 0001 2157 7667Department of dental Clinical Specialties, Faculty of dentistry, Complutense University of Madrid, 28040 Madrid, Spain
| | - Andrés Blanco-Carrión
- grid.11794.3a0000000109410645Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes). Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, 15705 A Coruña, Spain ,grid.488911.d0000 0004 0408 4897ORALRES group. Instituto de Investigación Sanitaria de Santiago (IDIS), 15706 Santiago de Compostela, Spain
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Choi JH, Kim MJ, Kho HS. Oral health-related quality of life and associated factors in patients with xerostomia. Int J Dent Hyg 2021; 19:313-322. [PMID: 34092041 DOI: 10.1111/idh.12528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/16/2021] [Accepted: 05/24/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to investigate clinical and demographic factors associated with oral health-related quality of life (OHRQoL) in patients with xerostomia. METHODS Forty-one patients (55.2 ± 13.8 years) with xerostomia as a chief complaint participated in the study. Comprehensive information about clinical and demographic characteristics of the patients with xerostomia, xerostomia-related symptoms and behaviours, and xerostomia-associated complaints was investigated using a xerostomia questionnaire. Flow rates of unstimulated and stimulated whole saliva were measured. The Oral Health Impact Profile-14 (OHIP-14) score was used to assess the OHRQoL of patients. The relationships between various factors and the OHIP-14 score were assessed by simple and multiple linear regression analyses. RESULTS The OHIP-14 score of patients with xerostomia was high (44.3 ± 13.2). Characteristics of the patients with xerostomia associated with high OHIP-14 score were the intensity of xerostomia-related symptoms, frequency of xerostomia-related behaviours and the presence of speaking difficulty. Results from multiple linear regressions found that self-reported amount of saliva in usual, everyday life (β = 0.622, p = 0.012) and the presence of a speaking difficulty (β = 0.348, p = 0.014) had significant adversely affected the OHRQoL in patients with xerostomia. CONCLUSIONS Subjective perceptions of the amount of saliva in the mouth and the experience of speaking difficulty affected the OHRQoL in patients with xerostomia.
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Affiliation(s)
- Jee-Hye Choi
- Department of Dental Hygiene, Yonsei University Graduate School, Seoul, Korea
| | - Moon-Jong Kim
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Hong-Seop Kho
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea.,Institute on Aging, Seoul National University, Seoul, Korea
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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: 6] [Impact Index Per Article: 1.5] [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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TÔrres LHDN, Fagundes MLB, Silva DDD, Neri AL, Hilgert JB, Hugo FN, Sousa MDLRD. Self-rated general and oral health and associated factors in independently-living older individuals. Braz Oral Res 2020; 34:e079. [PMID: 32696912 DOI: 10.1590/1807-3107bor-2020.vol34.0079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 04/20/2020] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to verify the association between sociodemographic, general health, and oral health data with self-rated general health (SRGH) and self-rated oral health (SROH) in independent-living older Brazilians. This cross-sectional study was part of a larger study with older individuals living independently in the city of Campinas, Brazil - the "Rede FIBRA" Study (the Frailty in Brazilian Elderly Study). A random sample of 688 older individuals responded the SRGH and 673, the SROH. SRHG and SROH were both assessed using a single item. The questionnaire included sociodemographic, general, and oral health data. The mean age was 72.28 ± 5.4 years. The adjusted analysis revealed that the probability of rating general health as bad was higher for illiterate participants (PR: 1.77, 95%CI: 1.13-2.77) or with low educational level (PR: 1.76, 95%CI: 1.17-2.65), those with depressive symptoms (PR: 1.45, 95%CI:1.21-1.74), participants that self-reported food limitation due to problems with denture or lack of it (PR: 1.29, 95%CI: 1.05-1.56), and those with xerostomia (PR 1.40, 95%CI: 1.17-1.67). The probability of rating general health as bad was lower for participants that presented 0-2 chronic diseases (PR: 0.64, 95%CI: 0.53-0.78) and were pre-frail (PR: 0.76, 95%CI: 0.61-0.96). With regard to SROH, the probability of rating oral health as bad was higher for participants with natural teeth (PR:1.61, 95%CI: 1.24-2.08), that reported xerostomia (PR: 1.44, 95%CI: 1.13-1.84), and food limitation due to problems with denture or lack of it (PR: 1.43, 95%CI: 1.07-1,91), and lower for participants that reported having enough money to cover daily expenses (PR: 0.78, 95%CI: 0.61-0.99). Oral health data and income seem to be related to self-perceptions of general and oral health.
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Affiliation(s)
| | | | - Débora Dias da Silva
- Departament of Community and Dental Health, Dental School, Universidade Paulista, Campinas, SP, Brazil
| | - Anita Liberalesso Neri
- Departament of Genrontology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Juliana Balbinot Hilgert
- Departament of Preventive and Social Dentistry, Dental School, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fernando Neves Hugo
- Departament of Preventive and Social Dentistry, Dental School, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Maria da Luz Rosário de Sousa
- Department of Health Sciences and Pediatric Dentistry, Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
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Gibson B, Periyakaruppiah K, Thornhill MH, Baker SR, Robinson PG. Measuring the symptomatic, physical, emotional and social impacts of dry mouth: A qualitative study. Gerodontology 2019; 37:132-142. [PMID: 31347735 DOI: 10.1111/ger.12433] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 05/21/2019] [Accepted: 06/08/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore the impacts of dry mouth in order to develop a comprehensive condition-specific OHRQoL measure. BACKGROUND Dry mouth has been shown to have significant, if not more severe impacts on OHRQoL, than dental caries. Yet there remain few studies reporting on how to develop a comprehensive measure of the impact of dry mouth on OHRQoL. METHODS This study was a qualitative study using semi-structured interviews. Data were collected from a purposive sample of 17 people with dry mouth (14 women, three men). The sample was drawn to capture a comprehensive range of impacts of dry mouth. These interviews were analysed using a framework approach informed by existing functionalist approaches to OHRQoL. RESULTS Participants reported a huge range of symptoms associated with perceived dry mouth resulting in extensive impacts on physical, emotional (psychological) and social functioning. Dry mouth could also result in restrictions in social participation which, under some conditions, could be disabling. These impacts were modified by psychological, social and environmental factors. CONCLUSIONS If we are to measure the impacts of oral conditions, it is important that this is done systematically and with reference to existing conceptual models of health. Current measures of the impact of dry mouth cover symptoms, discomfort and physical impacts along with some aspects of how people cope with the condition. This study proposes a more comprehensive approach that includes the full range of impacts people experience. Such an approach may enable us to focus on "downstream" and "upstream" interventions for dry mouth.
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Affiliation(s)
- Barry Gibson
- The School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | | | - Martin H Thornhill
- The School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Sarah R Baker
- The School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Lindroos EK, Saarela RK, Suominen MH, Muurinen S, Soini H, Kautiainen H, Pitkälä KH. Burden of Oral Symptoms and Its Associations With Nutrition, Well-Being, and Survival Among Nursing Home Residents. J Am Med Dir Assoc 2019; 20:537-543. [DOI: 10.1016/j.jamda.2018.10.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 10/17/2018] [Accepted: 10/19/2018] [Indexed: 01/11/2023]
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Castrejón-Pérez RC, Borges-Yáñez SA, Irigoyen-Camacho ME, Cruz-Hervert LP. Negative impact of oral health conditions on oral health related quality of life of community dwelling elders in Mexico city, a population based study. Geriatr Gerontol Int 2016; 17:744-752. [DOI: 10.1111/ggi.12780] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 02/02/2016] [Accepted: 02/22/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Roberto Carlos Castrejón-Pérez
- Departamento de Epidemiología Geriátrica, Dirección de Investigación; Instituto Nacional de Geriatría; Distrito Federal México
| | - S. Aída Borges-Yáñez
- División de Estudios de Posgrado e Investigación, Facultad de Odontología; Universidad Nacional Autónoma de México; Distrito Federal México
| | - Ma. Esther Irigoyen-Camacho
- Departamento de Atención a la Salud; Universidad Autónoma Metropolitana Campus Xochimilco; Distrito Federal México
| | - Luis Pablo Cruz-Hervert
- Centro de Investigaciones Sobre Enfermedades Infecciosas; Instituto Nacional de Salud Pública de México; Distrito Federal México
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Salom M, Hachulla E, Bertolus C, Deschaumes C, Simoneau G, Mouly S. Efficacy and safety of a new oral saliva equivalent in the management of xerostomia: a national, multicenter, randomized study. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:301-9. [DOI: 10.1016/j.oooo.2014.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 11/17/2014] [Accepted: 12/03/2014] [Indexed: 12/01/2022]
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Abstract
The purpose of study was to analyze the participants' opinions concerning the effectiveness of 6 denture adhesives (DA). The study group included 60 participants. Criteria for selecting the patients were as follows: reduced retention and stabilization of maxillary complete dentures and xerostomia. These features were evaluated on basis of clinical examination and standard sialometry tests (u-SFR). Retention of maxillary dentures was scored by modified Kapur index before application of DA. All participants were divided randomly into 6 groups regarding the use of the 6 DA during a 6-month period. After this time, participants completed an HRQL questionnaire. DA noticeably improved retention and stabilization of maxillary complete dentures. DA in the glue form had the best retention effectiveness in participants with xerostomia. These materials are difficult to clean from the denture base. The data are presented in tables and figures. The results of the study collected positive influence of adhesives on retention of dentures in xerostomia patients. The cleaning dentures and denture bearing tissues was difficult. DA help in the use of prostheses, but it is also necessary for the treatment of the causes and symptoms of xerostomia.
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Affiliation(s)
- Zdzislaw A Bogucki
- From the Department of Prosthetic Dentistry, Medical University Wroclaw, Wroclaw, Poland
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Charalambous A. Hermeneutic phenomenological interpretations of patients with head and neck neoplasm experiences living with radiation-induced xerostomia: The price to pay? Eur J Oncol Nurs 2014; 18:512-20. [DOI: 10.1016/j.ejon.2014.04.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 04/07/2014] [Accepted: 04/19/2014] [Indexed: 12/21/2022]
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Leung DY, Leung AY, Chi I. Factors associated with chewing problems and oral dryness among older Chinese people in Hong Kong. Gerodontology 2014; 33:106-15. [DOI: 10.1111/ger.12116] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Doris Y.P. Leung
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong China
| | | | - Iris Chi
- School of Social Work; University of Southern California; Los Angeles CA USA
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Al-Dwairi Z, Lynch E. Xerostomia in complete denture wearers: prevalence, clinical findings and impact on oral functions. Gerodontology 2012; 31:49-55. [PMID: 22957806 DOI: 10.1111/ger.12002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate the prevalence of dry mouth in a select sample of edentulous Jordanian older population wearing complete dentures and to evaluate its impact on oral functions. BACKGROUND The prevalence and impact of Xerostomia as a cofactor in causing denture problems in Jordanians have not been previously investigated. MATERIALS AND METHODS This study included 455 participants (253 men and 202 women). Perception of dry mouth was measured by a pilot-tested questionnaire. Xerostomic status was confirmed clinically. Complete denture function was also assessed. RESULTS One hundred and thirty six subjects (29.9%) had reported a subjective feeling of dry mouth with a prevalence of 24.9% in men (n = 63) and 36.1% in women (n = 73) (p < 0.01). 136 of the 145 subjects with satisfactory dentures showed one or more signs suggestive of Xerostomia. The majority of xerostomic participants with different sets of complete dentures were dissatisfied with oral functions (p < 0.05). There was a significant association between dry mouth and increasing age, female gender and smoking status (p < 0.05). CONCLUSION Among complete denture wearers, Xerostomia is significantly more prevalent in women and associated with increased age and smoking. Xerostomia adversely affects oral functions and overall satisfaction with dentures.
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Affiliation(s)
- Ziad Al-Dwairi
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
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Liu B, Dion MR, Jurasic MM, Gibson G, Jones JA. Xerostomia and salivary hypofunction in vulnerable elders: prevalence and etiology. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:52-60. [PMID: 22727092 DOI: 10.1016/j.oooo.2011.11.014] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Revised: 11/09/2011] [Accepted: 11/15/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The goal of this article is to review existing research on the prevalence and etiology of dry mouth in the vulnerable elders and identify knowledge gaps. STUDY DESIGN Vulnerable elders (VE) are persons aged >65 years who have any or all of the following: limited mobility, limited resources, or complex health status. A systematic search was conducted of PubMed sources from 1989 to May 2010. Evidence was evaluated on the prevalence and etiology of xerostomia and salivary gland hypofunction (SGH) in VE. RESULTS The search identified 1,422 publications. The inclusion/exclusion criteria yielded 348 articles, 80 of which are cited herein. CONCLUSIONS Research has showed a high prevalence of xerostomia and SGH in VE. Common etiologies include medications, poor general health, female gender, and age. Gaps still exist in the evaluation of dry mouth in VE. Nonetheless, oral dryness will remain an important health issue as life expectancy increases.
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Affiliation(s)
- Bing Liu
- Department of General Dentistry, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts 02118, USA.
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Katsoulis J, Schimmel M, Avrampou M, Stuck AE, Mericske-Stern R. Oral and general health status in patients treated in a dental consultation clinic of a geriatric ward in Bern, Switzerland. Gerodontology 2011; 29:e602-10. [DOI: 10.1111/j.1741-2358.2011.00529.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Quandt SA, Savoca MR, Leng X, Chen H, Bell RA, Gilbert GH, Anderson AM, Kohrman T, Arcury TA. Dry mouth and dietary quality in older adults in north Carolina. J Am Geriatr Soc 2011; 59:439-45. [PMID: 21391935 DOI: 10.1111/j.1532-5415.2010.03309.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To quantify prevalence of dry mouth, association between dry mouth and beverage intake and dietary quality, and association between dry mouth and self-reported dietary accommodations to oral health deficits. DESIGN Cross-sectional study; data from self-reports. SETTING Rural North Carolina counties with substantial African-American and American Indian populations. PARTICIPANTS Six hundred twenty-two participants aged 60 and older. MEASUREMENTS Data included the 11-item Xerostomia Inventory (higher scores connote greater effect from dry mouth), a food frequency questionnaire (converted into Health Eating Index-2005 scores), and survey items on foods modified before consumption or avoided because of oral health problems. RESULTS Dry mouth was associated with being female, lower education, and income below the poverty level. Although overall beverage consumption did not vary with dry mouth, consumption of certain sugar-sweetened beverages was positively associated with dry mouth. Overall dietary quality did not differ with dry mouth, but more-severe dry mouth was associated with lower intake of whole grains and higher intakes of fruits. Dry mouth was strongly associated with self-reported modification and avoidance of foods. Those in the highest tertile of dry mouth were more likely to modify several foods than those in the lowest tertile and were more likely to avoid three or more foods. CONCLUSION Older adults appear to modify foods or selectively avoid foods in response to perceived dry mouth. Despite these behaviors, dry mouth does not result in poorer dietary quality.
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Affiliation(s)
- Sara A Quandt
- Department of Epidemiology and Prevention, School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.
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Abstract
Saliva plays an important protective role in the oral environment, and reductions in saliva quantity are known to increase the risk of oral diseases. Importantly, xerostomia or the perception of a dry mouth is now being recognized as an important risk factor for dental diseases. Furthermore, the subjective sensation of a dry mouth is a debilitating condition in itself that impacts on the quality of life of sufferers. With approximately 1 in 5 people reporting some form of dry mouth, and an increasing prevalence in the elderly, it is important for clinicians to have a thorough understanding of this problem. The aim of this paper is to review some of the literature relating to xerostomia in order to provide an evidence based update for clinicians.
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Affiliation(s)
- M S Hopcraft
- Cooperative Research Centre for Oral Health Sciences, Melbourne Dental School, The University of Melbourne, Victoria.
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Smidt D, Torpet LA, Nauntofte B, Heegaard KM, Pedersen AML. Associations between oral and ocular dryness, labial and whole salivary flow rates, systemic diseases and medications in a sample of older people. Community Dent Oral Epidemiol 2010; 39:276-88. [PMID: 21070322 DOI: 10.1111/j.1600-0528.2010.00588.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To investigate the associations between age, gender, systemic diseases, medications, labial and whole salivary flow rates and oral and ocular dryness in older people. METHODS Symptoms of oral and ocular dryness, systemic diseases, medications (coded according to the Anatomical therapeutic chemical (ATC) classification system), tobacco and alcohol consumption were registered, and unstimulated labial (LS) and unstimulated (UWS) and chewing-stimulated (SWS) whole salivary flow rates were measured in 668 randomly selected community-dwelling elderly aged 65-95. RESULTS Presence of oral (12%) and ocular (11%) dryness was positively correlated. Oral dryness was associated with low UWS, SWS and LS, and ocular dryness with low UWS and SWS. Oral and ocular dryness was related to female gender, but not to age. Only four persons in the healthy and nonmedicated subgroups reported oral and ocular dryness. The numbers of diseases and medications were higher in the older age groups and associated with oral and ocular dryness, low UWS, SWS and LS. On average, women were slightly older, reported more oral and ocular dryness and had lower UWS, SWS, LS and higher numbers of diseases and medications. High prevalence and odds ratios for oral dryness were associated with metabolic, respiratory and neurological diseases and intake of thyroid hormones, respiratory agents (primarily glucocorticoids), psycholeptics and/or psychoanaleptics, antineoplastics, proton pump inhibitors, antidiabetics, loop diuretics, antispasmodics, quinine and bisphosphonates. Ocular dryness was especially associated with neurological diseases and intake of psycholeptics and/or psychoanaleptics. Intake of magnesium hydroxide, antithrombotics, cardiac agents, thiazides, beta-blockers, calcium channel blockers, ACE inhibitors/angiotensin II antagonists, statins, glucosamine, paracetamol/opioids, ophthalmologicals and certain combination therapies was related to oral and ocular dryness. CONCLUSIONS In older people, oral and ocular dryness are associated with low salivary flow rates, specific as well as high number of diseases and medications, but neither with age and gender per se nor with tobacco and alcohol consumption. New detailed information concerning associations between medications and oral and ocular dryness has been obtained using the ATC classification system.
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Affiliation(s)
- D Smidt
- Department of Odontology, Section of Oral Medicine, Clinical Oral Physiology, Oral Pathology and Anatomy, Faculty of Health Sciences, University of Copenhagen, Denmark
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So JS, Chung SC, Kho HS, Kim YK, Chung JW. Dry mouth among the elderly in Korea: a survey of prevalence, severity, and associated factors. ACTA ACUST UNITED AC 2010; 110:475-83. [DOI: 10.1016/j.tripleo.2010.05.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2009] [Revised: 05/06/2010] [Accepted: 05/09/2010] [Indexed: 11/16/2022]
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Riordain RN, McCreary C. The use of quality of life measures in oral medicine: a review of the literature. Oral Dis 2010; 16:419-30. [DOI: 10.1111/j.1601-0825.2009.01647.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Park MS, Ryu SA. Degree of Dry Mouth and Factors Influencing Oral Health-related Quality of Life for Community-Dwelling Elders. J Korean Acad Nurs 2010; 40:747-55. [DOI: 10.4040/jkan.2010.40.5.747] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Myung Sook Park
- Assistant Professor, Department of Nursing, Sun Moon University, Asan, Korea
| | - Se Ang Ryu
- Assistant Professor, Department of Nursing, Dongshin University, Naju, Korea
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Folke S, Paulsson G, Fridlund B, Söderfeldt B. The subjective meaning of xerostomia—an aggravating misery. Int J Qual Stud Health Well-being 2009. [DOI: 10.3109/17482620903189476] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Arslan A, Orhan K, Canpolat C, Delilbasi Ç, Dural S. Impact of xerostomia on oral complaints in a group of elderly Turkish removable denture wearers. Arch Gerontol Geriatr 2009; 49:263-267. [DOI: 10.1016/j.archger.2008.09.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Revised: 09/13/2008] [Accepted: 09/17/2008] [Indexed: 11/15/2022]
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Kandelman D, Petersen PE, Ueda H. Oral health, general health, and quality of life in older people. SPECIAL CARE IN DENTISTRY 2009; 28:224-36. [PMID: 19068063 DOI: 10.1111/j.1754-4505.2008.00045.x] [Citation(s) in RCA: 171] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The purpose of this report is to review the interrelationship between poor oral health conditions of older people and general health. The impact of poor oral health on quality of life (QOL) is analyzed, and the implications for public health intervention and oral health care are discussed. Findings from the current research may lead to the following conclusions: The available scientific evidence is particularly strong for a direct relationship between diabetes and periodontal disease; the direct relationship between periodontal disease and cardiovascular disease is less convincing. General and associated oral health conditions have a direct influence on elder people's QOL and lifestyle. The growing number of elderly people challenges health authorities in most countries. The evidence on oral health-general health relationships is particularly important to WHO in its effort to strengthen integrated oral health promotion and disease prevention around the globe.
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Affiliation(s)
- Daniel Kandelman
- Faculty of Dental Medicine, University of Montreal, Montreal, Canada.
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Hebling E, Pereira AC. Oral health-related quality of life: a critical appraisalof assessment tools used in elderly people. Gerodontology 2007; 24:151-61. [PMID: 17696892 DOI: 10.1111/j.1741-2358.2007.00178.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study was to undertake a critical appraisal of oral health-related quality of life (OHRQoL) measurements used for research in the elderly. BACKGROUND A variety of OHRQoL measurements have been developed in the past 20 years as a result of increased concern about the impact of oral conditions on a person's quality of life. There is need for an assessment aimed at prioritising the recommended measurements to be used for different purposes in the elderly. MATERIALS AND METHODS Original English language papers using measurements to assess OHRQoL in the elderly were identified from Web of Science, EMBASE, PubMed, Medline and Lilacs databases. The search included all papers published from 1985 to February 2007. The criteria of assessment were: (i) measurement criteria (number of items and domains, and classification of the results found for each measurement); (ii) quantitative-qualitative criteria (frequency, acceptability, reproducibility, reliability, sensitivity and capability of being reproduced in other language versions). RESULTS In a total of 152 papers selected, 20 measurements were identified. However, only seven fulfilled all the measurement and quantitative-qualitative criteria. CONCLUSION Geriatric Oral Health Assessment Index, Subjective Oral Health Status Indicators, Oral Health Impact Profile-49, Dental Impact on Daily Living, Oral Health Impact Profile-14, Oral Impact on Daily Performances and German Version of the Oral Heath Impact Profile were considered as instruments of choice to assess OHRQoL in the elderly. The other 13 instruments identified require further research aimed at a validation process and the use of a language other than English.
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Affiliation(s)
- Eduardo Hebling
- Department of Community Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, Sao Paulo, Brazil.
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Mouly S, Salom M, Tillet Y, Coudert AC, Oberli F, Preshaw PM, Desjonquères S, Bergmann JF. Management of Xerostomia in Older Patients. Drugs Aging 2007; 24:957-65. [DOI: 10.2165/00002512-200724110-00007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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