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At least 19 recordsLinked to original sources

PubMed2003

Xerostomia: etiology, recognition and treatment.

BACKGROUND: Clinicians may encounter symptoms of xerostomia, commonly called "dry mouth," among patients who take medications, have certain connective tissue or immunological disorders or have been treated with radiation therapy. When xerostomia is the result of a reduction in salivary flow, significant oral complications can occur. TYPES OF STUDIES REVIEWED: The authors conducted an Index Medicus--generated review of clinical and scientific reports of xerostomia in the dental and medical literature during the past 20 years. The literature pertaining to xerostomia represented the disciplines of oral medicine, pathology, pharmacology, epidemiology, gerodontology, dental oncology, immunology and rheumatology. Additional topics included the physiology of salivary function and the management of xerostomia and its complications. RESULTS: Xerostomia often develops when the amount of saliva that bathes the oral mucous membranes is reduced. However, symptoms may occur without a measurable reduction in salivary gland output. The most frequently reported cause of xerostomia is the use of xerostomic medications. A number of commonly prescribed drugs with a variety of pharmacological activities have been found to produce xerostomia as a side effect. Additionally, xerostomia often is associated with Sjögren's syndrome, a condition that involves dry mouth and dry eyes and that may be accompanied by rheumatoid arthritis or a related connective tissue disease. Xerostomia also is a frequent complication of radiation therapy. CONCLUSIONS AND CLINICAL IMPLICATIONS: Xerostomia is an uncomfortable condition and a common oral complaint for which patients may seek relief from dental practitioners. Complications of xerostomia include dental caries, candidiasis or difficulty with the use of dentures. The clinician needs to identify the possible cause(s) and provide the patient with appropriate treatment. Remedies for xerostomia usually are palliative but may offer some protection from the condition's more significant complications.

Candidiasis, Oral↗

PubMed2002

A randomized, double-blind, placebo-controlled trial of concomitant pilocarpine with head and neck irradiation for prevention of radiation-induced xerostomia.

BACKGROUND: Xerostomia is one of the disturbing side-effects of radiotherapy to the head and neck region. Pilocarpine has been approved for the treatment of this condition in the chronic phase, but its use concurrent with radiation could also be beneficial for prevention or reduction of the subsequent radiation-induced xerostomia. We undertook to test this hypothesis in a clinical trial. METHODS: At the start of radiotherapy, randomization was performed to either pilocarpine 5 mg three times daily or placebo in a double-blind setting. The drug was started with irradiation and continued until 3 months after the end of radiotherapy. Xerostomia was evaluated 6 months after the end of radiation by a subjective visual analog scale questionnaire. Also the objective grade of xerostomia was recorded by two separate observers. RESULTS: A total number of 60 patients were randomized into the trial, but unfortunately only 39 patients were finally evaluated for xerostomia, 18 in the pilocarpine and 21 in the placebo group. Mean age was 42 years, and mean parotid dose was 58 Gy. Mean subjective xerostomia was 40.3 mm in the pilocarpine group and 57 mm in the placebo group (P = 0.02). Also mean objective xerostomia grade was 2.2 in the pilocarpine group and 2.6 in the placebo group (P = 0.01). Subjective and objective xerostomia results were positively correlated (P = 0.01). Age and the parotid dose did not have a significant effect on xerostomia. CONCLUSIONS: Compared to placebo, pilocarpine used with radiotherapy could lead to a significant diminishment of subsequent radiation-induced xerostomia.

Administration, Oral↗

PubMed2001

Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer.

PURPOSE: To assess long-term xerostomia in patients receiving parotid-sparing radiation therapy (RT) for head-and-neck cancer, and to find the patient and therapy-related factors that affect its severity. PATIENTS AND METHODS: From March 1994 through January 2000, 84 patients received comprehensive bilateral neck RT using conformal and multisegmental intensity-modulated RT (IMRT) aiming to spare the major salivary glands. Before RT and periodically through 2 years after the completion of RT, salivary flow rates from each of the major salivary glands were selectively measured. At the same time intervals, each patient completed an 8-item self-reported xerostomia-specific questionnaire (XQ). To gain a relative measure of the effect of RT on the minor salivary glands, whose output could not be measured, the surfaces of the oral cavity (extending to include the surface of the base of tongue) were outlined in the planning CT scans. The mean doses to the new organ ("oral cavity") were recorded. Forty-eight patients receiving unilateral neck RT were similarly studied and served as a benchmark for comparison. Factors predicting the XQ scores were analyzed using a random-effects model. RESULTS: The XQ was found to be reliable and valid in measuring patient-reported xerostomia. The spared salivary glands which had received moderate doses in the bilateral RT group recovered to their baseline salivary flow rates during the second year after RT, and the spared glands in the unilateral RT group, which had received very low doses, demonstrated increased salivary production beyond their pre-RT levels. The increase in the salivary flow rates during the second year after RT paralleled an improvement in xerostomia in both patient groups. The improvement in xerostomia was faster in the unilateral compared with the bilateral RT group, but the difference narrowed at 2 years. The major salivary gland flow rates had only a weak correlation with the xerostomia scores. Factors found to be independently associated with the xerostomia scores were the pre-RT baseline scores, the time since RT, and the mean doses to the major salivary glands (notably to the submandibular glands) and to the oral cavity. CONCLUSION: An improvement over time in xerostomia, occurring in tandem with rising salivary production from the spared major salivary glands, suggests a long-term clinical benefit from their sparing. The oral cavity mean dose, representing RT effect on the minor salivary glands, was found to be a significant, independent predictor of xerostomia. Thus, in addition to the major salivary glands, sparing the uninvolved oral cavity should be considered as a planning objective to further reduce xerostomia.

Adult↗

PubMed1995

Xerostomia, xerogenic medications and food avoidances in selected geriatric groups.

OBJECTIVE: To study the relationship between complaints of xerostomia and salivary performance and food avoidances in four geriatric groups chosen to reflect a broad spectrum of individuals along the health-disease continuum. To determine whether xerogenic medications taken by these individuals could be associated with either complaints of xerostomia or with food avoidances. DESIGN: Cross-sectional survey. Clinical examinations and interview. SETTING: A VA dental clinic and a retirement home. PATIENTS AND OTHER PARTICIPANTS: Subjects were 529 individuals older than 56 years of age, living both in institutions and in the community (average age 70 years). Two hundred eight persons were recruited from a VA Dental Clinic, 114 from a residential retirement home, and 132 from a nursing/long-term-care facility; 75 were from an acute care ward and had a diagnosis of a cerebral vascular accident or other neurological condition. OUTCOME MEASURES: Prevalence of xerostomia, dental morbidity, salivary flow, and food avoidances. RESULTS: About 72% of the subjects experienced xerostomia sometime during the day. Stimulated salivary flow was found to be significantly lower in individuals who complained of xerostomia than in those who did not. Fifty-five percent of participants reported using one or more xerogenic medications, with an 86% prevalence in the nursing/long-term-care facility. Individuals with xerostomia had difficulty in chewing and in starting a swallow and were significantly more likely to avoid crunchy foods such as vegetables, dry foods such as bread, and sticky foods such as peanut butter in their diets. Specific medications such as the inhalants ipratropium and triamcinolone and the systemic agents oxybutynin and triazolam could be statistically associated with xerostomia and/or low salivary flow, and/or specific food avoidances. CONCLUSION: Xerostomia apparently affects the ability to chew and start a swallow. This leads to avoidance of certain foods, which raises the possibility that xerostomia could contribute to undernutrition in older persons. The topically applied ipratropium and triamcinolone and the systemic agents amitriptyline, oxybutynin and triazolam could be statistically associated with one or more complaints of xerostomia.

Aged↗

PubMed2005

Importance of the initial volume of parotid glands in xerostomia for patients with head and neck cancers treated with IMRT.

OBJECTIVE: Our aim was to evaluate predictors of xerostomia in patients with head and neck cancers treated with intensity-modulated radiation therapy (IMRT). METHODS: Thirty-three patients with pharyngeal cancer were evaluated for xerostomia after having been treated with IMRT. All patients were treated with whole-neck irradiation of 46-50 Gy by IMRT, followed by boost IMRT to the high-risk clinical target volume to a total dose of 56-70 Gy in 28-35 fractions (median, 68 Gy). For boost IMRT, a second computed tomography (CT-2) scan was done in the third to fourth week of IMRT. Xerostomia was scored 3-4 months after the start of IMRT. RESULTS: The mean doses to the contralateral and ipsilateral parotid glands were 24.0 +/- 6.2 and 30.3 +/- 6.6 Gy, respectively. Among the 33 patients, xerostomia of grades 0, 1, 2 and 3 was noted in one, 18, 12 and two patients, respectively. Although the mean dose to the parotid glands was not correlated with the grade of xerostomia, the initial volume of the parotid glands was correlated with the grade of xerostomia (P = 0.04). Of 17 patients with small parotid glands (< or =38.8 ml) on initial CT (CT-1), 11 (65%) showed grade 2 or grade 3 xerostomia, whereas only three (19%) of 16 patients with larger parotid glands showed grade 2 xerostomia (P < 0.05). The mean volume of the parotid glands on CT-1 was 43.1 +/- 15.2 ml, but decreased significantly to 32.0 +/- 11.4 ml (74%) on CT-2 (P < 0.0001). CONCLUSIONS: Initial volumes of the parotid glands are significantly correlated with the grade of xerostomia in patients treated with IMRT. The volume of the parotid glands decreased significantly during the course of IMRT.

Adult↗

PubMed2006

A longitudinal study of medication exposure and xerostomia among older people.

OBJECTIVE: To describe the incidence of xerostomia among a population of older people over a 6-year period, with particular attention to medications as risk factors. BACKGROUND: Understanding the natural history of xerostomia requires longitudinal epidemiological research, but only one study has examined changes in xerostomia over time. While medication is a recognised risk factor for dry mouth, the role of particular medication categories continues to be controversial. MATERIALS AND METHODS: Older South Australians (aged 60+) underwent an interview and dental examination at baseline, and these assessments were repeated 2, 5 and 11 years afterward. Medication data were collected at baseline, 5 and 11 years. Xerostomia data were collected at 5 and 11 years using the Xerostomia Inventory (XI) and a standard question. RESULTS: Of the 1205 dentate participants assessed at baseline, 669 remained after 5 years, and 246 were assessed at 11 years. Medication prevalence increased over the observation period, such that 94.8% of the cohort were taking at least one medication by 11 years. The prevalence of xerostomia increased from 21.4% to 24.8% between 5 and 11 years (p > 0.05), and the mean XI score increased from 20.0 (SD, 6.7) to 21.5 (SD, 7.9; p < 0.001). Some 14.7% of participants were incident cases of xerostomia, while 11.4% were remitted cases; 10.1% were cases at both 5 and 11 years. After controlling for gender and 'baseline' xerostomia severity (represented by the XI score at 5 years), participants who commenced taking daily aspirin after 5 years had over four times the odds of becoming incident cases, while those who commenced taking a diuretic after 5 years had nearly six times the odds of doing so. CONCLUSIONS: While the overall prevalence of xerostomia increased during the observation period, there was considerable instability, with one-quarter of the cohort changing their status. Medication exposure was strongly associated with the incidence of the condition, with recent exposure to diuretics or daily aspirin strongly predicting it.

Aged↗

PubMed2002

Secretory function of the salivary gland in patients with taste disorders or xerostomia: correlation with zinc deficiency.

A notable proportion of patients with taste disorders complain of xerostomia and when zinc is prescribed the xerostomia is often improved in conjunction with the taste disorder. To study the relationship between taste disorders, zinc deficiency and xerostomia, we measured salivary gland function and zinc levels in 93 patients with hypogeusia and/or xerostomia and 60 patients with unilateral acute peripheral facial palsy who served as controls. We then prescribed zinc for patients with low serum zinc levels and evaluated xerostomia and taste sensation after 6 months of this treatment. The salivary gland secretory ratio (SGSR), determined by dynamic salivary 99mTc scintigraphy, was found to be an objective measure of salivary gland function and was reduced in patients with xerostomia. Patients with salivary gland dysfunction also had abnormal morphology of the papillae of the tongue. No significant relation was found between the severity of taste disorders and SGSR values, but low SGSR values were found in patients with zinc deficiency. Patients with taste disorders and/or xerostomia who were treated with zinc had relief of symptoms at 6 months, indicating that both taste disorders and xerostomia are among the symptoms of zinc deficiency.

Adult↗

PubMed1995

Xerostomia in older adults: a longitudinal study.

Although xerostomia in older adults has received substantial research attention, there have been few longitudinal studies of non-patient populations. Consequently, little is known about the incidence or course of this condition among this group. This paper reports the results of a longitudinal study designed to address these issues. In 1989, data on xerostomia were collected from 907 randomly-selected community dwelling adults aged 50 years and over. Three years later, 611 (71% of those presumed to be alive) were followed-up and data on xerostomia collected again. At baseline, 15.5% of these 611 subjects reported xerostomia, while at follow-up this had risen to 29.5%. The majority of the latter (115/180) were incident cases, reporting xerostomia only at follow-up, while the remainder were chronic cases, reporting xerostomia at both baseline and follow-up. A crude estimate of the three-year incidence rate was 22.5%. In a logistic regression analysis, three baseline variables were associated with incidence; older subjects, those with one or more chronic medical conditions and those reporting their general health as poor were more likely to develop xerostomia. In a similar analysis, age was the only variable associated with chronicity, with older subjects more likely to be chronic cases. The data also suggest that the onset of xerostomia was associated with an increase in other oral symptoms and problems with eating, communication and social interaction.

Age Factors↗

PubMed2006

Prevalence of xerostomia in population-based samples: a systematic review.

The consequences of xerostomia on oral health have been studied for decades; however, the actual prevalence of this disorder on the general population remains controversial. The purpose of this systematic review was to determine the prevalence of xerostomia in population-based samples. Electronic databases were screened for relevant articles and reference lists of pertinent articles were also hand-searched. Thirteen articles meeting the final inclusion criteria were identified. Based on the definition of xerostomia used in this review, only publications including a subjective diagnosis of the disorder were included. All of the self-reported diagnoses were achieved through a questionnaire either by mail, telephone, interview or self-administered by the patient. There was a variation across papers regarding number and content of the questions as well as guidelines for the diagnosis of xerostomia (i.e. answer yes to one or more than one question). The prevalence of xerostomia in the selected articles ranged from 0.9% to 64.8%. The majority of these studies were performed in Scandinavia. In 9 of the articles, the studied samples were 50 years and older. None of the studies evaluated the prevalence xerostomia among individuals younger than 18 years. Based on these observations, it can be concluded that there is a need for population-based studies on prevalence of xerostomia in regions other than Scandinavia. A standardized protocol to diagnose xerostomia needs to be developed. Patient-perceived treatment needs and impact on quality of life should be included to have a complete picture of public health implications of the disease.

Age Distribution↗

PubMed2006

Associations between xerostomia and health status indicators in the elderly.

AIMS: This study investigated the associations between xerostomia (dry mouth) (low, moderate and high) with other categorical variables (e.g. demographic and health status indicators). This paper aims to report on the severity of xerostomia in the elderly population and investigate the relationship with other aspects of perceived health. METHOD: Data were obtained from a cross-sectional survey of 225 elderly people from a large multilevel geriatric care centre. The centre consists of three levels of care: an apartment building in which residents live more or less independently, a home for the aged, and a chronic care hospital. Participants in the study were recruited when they attended the dental care facility. Data were collected by means of a personal interview conducted either at the dental care facility or the participant's residence. RESULTS: The mean age was 83 years. Most were females (72%) and almost all (99%) reported one or more chronic medical conditions; 88% had physical disabilities. Xerostomia was recorded on a seven-point scale. Scores were categorised as low, medium or high and the proportions were 49.3%, 30.3% and 20.4% respectively Bivariate analysis showed no association between dry mouth and sex, age, general health change or life satisfaction. However, when the high xerostomia group was separated out and odds ratios calculated they were 2.3 to 4.9 times more likely to experience a negative impact on health than the low group. Xerostomia did not have a significant impact on chewing capacity, morale or stress, although it contributed to the variability of the oral health-related quality of life measures. It was the only variable with a significant effect (OR 2.55) for the Oral Health Impact Profile-14 and displayed a higher odds ratio (2.76) for the Geriatric Oral Health Assessment Index. Self-reported xerostomia in the elderly population can be categorised into a severity scale. Those suffering most from xerostomia are more likely to experience a negative impact on general health. CONCLUSION: The key finding in this study is that xerostomia has a significant and negative impact on the quality of life of elderly individuals, though oral function may be less affected.

Aged↗

PubMed2004

[Clinical analysis of xerostomia in patients with nasopharyngeal carcinoma after radiation therapy].

BACKGROUND & OBJECTIVE: There is few report on the xerostomia of the patients with nasopharyngeal carcinoma after conventional radiation therapy. Xerostomia is a serious, permanent, and ubiquitous sequelae in the patients with nasopharyngeal carcinoma after conventional radiation therapy. It has a significant impact on the patient's quality of life. This study was designed to investigate the severity of xerostomia and its impact on the quality of life in patients with nasopharyngeal carcinoma after conventional radiation therapy. METHODS: One hundred and thirty-six patients with nasopharyngeal carcinoma, treated by conventional radiation therapy in Cancer Center, Sun Yat-sen University, were surveyed by interview at the outpatient. A questionnaire and a visual analog scale (VAS) were used in analysis of xerostomia and xerostomia-related problems. RESULTS: Of 136 patents, 73.5% of the patients experienced a moderate to severe degree of xerostomia. 82.4% of the patients had to sip water to facilitate speech; 92.6% of the patients had to sip water to facilitate chewing and swallowing; 91.2% of the patients changed their feeding pattern (can eat only mashed food); 61.3% of the patients had to wake up to drink water because of dry mouth; 75.0% of the patients had teeth deteriorated. CONCLUSION: 73.5% of the patients with nasopharyngeal carcinoma after conventional radiation therapy experienced a moderate to severe degree of xerostomia. Xerostomia has a significant impact on the patient's speech, deglutition, sleep, and increases the morbidity rate of the tooth.

Adult↗

PubMed2005

Postradiotherapy quality of life for head-and-neck cancer patients is independent of xerostomia.

PURPOSE: To determine the relationship between quality of life (QOL) and xerostomia over time for patients undergoing radiotherapy (RT) for head-and-neck cancer in a prospective clinical trial. METHODS AND MATERIALS: Patients with head-and-neck cancer were randomized to pilocarpine (n = 65) vs. placebo (n = 65) during RT. QOL was measured using the McMaster Head and Neck Radiotherapy Questionnaire (HNRQ). Xerostomia was measured on a linear analog scale. No statistically significant differences were observed between arms; all 130 patients were analyzed together. RESULTS: Baseline QOL data were obtained for 98.5% of participants. The baseline HNRQ score of 5.7 declined significantly to 4.0 (p <0.0001) by RT Week 6 and returned to baseline (5.8) by 6 months after treatment. This represents a large, clinically important change of 1.7 of 7 (24%; effect size 1.34). The decline in HNRQ score during RT paralleled the onset of xerostomia on the linear analog scale (r = 0.36 at 1 month). After treatment, the QOL scores recovered without improvement in xerostomia. The trajectory of the linear analog scale score resembled that of the HNRQ's single xerostomia question (r = 0.75 at 1 month). CONCLUSION: Quality of life recovers to baseline after RT, despite persistent xerostomia. Either a response shift occurs or xerostomia in the absence of acute mucositis has a relatively small influence on overall QOL.

Carcinoma, Squamous Cell↗

PubMed2003

A Phase I-II study in the use of acupuncture-like transcutaneous nerve stimulation in the treatment of radiation-induced xerostomia in head-and-neck cancer patients treated with radical radiotherapy.

PURPOSE: Recent studies have suggested that acupuncture may improve radiation-induced xerostomia with an increase in the median salivary flow rate and sustained symptom relief. An acupuncture-like transcutaneous nerve stimulation method (Codetron) without invasive needles was developed to mimic acupuncture treatment. This Phase I-II study examined the effectiveness of Codetron in treating radiation-induced xerostomia. METHODS AND MATERIALS: Patients with symptomatic xerostomia after radical radiotherapy for head-and-neck cancer but with evidence of residual salivary function were recruited into the study. Two 6-week courses of Codetron treatment of acupuncture points preselected according to traditional Chinese medicine principles were given with a 2-week break between each course. Basal and citric acid-primed whole saliva production were measured at baseline and up to 1 year after treatment completion. Xerostomia symptoms were assessed by a five-item xerostomia symptom questionnaire with a visual analog scale and quality of life was evaluated using the Head and Neck Radiotherapy Questionnaire. RESULTS: We enrolled 46 patients in the study. All patients had received radiotherapy doses of >or=50 Gy to bilateral head-and-neck fields, including the parotid glands. Of the 46 patients, 37 completed the follow-up assessments at 3 and 6 months after treatment completion. No Codetron treatment-related complications occurred. Improvement in xerostomia symptoms was noted, with a mean increase in the visual analog scale score of 86 (p < 0.0005) and 77 (p < 0.0001) at 3 and 6 months after treatment completion, respectively. For all patients, the increase in the mean basal and citric acid-primed whole saliva production at 3 and 6 months after treatment completion was also statistically significant (p < 0.001 and p < 0.0001, respectively). No statistically significant change in the quality-of-life evaluation compared with baseline was observed. CONCLUSION: The results suggest that Codetron treatment improves whole saliva production and related symptoms in patients with radiation-induced xerostomia. The treatment effects were sustained for at least 6 months after Codetron treatment completion. A prospective randomized Phase III trial with appropriate controls is being planned.

Acupuncture Points↗

PubMed1997

Concomitant pilocarpine during head and neck irradiation is associated with decreased posttreatment xerostomia.

PURPOSE: To retrospectively compare subjective postirradiation xerostomia scores of patients who received concomitant oral pilocarpine during radiotherapy for head and neck cancer and 3 months thereafter with those of similar cohorts who did not receive pilocarpine. METHODS AND MATERIALS: Subjective xerostomia was assessed using a visual analog scale xerostomia questionnaire that measured oral dryness, oral comfort, difficulty with sleep, speech, and eating. The concomitant pilocarpine group had both parotid glands in the initial field treated to at least 45 Gy and received 5 mg pilocarpine hydrochloride four times per day (q.i.d.) beginning on the first day of radiotherapy and continuing for 3 months after completion of radiation. The control cohort had also received at least 45 Gy to both parotid glands and had not received pilocarpine at the time of evaluation. Scores on the visual analog scale were averaged and compared using the Student's t-test. RESULTS: Seventeen patients who received concomitant pilocarpine during head and neck irradiation and 18 patients who had not been treated with pilocarpine were available for follow-up. The mean intervals between completion of radiation and evaluation of xerostomia were 17 months and 16 months, respectively. Only one of the pilocarpine-treated patients was still taking pilocarpine at the time of evaluation. For each of the individual components of xerostomia scored on the visual analog scale, as well as the composite of all components, the group that had received oral pilocarpine during radiation had significantly less xerostomia (p < 0.01 for each). CONCLUSIONS: The use of 5 mg oral pilocarpine q.i.d. during radiotherapy for head and neck cancer and 3 months thereafter was associated with significantly less subjective xerostomia than that reported by a similar cohort of patients who had not received pilocarpine. The continued use of pilocarpine does not appear to be necessary to maintain this benefit in most patients.

Cohort Studies↗

PubMed2005

Late xerostomia after intensity-modulated radiation therapy versus conventional radiotherapy.

PURPOSE: To evaluate xerostomia following intensity-modulated radiation therapy (IMRT). MATERIALS AND METHODS: An institutional review board-approved study of xerostomia was conducted in 210 head and neck cancer patients who were beyond the acute recovery phase (> 1 year) after radiation therapy. Xerostomia was evaluated with the 8-question XQ developed and validated at the University of Michigan. RESULTS: Median XQ scores (normalized so that no xerostomia = 0 and maximum xerostomia = 100) were larynx-only group, 4 points, ipsilateral radiotherapy, 34 points; bilateral radiotherapy, 64 points; IMRT with mean contralateral parotid dose more than 26 Gy, 44 points; and IMRT with mean contralateral parotid dose 26 Gy or less, 32 points (P < 0.05 for all major comparisons). CONCLUSION: The XQ is an excellent tool for identifying important differences in xerostomia after radiation therapy for head and neck cancer. The authors' IMRT program decreases the severity of xerostomia symptoms compared with what is typically seen after conventional radiation therapy.

Adult↗

PubMed1996

Xerostomia and associated factors in a community-dwelling adult population.

Xerostomia is the subjective sensation of dry mouth. Estimates on the occurrence of xerostomia in community-dwelling adults have ranged from 10% among persons over age 50 to 40% for persons over age 65. Virtually no data are available for persons under age 50. To begin to establish a database on the occurrence of xerostomia and factors associated with it, a cross-sectional assessment of self-reported symptoms and salivary function was conducted across a broad age-range of generally healthy community-dwelling adults. A convenience sample of 710 adults who ranged from 19 to 88 years of age was drawn from various sources in the greater-Rochester, New York area. Study volunteers were administered a standardized questionnaire on general and oral health, which included questions on the symptoms of xerostomia, and were provided an oral screening examination, which included measurement of unstimulated and stimulated whole saliva flow rates. Overall, the observed prevalence of xerostomia was 24% among females and 18% among males. While xerostomia was more commonly observed in women than men, this association was only clear after age 50. Xerostomia was associated with: use of medications with hyposalivatory side-effects; difficulty with dry foods; cracked lips; dry eyes; difficulty swallowing; and, among males, current cigarette smoking. Results indicated a tendency for salivary flow rates to be lower for older persons, particularly the stimulated flow rate. There was a tendency in the younger cohorts for flow rates to be lower among individuals who reported sensation of dry mouth than among those who did not. This tendency was not apparent among older persons, suggesting that younger persons may be more likely to experience symptoms of oral dryness when salivary flow was low while older persons may relate symptoms of dry mouth to a more complex constellation of factors where salivary flow is only one component. These findings need to be examined further.

Adult↗

PubMed1999

The Xerostomia Inventory: a multi-item approach to measuring dry mouth.

OBJECTIVE: To develop a valid multi-item method of measuring the symptoms of xerostomia which includes the wide range of xerostomia symptoms in a single quantitative measure. DESIGN: A combination of qualitative and quantitative approaches. SETTING: A cohort study in South Australia. PARTICIPANTS: Older people aged 65 years or more who were taking part in the South Australian Dental Longitudinal Study. MEASURES: Xerostomia symptoms were evaluated using a multi-item inventory format and, for comparison purposes, a standard single dry-mouth question. Resting whole-salivary flow rate was estimated using the 'spit' method. RESULTS: Xerostomia and flow-rate data were available for 636 individuals. Factor analysis revealed the presence of a discrete xerostomia dimension, represented by 11 items whose responses were summated to give a single Xerostomia Inventory (XI) scale score. This had a very low correlation with resting flow rate but a much stronger, positive correlation with the standard dry-mouth question responses. CONCLUSIONS: The XI shows adequate content and concurrent validity, and appears to be a promising advance on previous approaches to xerostomia symptomatology although further testing is required.

Aged↗

PubMed1991

Chronic xerostomia increases esophageal acid exposure and is associated with esophageal injury.

OBJECTIVE: To assess the effects of chronic xerostomia on parameters of gastroesophageal reflux and esophagitis. DESIGN: Observational study of a cohort of male patients with xerostomia and age-matched control subjects. SETTING: Tertiary-care Veterans Affairs Medical Center. SUBJECTS: Sixteen male patients with chronic xerostomia secondary to radiation for head and neck cancers or medications. Nineteen age-matched male control subjects with comparable alcohol and smoking histories. MEASUREMENTS AND MAIN RESULTS: Esophageal motility was similar in patients with xerostomia and controls. Clearance of acid from the esophagus and 24-hour intraesophageal pH were markedly abnormal in patients with xerostomia. Symptoms and signs of esophagitis were significantly more frequent in subjects with xerostomia. CONCLUSIONS: Chronic xerostomia may predispose to esophageal injury, at least in part, by decreasing the clearance of acid from the esophagus and altering 24-hour intraesophageal pH. Esophageal injury is a previously unreported complication of long-term salivary deficiency.

Chronic Disease↗