Xerostomia and salivary hypofunction in vulnerable elders: prevalence and etiology

doi:10.1016/j.oooo.2011.11.014

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Volume 114, Issue 1, July 2012, Pages 52-60

https://doi.org/10.1016/j.oooo.2011.11.014 Get rights and content

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.

Section snippets

Materials and Methods

To ensure the comprehensive retrieval of all relevant research, the services of an experienced library scientist were enlisted. One of the authors (M.D.) duplicated the search for accuracy. Search strategies were conducted in PubMed only (from 1989 to May 2010), and the search was expanded to include salivary hypofunction, dry mouth, and salivary dysfunction. The following MeSH headings were individually combined with this prior category using boolean operators: demographics, epidemiology,

Prevalence of xerostomia and SGH in VE

Our literature search resulted in studies on VE, including community dwelling elders, institutionalized elders, and elders with various medical conditions. Table I summarizes the results. Studies conducted in the general public are also included for reference.

The prevalence of xerostomia in the general public ranged from 5.5% to 39%, and prevalence among community-dwelling elders ranged from 17% to 40%. In the institutionalized elders, the prevalence ranged from 20% to 72%. In the elders

Discussion

Current research clearly demonstrates that VE are at a higher risk of suffering from subjective and objective oral dryness owing to the characteristics of this unique population. All predisposing factors of dry mouth may work synergistically to create a “perfect storm” for the VE and clinicians to manage.

The “vulnerability” of VE includes medication and polypharmacy, diseases and conditions, age, reduced salivary capacity, being female, and limited resources. As stressed by Locker, these

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Oral medicineXerostomia and salivary hypofunction in vulnerable elders: prevalence and etiology

Objective

Study Design

Results

Conclusions

Section snippets

Materials and Methods

Prevalence of xerostomia and SGH in VE

Discussion

J Autoimmun

J Pain Symptom Manage

J Oral Maxillofac Surg

Lancet

Radiother Oncol

Br J Oral Maxillofac Surg

J Dent

Semin Radiat Oncol

J Diabetes Complications

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Oral Surg Oral Med Oral Pathol

Arch Gerontol Geriatr

J Am Dent Assoc

The xerostomia inventory: a multi-item approach to measuring dry mouth

Community Dent Health

Dry mouth and its effects on the oral health of elderly people

J Am Dent Assoc

Dry mouth: aging and oral health

Compend Contin Educ Dent

Age and medication are significant risk factors for xerostomia in an English population, attending general dental practice

Gerodontology

Prevalence of perceived symptoms of dry mouth in an adult Swedish population—relation to age, sex and pharmacotherapy

Community Dent Oral Epidemiol

Mouth dryness as reported by older Floridians

Community Dent Oral Epidemiol

A 15-yr longitudinal study of xerostomia in a Swedish population of 50-yr-old subjects

Eur J Oral Sci

Prevalence of symptoms of dry mouth and their relationship to saliva production in community dwelling elderly: the SEE projectSalisbury Eye Evaluation

J Rheumatol

Xerostomia and associated factors in a community-dwelling adult population

Community Dent Oral Epidemiol

Subjective reports of oral dryness in an older adult population

Community Dent Oral Epidemiol

Salivary conditions and cariogenic microorganisms in 55, 65, and 75-year-old Swedish individuals

Scand J Dent Res

Self-perceived oral function in elderly residents in a suburban area of Stockholm, Sweden

Oral Health Prev Dent

The occurrence of xerostomia and salivary gland hypofunction in a population-based sample of older South Australians

Spec Care Dentist

Hyposalivatory drug use, whole stimulated salivary flow, and mouth dryness in older, long-term care residents

Spec Care Dentist

Xerostomia, xerogenic medications and food avoidances in selected geriatric groups

J Am Geriatr Soc

Socio-medical condition and oral functional status in an older institutionalised population

Gerodontology

Medication and perception of dry mouth in a population of institutionalised elderly people

N Z Med J

Oral health conditions of community-dwelling cognitively intact elderly persons with disabilities

Gerodontology

Associations between self-assessed masticatory ability, nutritional status, prosthetic status and salivary flow rate in hospitalized elders

Oral Dis

Caries activity and associated risk factors in elderly hospitalised population—15-months follow-up in French institutions

Gerodontology

Oral and nutritional status in frail elderly

Spec Care Dentist

Salivary flow and its relation with oral symptoms in terminally ill patients

Cancer

Oral health status of 207 head and neck cancer patients before, during and after radiotherapy

Clin Oral Investig

The dental awareness and needs of a Parkinson's disease population

Gerodontology

Xerostomia, hyposalivation, and oral microbiota in type 2 diabetic patients: a preliminary study

J Med Assoc Thai

Associations between xerostomia and health status indicators in the elderly

J R Soc Promot Health

A quantitative study of histological changes in the human parotid gland occurring with adult age

J Oral Pathol

Oral medicine
Xerostomia and salivary hypofunction in vulnerable elders: prevalence and etiology