1. Introduction
The elderly population has been growing and is expected to continue to increase in the future [
1]. Dry mouth perception (xerostomia) increases with age, affecting nearly 30% of the elderly, and it is most common in medicated patients or can be related to systemic diseases such as diabetes or Sjögren syndrome [
2,
3]. Studies identify many medications with xerogenic potential such as antidepressants, anticonvulsants, anticoagulants, antihypertensives, antihistamines or hypoglycemic medication [
3,
4]. The purpose of this study was to evaluate the prevalence of xerostomia in an elderly local population and determine the influence of medication on dry mouth perception.
2. Materials and Methods
This study, approved by a state-recognized ethical committee, included 80 elderly patients who attended a university dental clinic, in the Lisbon region urban area (Portugal), over a 3-month period. Inclusion criteria were: age 65+ years, being non-institutionalized and having signed an informed consent. Participants were distributed into four groups according to their age (years): 65–70, 71–75, 76–80 and 81+. Information was gathered through a questionnaire about xerostomia symptoms (yes/no) and medication taken. Medication was classified by pharmacological group (antihypertensives, antidiabetics, antidepressants, anticonvulsants, antihistamines, cytotoxic, anticoagulants and other medications), and the number of medications taken (1, 2 or 3+) was recorded. Data were analyzed through descriptive and inferential statistical methodologies. A significance level of 5% (p = 0.05) was considered.
3. Results and Discussion
3.1. Presence of Xerostomia in Each Age Group
From all the participants of this study, the majority (52.5%) have xerostomia symptoms. The age group 65–70 years revealed the highest prevalence of xerostomia (65.5%), followed by the 81+ years age group, with a xerostomia prevalence of 53.8%.
3.2. Presence of Xerostomia and Medication
From the participants with xerostomia symptoms, 90.5% take medication. In each pharmacological group, more than half of the medicated participants have xerostomia; however, a significant difference between different pharmacological groups was not identified (p > 0.05).
3.3. Presence of Xerostomia and Number of Medications Taken
The presence of xerostomia increased with the number of medications taken: 45.2% of the participants who have xerostomia take three or more medications, and only 9.5% who have xerostomia do not take any medication. The number of medications taken by participants with xerostomia was significantly higher when compared with patients without xerostomia (p = 0.025).
Several studies linked xerostomia with medication intake and showed that elderly patients that do not ingest any medication had a higher salivary flow rate than medicated patients [
2]. Xerostomia-inducing medication interferes in the production of saliva or in the pathways responsible for salivary secretions, by direct or indirect action on the salivary glands [
5,
6]. An increase in medication leads to a reduction in salivary flow, affecting dry mouth perception, and the probability of having this symptom increases with additional medications, which demonstrates the synergistic effects of xerostomia-inducing medication in the elderly [
2,
5,
6].
In conclusion, the majority of the participants in all age groups have xerostomia symptoms, and most of them take medication. Furthermore, these symptoms increased with the number of medications taken, which emphasizes the importance of oral preventive measures towards a better quality of life in the elderly.
Institutional Review Board Statement
The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of Instituto Universitário Egas Moniz (protocol code 896, approved on 30 July 2020).
Informed Consent Statement
Informed consent was obtained from all subjects involved in the study.
Data Availability Statement
The data presented in this study are available on request from the corresponding author. The data are not publicly available due to the research is still under development.
Conflicts of Interest
The authors declare no conflict of interest.
References
- Van der Putten, G.J.; De Visschere, L.; Van der Maarel-Wierink, C.; Vanobbergen, J.; Schols, J. The importance of oral health in (frail) elderly people—A review. Eur. Geriatr. Med. 2013, 4, 339–344. [Google Scholar] [CrossRef]
- Niklande, S.; Veas, L.; Fuentes, F.; Chiappini, G.; Barrera, C.; Marshal, M. Risk factors, hyposalivation and impact of xerostomia on oral health-related quality of life. Braz. Oral Res. 2017, 31, 1–9. [Google Scholar] [CrossRef] [Green Version]
- Olofsson, H.; Ulander, E.L.; Gustafson, Y.; Hornsten, C. Association between socioeconomic and health factors and edentulism in people aged 65 and older—A population-based survey. Scand. J. Public Health 2017, 46, 690–698. [Google Scholar] [CrossRef] [PubMed]
- Villa, A.; Nordio, F.; Gohel, A. A risk prediction model for xerostomia: A retrospective cohort study. Gerodontology 2016, 33, 562–568. [Google Scholar] [CrossRef] [PubMed]
- Rogus-Pulia, N.M.; Gangnon, R.; Kind, A.; Connor, N.P.; Asthana, S. A Pilot Study of Perceived Mouth Dryness, Perceived Swallowing Effort, and Saliva Substitute Effects in Healthy Adults Across the Age Range. Dysphagia 2018, 33, 200–205. [Google Scholar] [CrossRef] [PubMed]
- Shetty, S.R.; Bhowmick, S.; Castelino, R.; Babu, S. Drug induced xerostomia in elderly individuals: An institutional study. Contemp. Clin. Dent. 2012, 3, 173–175. [Google Scholar] [CrossRef] [PubMed]
| Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).