Prevalence of Xerostomia and Associated Systemic Risk Factors in Riyadh, Saudi Arabia: A Cross-sectional Study

Purpose: Xerostomia is a feeling of dry mouth and may result in poor oral hygiene, dental caries, mucosal lesions and burning mouth syndrome. Medication, systemic diseases and stress are common etiological factors of xerostomia. The present study investigated the prevalence of xerostomia and explored the possible risk factors associa­ted with this condition among Saudi population. Methods: The present cross-sectional study was conducted on 418 participants visiting at Maxillofacial clinic, at secondary care hospital, Riyadh. Demographic data and complete medical history were obtained from participants. All participants were requested to fill the Xerostomia-Inventory (XI) questionnaire. Comparisons between mean scores of XI-inventory and categorical variables like gender, comorbid conditions were made with students t-test or Wilcoxon test. Chi-square or Fischer’s Exact test were used for comparison between categorical variables like gender and responses to XI-items (No/Yes). P value of <0.05 was considered significant. All analysis was done on JMP-version-12. Results: Total 418-participants with mean age (41.1 ± 12.8 years) were included in the study in which 302-participants (72.2%) were female and 116-participants (27.8%) were male. Xerostomia’s prevalence was 24.7% and it was higher in males (34%) as compared to females (21%). A statistically-significant association was found between xerostomia and participant’s age (P < 0.0001). The participants with systemic illness showed a significantly higher mean Xerostomia Inventory (XI) score as compared to the healthy patients. In our study population common comorbid conditions were hypertension and diabetes. Conclusion: The prevalence of xerostomia increases with increasing age and it has strong positive co-relation with chronic systemic diseases.

Pengaruh Berkumur dengan Rebusan Jahe Merah terhadap Skor Keluhan Xerostomia pada Pasien DM Tipe 2

Berkumur dengan menggunakan rebusan jahe merah diketahui dapat meningkatkan laju aliran saliva baik stimulus mekanik dan stimulus kimiawi. Xerostomia merupakan salah satu masalah yang terjadi akibat penurunan aliran saliva. Xerostomia merupakan masalah penyerta yang sering ditemukan pada pasien Diabetes Mellitus tipe 2. Tujuan dari penelitian ini adalah untuk mengetahui efek berkumur dengan rebusan jahe merah terhadap skor keluhan xerostomia pada pasien DM tipe 2. Penelitian ini bersifat kuantitatif. Desain penelitian yang digunakan adalah quasi eksperimen dengan pendekatan pre and post test without control. Alat pengumpulan data berupa lembar kuesioner Xerostomia Inventory (XI) versi bahasa Indonesia yg telah di uji validitas dengan nilai Cronbach's alpha 0,85 terdiri dari 11 pertanyaan. Penelitian ini dilakukan di Puskesmas Sungai Salak Kabupaten INHIL pada bulan juni 2020 dengan jumlah sampel 29 responden. Analisa menggunakan uji statistic wilcoxon. Hasil penelitian ini menyimpulkan bahwa terdapat perbedaan skor rerata sebelum (39,8) dan sesudah (27,1) berkumur rebusan jahe merah (p value 0,000; α < 0,05).

Assessment of Hyposalivation, Xerostomia, and Oral Health-Related Quality of Life in Polymedicated Patients

To investigate the self-reported impact of hyposalivation/xerostomia on Oral Health-Related Quality of Life (OHRQoL) reported by polymedicated patients and evaluate the association between hyposalivation/xerostomia and OHRQoL. A cross-sectional observational study was performed on 40 polymedicated patients selected from the Clínica Dentária Egas Moniz. The subjects signed a consent form, answered a questionnaire to assess xerostomia via the Summated Xerostomia Inventory (SXI-PL) and The Portuguese short version of the Oral Health Impact Profile Questionnaire (OHIP-14sp), and underwent sialometry evaluation. Patients with hyposalivation showed higher scores of SXI-PL (8.60 ± 2.56) and OHIP-14sp (16.0 ± 15.8). These findings suggest an association between hyposalivation and SXI-PL and OHIP-14sp scores (p < 0.05).

Lubricating properties of chewing stimulated whole saliva from patients suffering from xerostomia

Objectives The study aimed to quantify the lubricating properties of chewing stimulated whole saliva from healthy controls (n = 22), from patients suffering from primary Sjögren’s syndrome (n = 37) and from patients undergoing head-and-neck radiotherapy (n = 34). Materials and methods All participants had to complete the Xerostomia Inventory questionnaire to score dry mouth sensation. Lubrication was measured using an ex vivo tongue-enamel friction system in terms of Relief and Relief period. MUC5b and total protein concentrations of the saliva samples were measured by an enzyme-linked immunosorbent assay and a bicinchoninic acid assay, respectively. Results Relief of Sjögren’s patients’ saliva and post-irradiation patients’ saliva was similar compared with healthy controls, but saliva from post-irradiation patients lubricated significantly better than saliva from Sjögren’s patients. The Relief period was similar between the three groups. The Relief and Relief period were higher for saliva samples post-irradiation compared to pre-irradiation. MUC5b and total protein concentrations were comparable in all groups. MUC5b and total protein output were significantly lower in patients subjected to radiotherapy compared to saliva from healthy controls and pre-irradiation patients. MUC5b concentrations positively correlated with lubricating properties of post-irradiation patient saliva. Conclusions The lubricating properties of patient saliva were not any worse than healthy controls. Lower flow rate leads to lower availability of saliva in the oral cavity and decreases the overall output of protein and MUC5b, which might result in an insufficient replenishing of the mucosal salivary film. Clinical relevance An insufficient replenishing might underlie the sensation of a dry mouth and loss of oral function.

Differences in perceived intra-oral dryness in various dry-mouth patients as determined using the Regional Oral Dryness Inventory

Objectives Recently, it was shown that the Regional Oral Dryness Inventory (RODI) could determine differences in dry-mouth perception at different intra-oral locations. The main aim of this study was to determine whether the RODI might help to discriminate between various causes of oral dryness in dry-mouth patients. The second aim was to ascertain whether the RODI could become an additional diagnostic tool in dry-mouth patients. Materials and methods Data were collected retrospectively from patients who visited a specialized saliva clinic. Salivary flow rates, Xerostomia Inventory scores, and RODI scores were extracted from the medical records. Patients were stratified into subgroups according to their health status. Results Five hundred twenty-eight patients participated in this study (mean age of 59.6 ± 16.0 years; 68.4% female). Specific patient groups differed with regard to the region of the mouth they experienced as the most and least dry. The posterior palate was the area perceived as most dry by controls and Sjögren patients. In patients using limited or multiple medications, it was the anterior tongue. RODI scores also differed significantly among dry-mouth patient groups: whereas controls and patients using limited medication had the lowest RODI scores and experienced less intra-oral dryness, Sjögren patients had the highest RODI scores. Conclusion Our use of the RODI questionnaire showed that perceived intra-oral dryness differed between the various dry-mouth patients. Clinical relevance The RODI can be a valuable clinical diagnostic tool in dry-mouth diagnostics, in which it can be used to discriminate between the various causes of oral dryness in patients.

Biotribological properties of xerostomia patient saliva and its enhancement

The study aimed to quantify the lubricating properties of chewing stimulated whole saliva from healthy controls (n=22), from patients suffering from primary Sjögren’s syndrome (n=37) and from patients undergoing head-and-neck radiotherapy (n=34). Materials and Methods All participants had to complete the Xerostomia Inventory questionnaire to score dry mouth sensation. Lubrication was measured using an ex vivo tongue-enamel friction system in terms of Relief and Relief period. MUC5b and total protein concentrations of the saliva samples were measured by an enzyme-linked immunosorbent assay and a bicinchoninic acid assay, respectively. Results Relief of Sjögren’s patients saliva and post-irradiation patients saliva was similar compared with healthy controls, but saliva from post-irradiation patients lubricated significantly better than saliva from Sjögren’s patients. The Relief period was similar between the three groups. The Relief and Relief period were higher for saliva samples post-irradiation compared to pre-irradiation. MUC5b and total protein concentrations were comparable in all groups. MUC5b and total protein output were significantly lower in patients subjected to radiotherapy compared to saliva from healthy controls and pre-irradiation patients. MUC5b concentrations positively correlated with lubricating properties of post-irradiation patient saliva. Conclusions The lubricating properties of patient saliva were not any worse than healthy controls. Lower flow rate leads to lower availability of saliva in the oral cavity and decreases the overall output of protein and MUC5b, which might result in an insufficient replenishing of the mucosal salivary film. Clinical Relevance An insufficient replenishing might underlie the sensation of a dry mouth and loss of oral function. In the talk I will explain biomaterials related strategies, yet ex vivo, to enhance salivary lubrication despite of low flowrates.

CORRELATION BETWEEN ESTRADIOL SERUM LEVELS WITH XEROSTOMIA INVENTORY SCORE ON MENOPAUSAL WOMEN

Objective: Menopause is a condition of permanent cessation of menstruation for 12 consecutive months. This occurs due to the loss of follicular ovarian activity so that estrogen levels decrease in the body. Menopause can occur at various ages, where the average age of menopause is 51-55 y. Menopause can affect oral tissues as well as other organ systems and cause xerostomia. Some of the symptoms of xerostomia include burning feelings, taste abnormalities, dysarthria, dysphagia, dysgeusia, and halitosis. Methods: This study uses a case series design to assess the correlation between estradiol levels and the incidence of xerostomia in menopausal women. The incidence of xerostomia using the Xerostomia Inventory (XI) Score. This research was conducted in several places, namely H. Adam Malik General Hospital Medan and the hospital network of the Department of Obstetrics and Gynecology, Faculty of Medicine, University of Sumatra Utara. The study population was all postmenopausal women at the H. Adam Malik General Hospital in Medan and the Obgyn FK USU network hospital that met the study inclusion-exclusion criteria. This research was conducted in February with a minimum sample of 38 people. Results: In this study, 38 samples were obtained. Based on the results of the study, it was found that the most age groups were in the range of 56-60 y, the duration of menopause in the 5-10 y group, and the highest Body Mass Index (BMI) was obesity. The mean value of estradiol in menopausal women was 23.61±8.37 pg/ml; the mean value of XI score in menopausal women was 24.29±9.44. The correlation of estradiol levels and XI scores in menopausal women is a strong negative correlation that is-0.651 (p value<0.05). Correlation value of XI score and obesity in menopausal women is a low positive correlation with r = 0.342 (p value<0.05) while the value of correlation XI score with menopausal women who are not obese is a strong positive correlation with r = 0.793 (p value<0, 05). Conclusion: Changes in the oral cavity are caused by aging and hypoestrogenism. The mean age of postmenopausal women was 56.98±4.35, with a mean BMI of 28.24±4.41. Estradiol levels in menopausal women are lower than women of reproductive age in each phase of the menstrual cycle. Significant reduction in estrogen production during menopause causes a decrease in salivary flow, leading to hyposalivation and symptoms of xerostomia.

Regional differences in perceived oral dryness as determined with a newly developed questionnaire, the Regional Oral Dryness Inventory

Objectives Several questionnaires, such as the internationally validated and frequently used Xerostomia Inventory (XI), have been developed to quantify the subjective feeling of a dry mouth. These questionnaires quantify the overall perception of dry mouth but lack the possibility to differentiate between various intra-oral regions. In this light, a novel questionnaire, the Regional Oral Dryness Inventory (RODI), which quantifies the severity of dryness at various locations in the mouth, was evaluated. Materials and methods A retrospective case report study was designed. Data were collected from patients who visited the saliva clinic for Special Care Dentistry in Amsterdam. Data, including the saliva secretion rates, RODI scores, the Xerostomia Inventory (XI) score, and Clinical Oral Dryness Score (CODS), were extracted from the electronic health record system Oase Dental. Results A total of 337 patients participated in this study with an average age of 54 ± 17 years. The majority of the patients were female (68.5%). The perceived dryness as determined by the RODI was the highest for the posterior palate and the lowest for the floor of the mouth. The highest correlations were found between the corresponding regions in the RODI and regionally related individual items of the XI and CODS. Conclusion There is a significant difference in dry-mouth feeling at different intra-oral locations. Clinical relevance Regional evaluation of xerostomia with RODI might improve diagnosis of xerostomia by helping to discriminate between different potential causes of oral dryness in patients and for evaluating the efficacy of mouth-moistening products. RODI is highly accessible and easy to perform in dental practices during routine clinical assessment.