Abstract
Background: Despite developments in renal replacement therapy, therapeutic fluid restriction reportedly induces xerostomia in 28.2~85.5% of hemodialysis patients, which causes serious inconveniences in their daily living and is detrimental to their quality of life. Objective: The purpose of this study was to identify the effects of gargling with an aroma solution (A-Solution) on xerostomia, halitosis, and salivary pH in hemodialysis patients. Methods: This study design was a randomized controlled trial. The participants of this study were 56 hemodialysis patients of E General Hospital in Seoul, Korea. They were divided into an experimental group (n=28) treated by gargling with 20 ml of A-Solution for 15 seconds and a control group (n=28) where pateints did not gargle with A-Solution, and data were collected from October 1 to November 15, 2013. The outcome variables were measured in the pretest and at 5, 30, 60, and 120 minutes in the two groups. The collected data were analyzed using SPSS (version 18.0 for Windows). Results: Xerostomia was lower in the experimental group than in the control group at each time point apart from the pretest and differed significantly in the interaction between groups and time points. Salivary pH and halitosis differed significantly between the experimental and control groups, across time points, and in the interaction between group and time point. Conclusion: The findings of this study suggest that aroma gargling is a useful oral-care intervention for solving oral problems experienced by hemodialysis patients such as xerostomia and halitosis.
Highlights
Chronic renal failure is a condition in which the glomerular filtration rate decreases and renal tissue no longer functions due to the progressive and irreversible destruction of nephrons
The findings of this study suggest that aroma gargling is a useful oral-care intervention for solving oral problems experienced by hemodialysis patients such as xerostomia and halitosis
The same results were obtained in the homogeneity tests of their xerostomia, halitosis, and salivary pH (Table 2)
Summary
Chronic renal failure is a condition in which the glomerular filtration rate decreases and renal tissue no longer functions due to the progressive and irreversible destruction of nephrons. Xerostomia with a reduced salivary flow rate and high saliva viscosity generally causes halitosis by increasing the volatile sulfur compounds produced by intraoral bacteria [5]. Other factors that induce halitosis in hemodialysis patients include periodontal diseases and the acidification of saliva. When salivary secretion rate is low, salivary pH is decreased drastically, increasing halitosis [6]. A lower salivary flow acidifies saliva by decreasing the level of bicarbonate in the saliva, and this acidification worsens halitosis by causing dental caries and increasing the amount of tongue coating and the activity of intraoral acidic bacteria [9]. Despite developments in renal replacement therapy, therapeutic fluid restriction reportedly induces xerostomia in 28.2~85.5% of hemodialysis patients, which causes serious inconveniences in their daily living and is detrimental to their quality of life
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