How Common is Dry Mouth? Systematic Review and Meta-Regression Analysis of Prevalence Estimates.

Bernardo Antonio Agostini,Graziela Oro Cericato,Ethieli Rodrigues Da Silveira,Flavio Fernando Demarco,Gustavo Giacomelli Nascimento,Willian Murray Thomson,Francine Dos Santos Costa

doi:10.1590/0103-6440201802302

Abstract

The aim of this paper is to systematically review the literature to estimate the overall prevalence of xerostomia/hyposalivation in epidemiological studies. An electronic search was carried out up to February 2018 with no language restrictions. A total of 5760 titles were screened and just twenty-nine papers were included in review and the meta-analysis after a two independently reviewers applied the selection criteria. Data were extracted from PubMed and Web of Science databases. Eligibility criteria included original investigations from observational population-based studies that reported the prevalence of xerostomia or data that allowed the calculation of prevalence of xerostomia and/or hyposalivation. Studies conducted in samples with specific health conditions, literature reviews, case reports and anthropological studies, as conferences or comments were excluded. Sample size, geographic location of the study, study design, age of the studied population, diagnosis methods, and evaluation criteria used to determine xerostomia e/or hyposalivation were extracted for meta-analysis and meta-regression. Multivariate meta-regression analysis was performed to explore heterogeneity among studies. The overall estimated prevalence of dry mouth was 22.0% (95%CI 17.0-26.0%). Higher prevalence of xerostomia was observed in studies conducted only with elderly people. Despite diverse approaches to the condition's measurement, just over one in four people suffer from xerostomia, with higher rates observed among older people. Moreover, the measurement methods used currently may over- or underestimate xerostomia. These findings highlight the need for further work on existing and new clinical measure and will be useful to determine which one is more reliable in clinical and epidemiological perspectives.

Highlights

Xerostomia and hyposalivation are two distinct and independent phenomena, which may manifest alone or in combination (1)
Xerostomia is defined as the subjective sensation of dry mouth and it is diagnosed through selfreport (2)
This paper presents a systematic review of the literature on the prevalence of xerostomia and hyposalivation in order to obtain a global combined prevalence estimate for dry mouth, and to determine the factors behind the considerable variability in prevalence estimates

Summary

Introduction

Xerostomia and hyposalivation are two distinct and independent phenomena, which may manifest alone or in combination (1). Xerostomia is defined as the subjective sensation of dry mouth and it is diagnosed through selfreport (2). Either dry mouth situations may negatively affect oral health-related quality of life (4,5) and may cause oral health problems such as halitosis, impaired chewing and swallowing, and difficulties in prosthesis retention (6). There is evidence that lower salivary flow increases the risk of dental caries, due to an absence of the physical cleaning action and buffering capacity of saliva (7). This increasing risk is not exclusive of elderly and can occur in early age, specially in asthmatic patients under treatment

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