Sensation Of Dry Mouth Research Articles

Dry Mouth Sensation after Acupuncture in Xerostomia Patients

Dry Mouth Sensation after Acupuncture in Xerostomia Patients

Impact of xerostomia on oral complaints in a group of elderly Turkish removable denture wearers

The aim of this study was to examine the correlation of subjective dry mouth assessment (xerostomia) with age, sex, denture type, wear duration, denture stability, subjective discomfort, soreness in denture-bearing tissues, and dissatisfaction with chewing, tasting, or speaking in a group of elderly Turkish removable denture wearers. The participants of this study were 229 healthy subjects, 101 males (mean age: 68.1±5.2 years) and 128 females (mean age: 66.4±4.2 years), all aged 60 years and above. A self-administered structured questionnaire on sensation of dry mouth, its effects in the oral mucosa and ability in the oral functions were given to the participants. Associations of the categorical variables were examined using the χ2-test (p<0.05). Satisfaction in the ability of speaking, tasting foods, chewing hard food was determined statistically significant in patients without dry mouth (p<0.05). Overall satisfaction of dentures was significantly higher in patients without dry mouth (p<0.05). Participants with having dry mouth reported soreness in denture-bearing tissues in both complete and removable partial denture (RPD) wearers. It was also found that oral dryness significantly affects oral functions in terms of the satisfaction with removable denture and the ability in the oral functions independent to education level or gender.

Burning mouth syndrome

Burning mouth syndrome (BMS) is a chronic disease characterized by burning of the oral mucosa associated with a sensation of dry mouth and/or taste alterations. BMS occurs more frequently among postmenopausal women. The pathophysiology of the disease is still unknown, and evidence is conflicting; although some studies suggest a central origin, others point to a peripheral neuropathic origin. The efficacy of some medications in the treatment of BMS suggests that the dopaminergic system may be involved.

Oral and salivary flow characteristics of a group of Brazilian children and adolescents with chronic renal failure

We have described the oral status and salivary flow rate of 30 children and adolescents suffering from chronic renal failure (CRF) undergoing hemodialysis and compared the associated parameters with those of 30 clinically healthy subjects with no history of chronic disease. The subjects of the renal group (RG) and healthy group (HG) were paired by gender and age (7-19 years old). Anamneses and an interview consisting of questions on oral hygiene habits comprised the first step in the study, followed by whole and parotid saliva collection and intra-oral examination. No statistical significant difference was found between the RG and HG subjects in terms of the presence of gingival inflammation, dental history of caries, and enamel hypoplasia. However, statistical significant differences were found between the groups related to a sensation of dry mouth, salivary flow rate, delayed tooth eruption, dental staining by iron supplementation, presence of plaque, and dental calculus. Based on our results, we conclude that CRF children and adolescents undergoing hemodialysis present some oral manifestations related to their disease. These manifestations include a sensation of dry mouth, delayed tooth eruption, dental staining by iron supplementation, and dental calculus. A lower flow rate of whole and parotid saliva production just before hemodialysis was also observed.

Association of oral yeast carriage with specific host factors and altered mouth sensation

The aim of this study was to determine if there was a significant association between the presence of altered mouth and taste sensations with oral carriage of yeasts and to assess the factors that influence the yeast carriage. The oral and dental status including unstimulated (USFR) and stimulated (SSFR) whole salivary flow rates of a total of 509 subjects was recorded. Saliva specimens were collected for microbiologic examination. Multiple logistic regression analysis was performed to identify any factors that were significantly associated with the prevalence of oral yeasts. Old age, clinical signs of oral dryness, denture wearing, and a reduction in USFR increased the prevalence of yeasts, whereas patient gender, levels of dentition, the sensation of dry or burning mouth, taste disorders, and SSFR were not associated with increased prevalence of oral yeasts. An increased prevalence of oral yeasts was not found to relate to changes in mouth sensation alone. Other factors, most notably patient age, the wearing of dentures, clinical signs of oral dryness, and salivary flow rate under rest conditions, were, however, found to be closely associated with oral yeast carriage.

Evaluation of the clinical efficacy of a mouthwash and oral gel containing the antimicrobial proteins lactoperoxidase, lysozyme and lactoferrin in elderly patients with dry mouth – a pilot study

To evaluate the clinical efficacy of a mouthwash and oral gel containing the antimicrobial proteins lactoperoxidase, lactoferrin and lysozyme, in a sample of elderly individuals with dry mouth. Twenty elderly institutionalised subjects with dry mouth and with a certain degree of independence for daily life activities were included in this pilot study. A randomised, double blind and cross-over design was used. The study variables comprised subjective dry mouth sensation, the severity of discomfort assessed by means of a visual analogical scale (VAS), the Oral Health Impact Profile (OHIP), the presence of signs and symptoms of dry mouth, sialometry and Candida albicans culture. All the variables were recorded before and after each of the two periods of the study. The 20 selected subjects we made up of 16 women and four men, with a mean age of 81.3 years. Improvement was observed on analysing the data between the first and second intervention period in terms of the OHIP values, the presence of dry mouth, and the need to drink fluids to swallow. However, the improvement in certain variables before and after treatment did not take a positive course in all cases, and some subjects even improved with placebo. The evaluated mouthwash and oral gel improved some subjective and clinical aspects in elderly individuals with dry mouth, though a placebo effect cannot be entirely discarded.

Oral manifestations of HIV/AIDS in clients attending TASO clinics in Uganda

The objective of the study is to establish the prevalence of oral manifestations and their influence on oral functions. A total of 514 subjects aged 18 to 58 years (mean 42 years) were randomly recruited from five The AIDS Support Organization (TASO) clinics in Uganda. They were clinically examined for oral lesions under field conditions by four trained dentists based on World Health Organization criteria. Women constituted 74.5% of the study population. Oral manifestations were recorded in 72% of the subjects, out of which 70% had candidiasis of pseudomembranous, erythematous, and angular cheilitis variants. Non-Hodgkin's lymphoma, atypical ulcers, necrotizing periodontitis, and hairy leucoplakia were least frequently observed in the subjects. Of those who had oral lesions (n = 370), 68.4% had some form of discomfort in the mouth. Tooth brushing, chewing, and swallowing were frequently associated with discomfort. Reported forms of discomfort were dry mouth, increased salivation, and burning sensation especially on taking salty and spicy foods or acidic drinks. Only 8.5% (n = 44) of the subjects were taking medications specifically for oral lesions, which included antifungal, antiviral, and antibacterial agents. None of the subjects were on antiretroviral therapy. Oral lesions associated with human immunodeficiency virus/acquired immunodeficiency syndrome in TASO clients is a major public health problem requiring education in recognition and appropriate management.

Saliva Secretion in Patients with Allergic Rhinitis

Background: Allergic rhinitis is manifested by watery discharge; however its clinical effect on the watery volume in the oral cavity is unknown. In addition, the low incidence of dry mouth due to treatment with the new generation antihistamines is based on subjective patients’ reports only. This study aimed to examine the effect of loratadine and fexofenadine on the salivary gland function in patients diagnosed with allergic rhinitis compared to untreated allergic patients and healthy individuals. Methods: A comparative observational study assessed parameters related to the patients’ perception of dry mouth as well as clinically observed parameters in fexofenadine-treated patients (group A) and in loratadine-treated patients (group B). Allergic patients without pharmacological treatment (group C) and healthy individuals (group D) served as a double control in order to evaluate the effect of allergy itself on dry mouth. A total of 36 patients were enrolled. Results: Patients in groups A and C reported the highest intensity of xerostomia. Sialometry values were significantly lower in these 2 groups compared to the healthy controls (p = 0.02 and 0.03, respectively). Average sialometry was over 0.2 ml/min in all groups and subjective dry mouth sensation ranged in the lower quarter of the visual analogue scale. Conclusions: In this pilot study, patients diagnosed with allergy presented a significant difference in salivary flow rate compared to healthy controls. Unlike the effect of loratadine, fexofenadine-treated patients showed significantly lower salivary flow rates compared to healthy individuals. In all cases the intensity of dry mouth was low.

Xerostomia: a common adverse effect of drugs and radiation

Xerostomia is the subjective sensation of dry mouth. Many drugs, especially those with anticholinergic effects, can cause xerostomia, particularly in the elderly.

Preliminary study on the effect of oral care on recovery from surgery in elderly patients

This study aimed to clarify the effectiveness of post-operative oral care, including tooth brushing, denture cleaning and tongue cleaning, after digestive tract surgery. Subjects included 30 elderly patients aged 60-98 years (74.9 +/- 7.8 years) who underwent digestive tract surgery. Subjects were randomly divided into an intervention group and a control group. In the intervention group, the following oral care was provided daily over a 5-min period in the morning starting at baseline (day of surgery) and continued for 5 days: gargling with povidone iodine, tooth brushing, denture cleaning using a special brush and tongue cleaning using a tongue brush. In the control group, the subjects only gargled with povidone iodine. We compared the following variables between the two groups at baseline and 5 days later: the sensation of dry mouth, intra-oral gas concentration, pulmonary sounds, body temperature and bacterial flora. The number of patients with abnormal pulmonary sounds (dry or moist rales) increased from 1 to 2 in the intervention group and from 0 to 4 in the control group (P < 0.05). The average number of bacterial species per subject for the control group was 3.64 +/- 1.34 pre-operatively and 3.50 +/- 1.74 post-operatively, whereas that for the intervention group was 3.08 +/- 0.95 pre-operatively and 2.62 +/- 0.65 post-operatively. In the intervention group, there was a significant decrease in the number of bacterial species (P < 0.05). These findings indicate that post-operative oral care in elderly patients undergoing digestive tract surgery lowers the number of bacterial species found in the oral cavity. This effect, in turn, might improve respiratory function.

Self‐reported oral hygiene habits among institutionalised elderly and their relationship to the condition of oral tissues in Taubaté, Brazil

To record self-reported hygiene habits, examine the oral conditions of a sample group of institutionalised elderly, and examine possible relationships between these habits and conditions. Cross-sectional. All the institutions for the elderly in Taubaté, Brazil. The entire population of these institutionalised elderly people (n = 553). The subjects were interviewed and underwent an oral examination. Oral hygiene habits, oral conditions and statistical relationships between habits and oral conditions were recorded. The average age of the subjects who knew their age (n = 364) was 74.9 years (+/-12.9), and 64.7% of the sample group were females. Denture-related stomatitis was found in 19.5%, impaired manual dexterity in 40%, dry mouth sensation in 36.3%, difficulty in performing oral hygiene in 20%, no oral hygiene-related orientation in 54.1%, no periodic oral examinations in 59.5%, and no tongue cleaning in 68.3% was declared. Among dentate subjects, 73.3% had periodontal disease, 54.7% had caries, 26% reported no toothbrushing, and 7.3% reported flossing. Of the denture wearers, 7% did not brush their dentures. Denture-related stomatitis showed a statistical relationship with impaired manual dexterity (p = 0.012) and an inverse statistical relationship with denture brushing frequency (p = 0.006). Periodontal disease showed an inverse relationship to flossing (p < 0.001) and tongue cleaning (p = 0.0026). Caries showed an inverse relationship with tooth-brushing (p = 0.043), flossing (0.022), proper oral hygiene orientation (p = 0.041) and periodical check-ups (p = 0.007). Oral hygiene practices in this sample group were found to be inadequate, and statistically significant relationships were verified between the lack of good oral hygiene practices and the deleterious oral conditions.

Oral health status and health-related quality of life: a systematic review

This study was conducted in order to identify the literature on oral health status and health-related QOL, review the findings systematically, and assess the association between them. We performed a literature search of reports published between January 1973 and June 2004, using five databases including MEDLINE. Only studies that used validated generic health-related QOL instruments were selected. The reviewers evaluated selected articles independently and resolved disagreements by consensus. A total of 1,726 articles were retrieved and seven were selected for the review; five observational studies and two intervention studies. Four studies showed significant associations between oral health status and health-related QOL. Temporomandibular disorders were highly associated with reduced health-related QOL. Poor oral status linked to both craniomandibular and cervical spinal pain was associated with increased impairment of health-related QOL. Dissatisfaction with the teeth and mouth, and a sensation of dry mouth contributed to reduce health-related QOL. Providing edentulous patients with implant-supported full dentures contributed to improve health-related QOL. Assessment of health-related QOL in relation to oral health with validated instruments remains insufficient. The present findings suggest that oral health status could affect health-related QOL in some settings; however, further evidence is needed to support this interpretation.

Two phase III clinical studies of cevimeline for post-radiation xerostomia in patients with head and neck cancer

5503 Background: Xerostomia is a frequent debilitating complication of head and neck cancer radiotherapy. Morbidities include dental caries, oral infections, and impaired quality of life. Methods: Two multicenter double-blind trials were conducted to assess the efficacy and safety of cevimeline in the treatment of radiation-induced xerostomia. Each trial enrolled subjects ≥18 years of age with head and neck cancer who had received >4000 cGy of radiation ≥4 months before entry and had clinically significant salivary gland dysfunction. Subjects were randomized to cevimeline 30 mg TID or placebo for 12 weeks, with escalation to 45 mg TID or placebo equivalent at 6 weeks if no improvement was reported. Subjects experiencing side effects after dose escalation could de-escalate to 30 mg TID. The primary efficacy endpoint was global evaluation of oral dryness, with a secondary endpoint being change in unstimulated salivary flow. Results: A total of 570 subjects (284 in the 003 and 286 in the 004 study) were randomized. In the final (visit 5) global evaluation of dry mouth in the intention-to-treat (ITT) analysis, improvement was reported by a greater percentage of subjects treated with cevimeline compared with placebo recipients (47.4% vs 33.3%, P=0.0162) in the 003 study; differences between groups were significant at visits 3 through 5 (P≤0.0162). Differences of global evaluation of oral dryness between the treatment and placebo groups were not statistically significant in the 004 study, although a high placebo response rate was observed (48.9% vs 47.6%, P=0.9565). In both studies, cevimeline-treated patients had significantly greater mean increases in unstimulated salivary flow than placebo treated patients at the final visit (ITT, P=0.0093 [003] and P=0.0215 [004]). Cevimeline was well tolerated in both studies. Adverse event frequency was comparable in the placebo and cevimeline groups, with the exception of increased sweating in the cevimeline group. Conclusions: Cevimeline 30 to 45 mg TID increased mean unstimulated salivary flow in both studies and in one study improved subjective dry mouth sensation in subjects with xerostomia following radiation therapy for head and neck cancer. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Daiichi

The significance of saliva during sleep and the relevance of oromotor movements

Saliva is an essential component of the oroesophageal milieu and allows for normal speech, taste, mastication, food bolus formation and swallowing. Saliva has important functions in protecting the hard and soft tissues of the oral cavity from acids and pathogenic microbes. A large number of people suffer either subjective or objective alterations in quantity and/or quality of their saliva that may be secondary to disease, medications, medical treatments or emotional events. Sleep-related xerostomia is a sensation of dry mouth associated with a report of either mouth and/or throat discomfort that induces awakenings for water intake. The prevalence of self-reported dry mouth complaint during sleep (associated with awakening and water intake) in a Canadian survey was estimated at 23%. The biological significance of decreased saliva during sleep is unknown and it is unclear how the oral cavity compensates for this period of relative dryness. The amount of saliva produced is greatest during the waking hours of the day and diminishes dramatically during sleep and may represent another process in the human body that displays a circadian rhythmicity. Salivary secretion during wakefulness is, in part, associated with oromotor activity involving the masticatory muscles. Rhythmic masticatory muscle activity and swallowing are non-disruptive events that occur during normal sleep. We hypothesize herein that lubrication from saliva is necessary during sleep to protect tissue integrity and health of oroesophageal structures.

Effects of mouth dryness on drinking behavior and beverage acceptability

In humans, the association between mouth dryness and thirst has been examined in a variety of contexts. Typically, drinking behavior produces a concomitant reduction in unpleasant dry mouth sensations. Evidence is reviewed for a mechanism that influences the termination of drinking behavior by metering this change. Drinking behavior causes a progressive increase in parotid saliva flow. Thus, one possibility is that satiety results from a decrease in the reward associated with mouth wetting during a drinking episode. Beverages can differ in their satiating ability. This variability may be related to their mouth-wetting characteristic, and may be reflected in a shift in their acceptability when the mouth becomes dry. Physically drying the mouth appears to increase the acceptability of beverages that are either cold or acidic. It may be significant that two important determinants of mouth wetting are temperature and acidity. Cold or acidic beverages are also likely to be regarded as ‘thirst-quenching.’ Thus, shifts in acceptability, ‘thirst quenching’ and satiety may all be related to the mouth-wetting properties of a beverage. The extent to which this coincidence is meaningful warrants further investigation. However, if a common underlying process exists, then this may help to elucidate reasons for voluntary dehydration and aberrant drinking behavior in the elderly.

The Role of Acetaldehyde in the Actions of Alcohol (Update 2000)

Background : Recent advances in the field of acetaldehyde (AcH) research have raised the need for a comprehensive review on the role of AcH in the actions of alcohol. This update is an attempt to summarize the available AcH research.Methods : The descriptive part of this article covers not only recent research but also the development of the field. Special emphasis is placed on mechanistic analyses, new hypotheses, and conclusions.Results : Elevated AcH during alcohol intoxication causes alcohol sensitivity, which involves vasodilation associated with increased skin temperature, subjective feelings of hotness and facial flushing, increased heart and respiration rate, lowered blood pressure, sensation of dry mouth or throat associated with bronchoconstriction and allergy reactions, nausea and headache, and also reinforcing reactions like euphoria. These effects seem to involve catecholamine, opiate peptide, prostaglandin, histamine, and/or kinin mechanisms. The contribution of AcH to the pathological consequences of chronic alcohol intake is well established for different forms of cancer in the digestive tract and the upper airways. AcH seems to play a role in the etiology of liver cirrhosis. AcH may have a role in other pathological developments, which include brain damage, cardiomyopathy, pancreatitis, and fetal alcohol syndrome. AcH creates both unpleasant aversive reactions that protect against excessive alcohol drinking and euphoric sensations that may reinforce alcohol drinking. The protective effect of AcH may be used in future treatments that involve gene therapy with or without liver transplantation.Conclusions : AcH plays a role in most of the actions of alcohol. The individual variability in these AcH‐mediated actions will depend on the genetic polymorphism, not only for the alcohol and AcH‐metabolizing enzymes but also for the target sites for AcH actions. The subtle balance between aversive and reinforcing, protecting and promoting factors will determine the overall behavioral and pathological developments.

The role of acetaldehyde in the actions of alcohol (update 2000).

Recent advances in the field of acetaldehyde (AcH) research have raised the need for a comprehensive review on the role of AcH in the actions of alcohol. This update is an attempt to summarize the available AcH research. The descriptive part of this article covers not only recent research but also the development of the field. Special emphasis is placed on mechanistic analyses, new hypotheses, and conclusions. Elevated AcH during alcohol intoxication causes alcohol sensitivity, which involves vasodilation associated with increased skin temperature, subjective feelings of hotness and facial flushing, increased heart and respiration rate, lowered blood pressure, sensation of dry mouth or throat associated with bronchoconstriction and allergy reactions, nausea and headache, and also reinforcing reactions like euphoria. These effects seem to involve catecholamine, opiate peptide, prostaglandin, histamine, and/or kinin mechanisms. The contribution of AcH to the pathological consequences of chronic alcohol intake is well established for different forms of cancer in the digestive tract and the upper airways. AcH seems to play a role in the etiology of liver cirrhosis. AcH may have a role in other pathological developments, which include brain damage, cardiomyopathy, pancreatitis, and fetal alcohol syndrome. AcH creates both unpleasant aversive reactions that protect against excessive alcohol drinking and euphoric sensations that may reinforce alcohol drinking. The protective effect of AcH may be used in future treatments that involve gene therapy with or without liver transplantation. AcH plays a role in most of the actions of alcohol. The individual variability in these AcH-mediated actions will depend on the genetic polymorphism, not only for the alcohol and AcH-metabolizing enzymes but also for the target sites for AcH actions. The subtle balance between aversive and reinforcing, protecting and promoting factors will determine the overall behavioral and pathological developments.

Perception of dry mouth in a sample of community-dwelling older adults in Japan.

The purpose of this study was to examine the prevalence of perceived dry mouth among a group of independently-living elderly persons in Japan, and to determine its association with general disease, medication, and dental status, as well as its effect on oral function. The study population consisted of participants of the Senior Citizens' College. The subjective sensations of oral dryness on waking and while eating a meal were measured by a questionnaire. The number of usable questionnaires was 1003 or 77.9%. The mean age of the subjects was 66.3 +/- 4.2 years, and 53.0% were male. More than one-third (37.8%) of the subjects reported oral dryness on waking. Only 9.1% of them noticed a subjective feeling of dry mouth during eating. Persons who had at least one of these symptoms made up 41.0%. A multiple stepwise logistic regression analysis indicated the following results: Perception of dry mouth on waking was more frequent among males (p < 0.001), persons who had a low BMI (p < 0.05), and those taking two or more prescribed drugs (p < 0.01). Sensation of dry mouth when eating was more frequent among subjects with a low BMI (p < 0.001) and those who wore a denture in the maxillary arch (p < 0.05). Perception of dry mouth when eating was associated with self-assessed chewing ability (p < 0.01) and dissatisfaction with speaking clearly (p < 0.05), as well as dental status. However, dissatisfaction with tasting a meal had a significant relationship with the reports of mouth dryness on waking (p < 0.01). Our findings suggest that a substantially higher percentage of persons have the perception of dry mouth on waking than when eating, which was associated with medications, being male, and having a low BMI. This perception may influence oral function, especially the reported dissatisfaction with tasting foods.

A controlled study of oral self-care and self-perceived oral health in type 2 diabetic patients

A controlled study was carried out in mid-Sweden with the aim of comparing oral self-care and selfperceived oral health in 102 randomly sampled type 2 diabetic patients with that of 102 age-and-gendermatched non-diabetic controls. Oral health variables were also related to glycemic control (HbA1c), duration, anti-diabetic treatment, and late complications. Questionnaires were used to collect data on oral self-care and self-perceived oral health. Diabetes-related variables were extracted from medical records. Eighty-five percent of the diabetic subjects had never received information about the relation between diabetes and oral health, and 83% were unaware of the link. Forty-eight percent believed that the dentist/ dental hygienist did not know of their having diabetes. Most individuals, but fewer in the diabetic group, were regular visitors to dental care and the majority felt unaffected when confronted with dental services. More than 90% in both groups brushed their teeth daily and more than half of those with natural teeth did proximal cleaning. Subjects in the diabetic group as well as in the control group were content with their teeth and mouth (83% vs 85%). Those with solely natural teeth and those with complete removable dentures expressed most satisfaction. Sensation of dry mouth was common among diabetic patients (54%) and subjects with hypertension exhibited dry mouth to a greater extent (65%) than those who were normotensive. Our principal conclusion is that efforts should be made to give information about diabetes as a risk factor for oral health from dental services to diabetic patients and diabetes staff.

Depressive symptoms as an underlying factor of the sensation of dry mouth.

The purpose of this survey was to study the sensation of oral dryness and its underlying factors in the 55-year-old population of Oulu (a medium-sized Finnish town), 780 of whom (77%) participated. In addition to the examination of oral health status and salivary flow rate measurements, depressive symptoms were determined on the basis of the Zung Self-Rating Depression Scale (ZSDS). The participants were also interviewed about their health, medication, physical health, physical activity, smoking habits, alcohol consumption, and factors related to their work. The prevalence of subjective sensations of dry mouth was 25.8% among men and 33.3% among women (p = 0.025). A statistically significant association was found between a subjective sensation of dry mouth and a low unstimulated flow rate, regular smoking, xerogenic medication, and the presence of at least one illness connected with dry mouth. Those who had a sensation of dry mouth also thought their physical condition and their health to be poorer and more often had a high rate of depressive symptoms. After the confounding factors had been added stepwise into the logistic regression model, depressive symptoms were still significantly associated with the sensation of oral dryness. When evaluating the causes of the sensation of dry mouth, the possibility of depression as an underlying factor should be considered.