Subjective Feeling Of Dry Mouth Research Articles

Xerostomia in a Group of Turkish Patients Using an Online Survey During the COVID-19 Pandemic.

Background Xerostomia is defined as the subjective feeling of dry mouth and affects millions of patients worldwide. Most studies are based on samples of the elderly in nursing homes. This study aimed to investigate the presence of xerostomia and the severity of self-reported xerostomia by sociodemographic variables and to evaluate xerostomia symptoms (self-reported halitosis, burning mouth, and mouth sores) in young adults. Methodology A questionnaire regarding sociodemographic data and the 11-item Xerostomia Inventory was delivered to patients aged 20-65 years who applied to the Ankara University Faculty of Dentistry for dental treatment before the COVID-19 pandemic. Statistical analyses were performed to determine the relationships between the presence of xerostomia and other variables such as age, gender, the presence of a systemic disease, medication use, smoking, alcohol consumption, and the use of removable prostheses. Results A total of 300 patients were included in the study. Xerostomia presence of 54.6% (164 patients) was identified. A significant relationship was found between age and xerostomia (p = 0.023; p = 0.001). The presence of xerostomia decreased as age increased. Xerostomia was more common in female patients (p = 0.028; p = 0.004). The presence of xerostomia was found to be high, not only in the elderly but also in younger adults. Conclusions This study sheds light on the current status, symptoms, and etiology of xerostomia presence in the young population in Turkey. Factors associated with xerostomia were age, female gender, and the number of cigarettes smoked per day. In this study, the high presence of xerostomia was due to smoking.

Discordance between hyposalivation and xerostomia among community-dwelling older adults in Japan.

Individuals with an objective decrease in salivary flow (objective dry mouth) may not be aware of subjective dry mouth (xerostomia). However, no clear evidence exists to explain the discordance between subjective and objective dry mouth. Therefore, this cross-sectional study aimed to assess the prevalence of xerostomia and decreased salivary flow among community-dwelling elderly adults. In addition, this study assessed several potential demographic and health status determinants of the discrepancy between xerostomia and reduced salivary flow. The 215 participants in this study were community-dwelling older people aged 70 years and above who underwent dental health examinations between January-February 2019. Symptoms of xerostomia were collected in the form of a questionnaire. The unstimulated salivary flow rate (USFR) was measured by a dentist using visual inspection. The stimulated salivary flow rate (SSFR) was measured using the Saxon test. We identified 19.1% of participants as having mild-severe USFR decline with xerostomia and 19.1% as having mild-severe USFR decline without xerostomia. Additionally, 26.0% of participants had low SSFR and xerostomia, and 40.0% had low SSFR without xerostomia. Except for the age trend, no factors could be associated with the discordance between USFR measurement and xerostomia. Furthermore, no significant factors were associated with the discordance between the SSFR and xerostomia. However, females were significantly associated (OR = 2.608, 95% CI = 1.174-5.791) with low SSFR and xerostomia, as compared to males. Age was a factor that was also significantly associated (OR = 1.105, 95% CI = 1.010-1.209) with low SSFR and xerostomia. Our findings indicate that approximately 20% of the participants had low USFR without xerostomia, and 40% had low SSFR without xerostomia. This study showed that age, sex, and the number of medications may not be factors in the discrepancy between the subjective feeling of dry mouth and reduced salivary flow.

Quantification of very late xerostomia in head and neck cancer patients after irradiation.

ObjectiveRadiation therapy (RT) for head and neck cancer (HNC) can result in severe xerostomia, or the subjective feeling of dry mouth. Characterizing xerostomia is critical to designing future clinical trials investigating how to improve HNC patients' quality of life (QoL). Few studies have investigated the very late (>5 years post‐RT) effects of RT for HNC. We undertook preliminary studies quantifying very late xerostomia.MethodsSix adults who underwent RT for HNC at least 5 years prior and reported xerostomia were enrolled. Five healthy adults without a self‐reported history of HNC or xerostomia were enrolled as controls. All participants completed three validated surveys to measure xerostomia‐related QoL. Salivary production rates were measured and compositional analysis of the saliva and oral microbiome was completed.ResultsThe QoL survey scores for the HNC participants were significantly worse as compared to the control participants. The HNC participants produced less unstimulated saliva (p = .02) but not less stimulated saliva. The median salivary mucin significantly higher in HNC participants than in control participants (p = .02). There was no significant difference between the pH, amylase, or total protein. Microbiome analysis revealed alpha diversity to be significantly lower in the HNC participants.ConclusionIn the survivors of HNC who suffer from late toxicities, multiple means of measuring toxicity may be useful. We found that in patients with radiation‐induced xerostomia over 5 years after therapy, not only were the QoL surveys significantly worse, as expected, but other measurements such as mucin and oral microbiome diversity were also significantly different.Level of evidence3.

Association between Diet and Xerostomia: Is Xerostomia a Barrier to a Healthy Eating Pattern?

Objective. Xerostomia is a subjective feeling of dry mouth and is commonly observed in patients with autoimmune diseases. Our study examines the association between xerostomia and diet. Materials and Methods. The cross-sectional study includes 1405 adults from 15 Lithuanian geographical areas (52% response rate). A self-reported questionnaire inquired about xerostomia, sex, age, education, residence, and consumption of selected 23 diet items. For the multivariable analysis, 23 diet items were categorized into eight major diet groups. The data were analyzed by bivariate and multivariable analyses. Results. When comparing participants with and without xerostomia, there were significant differences in consumption frequencies concerning cold-pressed oil (p = 0.013), bread (p = 0.029), processed meat products (p = 0.016), fat and lean fish (p = 0.009), and probiotic supplements (p = 0.002). In the multivariable binary logistic regression model, when controlled for other determinants, the higher consumption of carbohydrates (OR 0.39, 95% CI 0.23–0.65), proteins (OR 0.56, 95% CI 0.32–0.99), and oils (OR 0.58, 95% CI 0.34–1.00) was associated with a lower likelihood of xerostomia. Conclusions. The association between xerostomia and the consumption of the six diet items—cold-pressed oils, lean and fat fish, bread, processed meat, and probiotic supplements— and the three major diet groups—carbohydrates, proteins, and oils—was observed. Longitudinal studies are needed to validate the observed associations.

Changes in saliva characteristics and carious status related to metabolic control in patients with type 2 diabetes mellitus

ObjectivesThis cross-sectional study aimed: 1) to compare the saliva characteristics and the occurrence of caries in patients with type 2 diabetes mellitus (T2DM) and patients without T2DM, 2) to study the impact of inadequate glycemic control on saliva and caries prevalence. Methods23 adults with T2DM and 18 controls participated. Patients with T2DM were divided depending on their metabolic control: a) well-controlled (W.C.): HbA1c≤7 %, and b) poorly-controlled (P.C.): HbA1c> 7 %). The examined clinical parameters were: 1) number of natural teeth, 2) DMFT index of coronal caries, 3) saliva pH, 4) saliva flow and buffering capacity, and 5) subjective feeling of dry mouth. ResultsThe groups W.C and P.C showed significant differences in the number of teeth, the saliva flow, and DMFT. The C and P.C groups presented differences in pH, saliva flow, buffer capacity, and DMFT. Finally, the W.C and C groups indicated differences in the buffer capacity, saliva flow, and DMFT. The subjective feeling of dry mouth is related to the duration of the disease. The DMFT value correlated negatively with the status of metabolic regulation. Multiple linear regression revealed that the DMFT value was positively associated with serum HbA1c levels. Conclusions1) Adults with T2DM present a lower saliva flow rate and buffering capacity, as well as higher caries prevalence than controls; 2) The metabolic control of T2DM is essential for the maintenance of saliva flow rate and buffering capacity, and caries prevalence; 3) The duration of T2DM is of importance for the subjective sense of dry mouth. Clinical significanceThe duration and metabolic control of T2DM are important clinical parameters for oral complications. Awareness and co-operation of diabetologists and dentists are needed to detect oral lesions in patients with diabetes and be treated timely and effectively.

Impact of benign parotid gland tumors on whole salivary flow rate

The impact of benign tumors of the parotid gland on whole salivary flow or sialochemistry is unclear. A total of 22 patients with benign parotid tumors and 18 healthy controls underwent measurements of unstimulated and stimulated whole saliva flow and sialochemistry (Na+, K+, Ca++, Amylase, and pH). Assessment of xerostomia was performed by means of a visual analogue scale (VAS) and a questionnaire (QoL). Stimulated whole salivary flow was significantly lower in patients with benign parotid tumors in comparison to the control group (2.76 ± 0.96 ml/min vs. 3.85 ± 0.72 ml/min; p = 0.009). However, assessment of unstimulated whole salivary flow, sialochemistry, and subjective parameters (VAS, QoL) showed no significant differences between the patient and control groups (0.73 ± 0.41 ml/min vs. 0.68 ± 0.39 ml/min; p = 1). Benign salivary gland tumors appear to reduce whole stimulated salivary flow and leave unstimulated whole salivary flow and sialochemistry unchanged. The patients' subjective feelings of dry mouth do not seem to be influenced by the reduction in salivary flow.

Clinical efficacy of casein phosphopeptide - amorphous calcium phosphate and casein phosphopeptide-amorphous calcium fluoride phosphate and their influence on the quality of life in patients with Sjögren’s syndrome

Introduction/Objective. The purpose of this study was to compare clinical efficacy of casein phosphopeptide ? amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP) with 0.05% NaF, and to assess their influence on the quality of life among individuals with Sjogren?s syndrome. Methods. Thirty patients were randomized into three groups treated with different remineralizing agents: CPP-ACP, CPP-ACFP, and 0.05% NaF. Oral health was evaluated at the beginning of the study, after 28 days (short-term effects), and after six months. The diagnosis of dental caries was performed using the decayed, missing, and filled teeth (DMFT) / decayed and filled surfaces (DFS) criteria. Enamel demineralization was visually examined using the white spot lesion index (Gorelick). The gingival health was evaluated with the gingival index (Loe?Silness). Assessment of oral hygiene was done using the simplified oral hygiene index (Greene?Vermilion). The Xerostomia Inventory was used to quantify dry-mouth symptoms. The oral health-related quality of life was analyzed using the short form of the Oral Health Impact Profile (OHIP-14). Results. During the evaluation period, caries increment was not significant. Considerable regression of white spot lesions was noted in all three experimental groups (p < 0.001). No significant improvement in gingival health and oral hygiene was observed. Physical pain was decreased in all three experimental groups, and subjective feeling of dry mouth was reduced in CPP-ACP and CPP-ACFP groups. Conclusion. CPP-ACP and CPP-ACFP may reduce the caries activity and relieve the dry-mouth symptoms in patients with Sjogren?s syndrome.

Relationship between dry mouth, depression and systemic diseases in patients over 55 years of age from care homes and family homes

Abstract Introduction: Xerostomia (dry mouth, oral dryness) is the subjective sensation of dryness in the mouth. The gradual slight decrease in the secretion of saliva is physiologically related to aging of the body. Factors that predispose patients to the occurrence of dry mouth include systemic diseases, radiotherapy, anxiety and depression. The aim of this study was to analyse the relationship between dry mouth, depression and systemic diseases in respondents living in nursing homes (NH) and family homes (FH). Materials and methods: The study group comprised 226 respondents; 106 residents aged 55–101 years in two NH and 120 respondents living in FH. There were 110 men and 116 women. The study was based on the results of a diagnostic survey using an original questionnaire regarding general medical issues, and also the subjective feeling of dry mouth investigated with a standard Fox test. A shortened version of the Geriatric Depression Scale (GDS) was used to assess the wellbeing of patients and their state/sense of depression. The data obtained from the survey were analysed using Statistica 12 software (StatSoft Poland). Results: On the basis of the information and an analysis of the medical documentation of the NH group of patients, isolated systemic illness was found in only a limited number of patients. High blood pressure combined with heart disease was most frequently noted in NH (26.4%) and FH patients (25%). There was a significantly higher incidence of hypofunction and decreased secretion of saliva in NH patients (56.8%) than in FH patients (41.6%). No correlation between these symptoms and systemic diseases or depression was found in patients from either group. Conclusions: There was no correlation between the symptoms of dry mouth and the diagnosed systemic diseases in respondents from either group. The residents of NH were characterized by a worse mental state than those in FH. The symptoms of dry mouth were statistically significantly more frequent in residents of NH than in residents of FH. The residents of NH exhibiting worse mental state more often complained of a dry mouth sensation, however the difference was not statistically significant.

Investigation of the relationship between sleep disorders and xerostomia.

To investigate the relationship between sleep disorders, morning hyposalivation, and subjective feeling of dry mouth. A cross-sectional, observational, clinical study was carried out in a homogenous population sample which consists of Greek male soldiers without any medical history. After the application of oral modified Schirmer test, the sample was divided into a study group (n = 63) (MST < 25mm/3min) and a control group (n = 110) (MST ≥ 25mm/3min). In order to assess daytime sleepiness, risk of obstructive sleep apnea (OSA), sleep quality, sleep bruxism (SB), and subjective feeling of dry mouth, all the participants filled in the following scales in Greek version: Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Berlin Questionnaire (BQ), a SB questionnaire, and Xerostomia Inventory (XI) respectively. In every subgroup that came of ESS, PSQI, BQ, and SB questionnaire scoring, subjective feeling of dry mouth was evaluated, based on XI values. Statistically significant difference (p < 0.001) through PSQI scores was found between the study and control group. In contrast, a statistically significant difference was not obtained for the scores of ESS (p = 0.293), BQ (p = 0.089), and SB questionnaire (p = 0.730). XI scores introduced statistically significant difference between the subgroups of PSQI (p < 0.001), BQ (p = 0.001), SB questionnaire (p = 0.004) and statistically weak between the subgroups of ESS (p = 0.049). This is the first research study so far suggesting that patients with morning hyposalivation exhibit poor sleep quality using an objective method. The present results have, also, shown that subjective feeling of dry mouth is related to excessive daytime sleepiness, poor sleep quality, high risk of obstructive sleep apnea, and sleep bruxism, but larger-scale studies are still needed. These findings should keep dentists aware of a possible association between xerostomia and sleep disorders and support larger-scale studies.

Anticholinergic Burden and Dry Mouth in Middle-Aged People.

Anticholinergic burden refers to the cumulative effect of taking 1 or more drugs with anticholinergic properties. At the moment, little is known about the association between the anticholinergic burden and dry mouth. The objective of this article was to study, whether an anticholinergic burden is associated with dry mouth among middle-aged people. The study population included 1,345 people aged 46 y from the Northern Finland Birth Cohort 1966 (NFBC1966) study, who took part in a clinical medical and dental examination during 2012-2013. Medication data comprised both self-reported drug use and information obtained from the national register. Anticholinergic burden was measured using 10 different anticholinergic scales. Dry mouth was defined on the basis of having either a subjective feeling of dry mouth (xerostomia) or objectively measured low unstimulated or stimulated whole salivary flow rates (hyposalivation). Poisson regression models with robust error variance were used to estimate relative risk (RR). Regression models were adjusted for sex, smoking, diabetes, rheumatoid diseases, depressive symptoms, anxiety, total number of drugs, and antihypertensive drugs. Approximately 14% of the participants reported having xerostomia and about 2% had hyposalivation. The RRs of different anticholinergic scales for xerostomia varied from 1.05 to 1.68. The scales' RRs were between 0.89 and 2.03 for low unstimulated whole salivary flow (<0.1 mL/min) and between 0.59 and 1.80 for low stimulated whole salivary flow (<0.7 mL/min). Seven of 10 studied anticholinergic scales associated statistically significantly with dry mouth, either with xerostomia or hyposalivation. Most of the anticholinergic scales were associated with dry mouth, either with xerostomia or hyposalivation. There was considerable variation in the strength of the associations between anticholinergic scales and dry mouth. The findings of this study suggest that dentists should take notice of the use of drugs with anticholinergic properties and their harmful effects among middle-aged people. Dentists should provide these patients with necessary guidance on how to cope with dry mouth and give them prophylactic measures against oral diseases associated with dry mouth.

The combined effect of individually tailored xerostomia and nutritional interventions on dry mouth among nutritionally compromised old home care clients.

To examine the effectiveness of tailored xerostomia and nutritional 6-month interventions on xerostomia among home care clients aged 75years or over who were malnourished or at risk of malnutrition. A subjective feeling of dry mouth (xerostomia) is common among older adults and affects their quality of life, nutrition and oral health. Medical conditions, polypharmacy, dehydration and malnutrition are often underlying causes of xerostomia. The data are based on the NutOrMed study with a dietary intervention group of 119 patients and control group of 97 patients. In-home interviews were carried out by home care nurses, nutritionists, dental hygienists and pharmacists and tailored interventions by nutritionist and dental hygienists. Xerostomia intervention included individual counselling on dry mouth care and was applied to all those suffering occasionally or continuously from xerostomia (57%, n=66) in the intervention group. Nutritional intervention was applied to all participants in the intervention group, and it included instructions on increasing the number of meals, energy, protein intake and liquid intake. Among participants who received both interventions, xerostomia decreased by 30% and malnutrition or risk of malnutrition decreased by 61%. The interventions were highly significant (OR 0.1, 95% CI: 0.06; 0.2) in reducing xerostomia. Home care clients suffering from xerostomia profited significantly from tailored xerostomia and dietary interventions. Evaluation and treatment of xerostomia are important among older persons who are malnourished or at risk of malnutrition as a part of a comprehensive health intervention to improve their nutrition and oral health.

Influence of habitual mouth breathing on taste sensation

PurposeAlthough habitual mouth breathing is recognized to cause various disorders of orofacial growth and function, including taste sensation, the relationship between habitual mouth breathing and taste disorders has not been investigated sufficiently. This study aimed to examine the influence of habitual mouth breathing on taste sensitivity and relevant factors such as salivation, oral moisture, and olfactory function. Materials and methodsThirty volunteers (male, 18; female, 12) aged 22–35 years participated in this study. On the basis of their responses to a questionnaire regarding habitual breathing, 15 subjects each were assigned to the mouth-breathing (MB) and control groups. Recognition thresholds for sweet, salty, sour, bitter, and umami tastes at the tip and root of the tongue were measured using the filter-paper disk method. Salivary flow and spinnbarkeit (viscosity), oral moisture, and olfactory function were also measured as factors related to taste sensitivity. Additionally, a questionnaire about dry mouth, nasal obstruction, snoring, and olfaction was implemented. ResultsThe MB group exhibited significantly higher recognition thresholds for sweetness and sourness at the tip and for bitterness and sourness at the root of the tongue compared with the control group. However, there was no significant intergroup difference in the threshold for salty or umami taste, salivary flow or spinnbarkeit, oral moisture, or olfactory function. The MB group exhibited a significantly higher subjective feeling of dry mouth, nasal obstruction, and snoring than the control group. ConclusionsMouth breathing habit poses a risk for taste deterioration without affecting salivary secretion and olfactory function.

Dietary nitrate protects submandibular gland from hyposalivation in ovariectomized rats via suppressing cell apoptosis

Xerostomia, a major oral symptom of menopause, is a subjective feeling of dry mouth associated with oral pain and difficulties in deglutition and speech, which significantly reduces patient's quality of life. Dietary nitrate, which can be converted to nitric oxide, has multiple physiological functions in the body, including antioxidant activity and vasodilatation; however, its protective effect against xerostomia remains poorly understood. The present study aimed to evaluate the effects of dietary nitrate on estrogen deficiency-induced xerostomia. We established an ovariectomized (OVX) rat model, which included five groups: sham-operated, OVX, OVX + 0.4 mM nitrate, OVX + 2 mM nitrate, and OVX + 4 mM nitrate (n = 6). After ovariectomy, animals in the nitrate treatment groups received appropriate amounts of sodium nitrate dissolved in distilled water for 3 months. The results showed that nitrate treatment reduced body weight and water intake, and increased serum nitrate and nitrite levels. Furthermore, nitrate uptake increased saliva secretion as evidenced by saliva flow rates and aquaporin 5 expression, and alleviated histological lesions as evidenced by reduction of the fibrotic area and cell atrophy in the salivary glands. Although protective effects of nitrate against estrogen deficiency-induced xerostomia were observed at all doses, treatment with 2 mM nitrate was more effective than that with 0.4 mM and 4 mM nitrate. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) and caspase-3 expression analyses showed that nitrate also protected cells from apoptosis, possibly through upregulation of Cu-Zn superoxide dismutase (Cu-Zn SOD) known to inhibit oxidative stress-related apoptosis. Our findings indicate that nitrate could improve functional activity of the salivary glands in OVX rats by suppressing apoptosis and upregulating Cu-Zn SOD expression, suggesting that dietary nitrate may potentially prevent hyposalivation in menopausal women.

The Oral Cavity State in Renal Transplant Recipients.

Patients with a solid organ transplant can have many different complications in the mouth, as a result of immunosuppression and side effects of drugs. The aim of this study was to examine the frequency and type of oral lesions in renal transplant patients, dental status, oral hygiene, oral lesions related to drugs which patients take and the time of transplantation as well as the frequency of patient's visits to the dentist in the post-transplant period. The study was performed in a period of two years and included 100 subjects with a renal transplant during their regular control visits to the Department of Nephrology and Dialysis, Clinical Hospital Centre Zagreb and the Department of Oral Medicine, School of Dental Medicine, University of Zagreb and 100 randomly selected control subjects at the Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb. Results showed a significantly higher incidence of oral lesions in patients with renal transplant (31%) compared to control subjects. The most frequent were erythematous (inflammatory changes), keratotic lesions and gingival hyperplasia. The average DMFT index was significantly lower in patients with renal transplant than in the control group. One third of patients had a subjective feeling of dry mouth. Oral hygiene was poor overall, and only a small number of subjects used the additional sustainers for oral hygiene. Most patients did not visit the dentist after the transplantation. Renal transplant patients need a comprehensive and regular dental care during the pre- and post-transplant period and a doctor of dental medicine should be part of a multidisciplinary team of medical specialists.

Self-Reported Oral Symptoms and Signs in Liver Transplant Recipients and a Control Population

Recipients of liver transplantation (LT) receive lifelong immunosuppression, which causes side effects. We investigated self-reported oral symptoms and associated risk factors with the following hypothesis: symptoms and signs would differ between LT recipients of different etiology groups and also between LT recipients and a control population. Eighty-four LT recipients (64 with chronic liver disease and 20 with acute liver disease) were recruited for clinical oral and salivary examinations (median follow-up = 5.7 years). A structured questionnaire was used to record subjective oral symptoms. Matched controls (n = 252) came from the National Finnish Health 2000 survey. The prevalence of symptoms was compared between the groups, and the risk factors for oral symptoms were analyzed. Xerostomia was prevalent in 48.4% of the chronic LT recipients and in 42.1% of the acute LT recipients. This subjective feeling of dry mouth was only partly linked to objectively measured hyposalivation. The chronic transplant recipients had significantly lower unstimulated salivary flow rates than the acute transplant recipients (0.34 ± 0.31 versus 0.61 ± 0.49 mL/minute, P = 0.005). Among the chronic transplant recipients, hyposalivation with unstimulated salivary flow was associated with fewer teeth (17.7 ± 8.2 versus 21.9 ± 8.4, P = 0.047) and more dentures (33.3% versus 12.2%, P = not significant). The chronic patients reported significantly more dysphagia than their controls (23.4% versus 11.5%, P = 0.02). Increases in the number of medications increased the symptoms in all groups. In conclusion, dysphagia was significantly more prevalent among the chronic LT recipients versus the controls. The number of medications was a risk factor for dry mouth-related symptoms for both the LT recipients and the controls. The chronic transplant recipients presented with lower salivary flow rates than the acute transplant recipients. Hyposalivation correlated with generally worse oral health among the chronic transplant recipients. These differences between the chronic and acute LT recipients may have been due to differences in their medical conditions due to the different etiologies.

Xerostomia in complete denture wearers: prevalence, clinical findings and impact on oral functions

To investigate the prevalence of dry mouth in a select sample of edentulous Jordanian older population wearing complete dentures and to evaluate its impact on oral functions. The prevalence and impact of Xerostomia as a cofactor in causing denture problems in Jordanians have not been previously investigated. This study included 455 participants (253 men and 202 women). Perception of dry mouth was measured by a pilot-tested questionnaire. Xerostomic status was confirmed clinically. Complete denture function was also assessed. One hundred and thirty six subjects (29.9%) had reported a subjective feeling of dry mouth with a prevalence of 24.9% in men (n=63) and 36.1% in women (n=73) (p<0.01). 136 of the 145 subjects with satisfactory dentures showed one or more signs suggestive of Xerostomia. The majority of xerostomic participants with different sets of complete dentures were dissatisfied with oral functions (p<0.05). There was a significant association between dry mouth and increasing age, female gender and smoking status (p<0.05). Among complete denture wearers, Xerostomia is significantly more prevalent in women and associated with increased age and smoking. Xerostomia adversely affects oral functions and overall satisfaction with dentures.

Diagnostic performance of labial minor salivary gland flow measurement for assessment of xerostomia

ObjectiveMinor salivary gland flow rate (MF) has been proposed as a key feature of xerostomia (subjective feeling of dry mouth). To assess its diagnostic performance, MF was compared in xerostomia and control subjects. DesignSixty-six subjects with xerostomia and 30 controls were enrolled. MF was measured in the lower labial mucosa using the iodine–starch filter paper method. Stimulated whole salivary flow rates were also measured using the gum test (stimulated-WF). ResultsBoth labial-MF and stimulated-WF were significantly lower in xerostomia subjects than in controls. There was a positive correlation between labial-MF and stimulated-WF in control but not xerostomia subjects. In xerostomia subjects compared to controls, there was a significantly larger reduction in labial-MF than in stimulated-WF. Xerostomia was most accurately diagnosed using a labial-MF cutoff value of 0.25μL/cm2/min. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy at this cutoff value were 1.00, 0.87, 0.93, 1.00, and 0.96, respectively. Compared to respective values of 0.64, 1.00, 1.00, 0.56, and 0.75 for stimulated-WF at the traditional cutoff of 1.0mL/min, these data indicate the higher sensitivity, negative predictive value, and diagnostic accuracy of labial-MF. ConclusionsXerostomia was more strongly related to reduction of labial-MF than to that of stimulated-WF. Xerostomia was most likely triggered at a labial-MF cut-off value of 0.25μL/cm2/min based on results from the iodine–starch method.

Effect of Pilocarpine Mouthwash on Xerostomia

Xerostomia is subjective feeling of dry mouth, a symptom that may or may not be accompanied by hyposalivation, an objective decrease in salivary flow. There are many causes induced xerostomia like drugs, salivary gland diseases, radiation therapy to the head and neck region, Sjogren syndrome, emotional stress etc. Insufficient salivary flow creates complications with oral candidiasis, dental caries, periodontitis, halitosis, dysgeusia. So finally, these complications lead to an overall decline in quality of life. Managements of xerostomia are eliminating or alterating the etiologic factors, relieving symptoms, preventing or correcting the consequences of salivary dysfunction, treating underlying disease and stimulating salivation. One of the salivation stimulation agents studied to treat xerostomia was the pilocarpine muscarinic agonist. Pilocarpine is one of salivation stimulants, a parasympathomimetic drug and non-selective muscarinic receptor agonist. Systemic pilocarpine has been used to stimulate salivary secretion. But systemic administration of pilocarpine has limitations such as increased risk of side effects and contraindications. Side effects of systemic pilocarpine administration are sweating, urinary and gastrointestinal disturbance, risk of cardiovascular and pulmonary disorders. This drug must be used carefully by patients with controlled asthma, chronic bronchitis, pulmonary or cardiac disease. Patient with acute asthma, narrow angle glaucoma, iritis should not use pilocarpine. Like this, systemic pilocarpine has many limitations. So, many investigators also have looked at the effectiveness of topical pilocarpine. Here we present patients with xerostomia which was relieved by pilocarpine mouthwash.

Isolation of Mouse Salivary Gland Stem Cells

Mature salivary glands of both human and mouse origin comprise a minimum of five cell types, each of which facilitates the production and excretion of saliva into the oral cavity. Serous and mucous acinar cells are the protein and mucous producing factories of the gland respectively, and represent the origin of saliva production. Once synthesised, the various enzymatic and other proteinaceous components of saliva are secreted through a series of ductal cells bearing epithelial-type morphology, until the eventual expulsion of the saliva through one major duct into the cavity of the mouth. The composition of saliva is also modified by the ductal cells during this process.In the manifestation of diseases such as Sjögren's syndrome, and in some clinical situations such as radiotherapy treatment for head and neck cancers, saliva production by the glands is dramatically reduced 1,2. The resulting xerostomia, a subjective feeling of dry mouth, affects not only the ability of the patient to swallow and speak, but also encourages the development of dental caries and can be socially debilitating for the sufferer.The restoration of saliva production in the above-mentioned clinical conditions therefore represents an unmet clinical need, and as such several studies have demonstrated the regenerative capacity of the salivary glands 3-5. Further to the isolation of stem cell-like populations of cells from various tissues within the mouse and human bodies 6-8, we have shown using the described method that stem cells isolated from mouse salivary glands can be used to rescue saliva production in irradiated salivary glands 9,10. This discovery paves the way for the development of stem cell-based therapies for the treatment of xerostomic conditions in humans, and also for the exploration of the salivary gland as a microenvironment containing cells with multipotent self-renewing capabilities.

Isolation of Mouse Salivary Gland Stem Cells

Mature salivary glands of both human and mouse origin comprise a minimum of five cell types, each of which facilitates the production and excretion of saliva into the oral cavity. Serous and mucous acinar cells are the protein and mucous producing factories of the gland respectively, and represent the origin of saliva production. Once synthesised, the various enzymatic and other proteinaceous components of saliva are secreted through a series of ductal cells bearing epithelial-type morphology, until the eventual expulsion of the saliva through one major duct into the cavity of the mouth. The composition of saliva is also modified by the ductal cells during this process. In the manifestation of diseases such as Sjögren's syndrome, and in some clinical situations such as radiotherapy treatment for head and neck cancers, saliva production by the glands is dramatically reduced 1,2. The resulting xerostomia, a subjective feeling of dry mouth, affects not only the ability of the patient to swallow and speak, but also encourages the development of dental caries and can be socially debilitating for the sufferer. The restoration of saliva production in the above-mentioned clinical conditions therefore represents an unmet clinical need, and as such several studies have demonstrated the regenerative capacity of the salivary glands 3-5. Further to the isolation of stem cell-like populations of cells from various tissues within the mouse and human bodies 6-8, we have shown using the described method that stem cells isolated from mouse salivary glands can be used to rescue saliva production in irradiated salivary glands 9,10. This discovery paves the way for the development of stem cell-based therapies for the treatment of xerostomic conditions in humans, and also for the exploration of the salivary gland as a microenvironment containing cells with multipotent self-renewing capabilities.