Subjective Sensation Of Dry Mouth Research Articles

Common Drugs Causing Xerostomia

Saliva is need for maintaining a healthy mouth environment and general health.Many factors can affect the volume and compositions of saliva. Xerostoma which refers to a subjective sensation of dry mouth, is derived from the Greek words "xeros" (ξηρός), which means "dry," and "stoma" (στόμα), which means "mouth." Reduced salivary flow and altered salivary gland composition and function are the outcomes of xerostomia.Symptoms of xerstomia include dryness or a feeling of stickiness in your mouth. Saliva that seems thick and stringy, bad breath and having hard time chewing, speaking and swallowing. There are many different causes of xerostomia, which include medicine, aging, cancer therapy, nerve damage and tabaco and alcohol use. The most common drugs causing xerstomia anticholinergic drugs, antidepressant drugs, diuretics, calcium channel blocker and beta-blockers. Different mechanism of causing xerostomia cytotoxic drugs by direct damage to salivary gland, antidepressant drugs by their anticholinergic side effects, and diuretic by excreting more fluid and electrolytes.

World Workshop on Oral Medicine VIII: Development of a core outcome set for dry mouth: a systematic review of outcome domains for xerostomia

The purpose of this study was to identify all outcome domains used in clinical studies of xerostomia, that is, subjective sensation of dry mouth. This study is part of the extended project "World Workshop on Oral Medicine Outcomes Initiative for the Direction of Research" to develop a core outcome set for dry mouth. A systematic review was performed on MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials databases. All clinical and observational studies that assessed xerostomia in human participants from 2001 to 2021 were included. Information on outcome domains was extracted and mapped to the Core Outcome Measures in Effectiveness Trials taxonomy. Corresponding outcome measures were summarized. From a total of 34,922 records retrieved, 688 articles involving 122,151 persons with xerostomia were included. There were 16 unique outcome domains and 166 outcome measures extracted. None of these domains or measures were consistently used across all the studies. The severity of xerostomia and physical functioning were the 2 most frequently assessed domains. There is considerable heterogeneity in outcome domains and measures reported in clinical studies of xerostomia. This highlights the need for harmonization of dry mouth assessment to enhance comparability across studies and facilitate the synthesis of robust evidence for managing patients with xerostomia.

Effect of Pilocarpine Mouthwash on Salivary Flow Rate in Patients with Xerostomia: A Systematic Review and Meta-Analysis.

Xerostomia is a subjective sensation of dry mouth considered as a complex state affecting multiple oral functions. Pilocarpine may be a useful medication for the treatment of xerostomia, but its side effects limit its use under certain conditions. Recent studies have focused on the pilocarpine mouthwash as an alternative. We have undertaken this study to review the latest available scientific evidence systematically, concerning the effects of pilocarpine mouthwash on salivary flow rate in patients with xerostomia. An electronic search for randomized controlled trials published in English until September 2021 related to pilocarpine mouthwash and salivary flow rate in patients with dry mouth was performed in PubMed/Medline, Web of Science, Google Scholar, Embase, and Scopus. A random-effects meta-analysis was conducted to evaluate the relationship between the groups. Two papers with 86 patients were selected for the final review based on strict eligibility criteria. According to the results of the meta-analysis, the mean visual analogue scale in the patient treated with pilocarpine mouthwash was 0.88 unit lower than that of the control group in the fourth week follow; however, it was not statistically significant (pooled mean difference=-0.88, 95% CI = (-2.72; 0.95), p= 0.34). It seems that the use of pilocarpine mouthwash can increase the salivary flow rates; however, no optimal dose and application regimen can currently be suggested due to the high heterogeneity of the data. Regarding the relief of the symptoms using pilocarpine mouthwash, the existing evidence does not support its effectiveness.

A retrospective study of drugs associated with xerostomia from the Australian Database of Adverse Event Notifications.

Xerostomia is a subjective sensation of dry mouth associated with many medications and increases the risk of tooth decay and other oral complications. The aim of this study was to identify unreported medications associated with dry mouth from the Australian Database of Adverse Event Notifications (ADAEN) from the Therapeutic Goods Administration (TGA) in Australia. This was a descriptive retrospective study. A request was made to the TGA to provide all reports associated with dry mouth. De-identified reports were provided from the commencement of the database in 1971 until June 2020. Drugs were divided into established drugs that are associated with xerostomia in the primary literature and secondary drugs not reported in the primary literature. There were 1927 individual case reports for dry mouth associated with medications. Of these, there were 1379 reports of established (primary) drugs and 1481 reports of secondary drugs associated with xerostomia. Dry mouth was found to be associated with many medication classes; analgesics, cardiovascular and gastrointestinal drugs had the greatest number of secondary drugs reported. A comprehensive list of suspected medications associated with xerostomia has been established. This adds to the growing catalogue of medications associated with dry mouth, where several medications have not previously been identified in the primary literature.

Salivary Gland Dysfunction Secondary to Cancer Treatment.

The number of cancer survivors are increasing and so are the oral toxicities from cancer therapy. Most patients receiving treatment for cancer develop some form of oral adverse events including, but not limited to, mucositis, opportunistic infections, dry mouth, and/or osteonecrosis of the jaw. One of the most common complications from head and neck cancer radiation therapy is salivary gland dysfunction (SGD). SGD is an umbrella term that includes the subjective sensation of dry mouth (xerostomia) and hyposalivation (objective reduction of the salivary flow rate). Dry mouth in cancer patients may lead to functional defects (e.g., eating, speaking, and swallowing), increase the risk of dental caries and oral candidiasis, and can have a negative effect on the nutritional and psychological status of the patients. The aim of this mini review was to summarize the current criteria for diagnosis and management of SGD associated with cancer treatment.

Mesenchymal stromal/stem cell therapy for radiation-induced salivary gland hypofunction in animal models: a protocol for a systematic review and meta-analysis

BackgroundSalivary gland (SG) hypofunction (objectively reduced saliva flow rate) and xerostomia (subjective sensation of dry mouth) are common and burdensome side effects of radiotherapy to the head and neck region. Currently, only sparse symptomatic treatment is available to ease the discomfort of xerostomia. The objective of this study is to assess the effect of mesenchymal stem cell (MSC) therapy on SG function after radiation-induced injury.MethodsThis systematic review will include animal intervention studies assessing efficacy and safety of MSCs in treating radiation-induced SG hypofunction. The primary outcome is the effect of MSC administration on salivary flow rates (SFR), by comparing treated groups to control groups when available. Secondary outcomes are morphological and immunohistochemical effects as well as safety of MSC treatment. Electronic searches in MEDLINE (PubMed) and Embase databases will be constructed and validated according to the peer review of electronic search strategies (PRESS) and assessed by two independent researchers. Data from eligible studies will be extracted, pooled, and analyzed using random-effects models. Risk of bias will be evaluated with the Systematic Review Centre for Laboratory animal Experimentation (SYRCLE) risk of bias tool.DiscussionThus far, critical appraisal of MSC therapy as an effective treatment for SG hypofunction caused solely by radiation injury has not been conducted. A summary of the existing literature on preclinical studies concerning this issue can provide valuable information about effectiveness, mode of action, and safety, allowing further optimization of preclinical and clinical trials.Systematic review registrationPROSPERO CRD42021227336

Therapeutic Strategies for Dry Mouth Management with Emphasis on Electrostimulation as a Treatment Option.

Objectives Xerostomia is a subjective sensation of dry mouth. It is commonly associated with salivary gland hypofunction. Both changes in the composition of the saliva and a reduction in the quantity secreted may be an objective finding of dry mouth. Although there are no currently available cures for the conditions resulting in dry mouth, there are several treatment options that give hope for patients who suffer from xerostomia. Individuals with some residual salivary gland function, which are contraindicated to pharmacological therapies, would benefit the most from identifying novel, alternative effective methods for stimulating production of saliva. The aim of this study was to give an overview of the latest and most relevant data related to treatment modalities for the management of dry mouth conditions. Data Resources and Study Selection. The present review was prepared by searching the National Library of Medicine database using the relevant medical terms and their combinations. A total of thirty-three studies met the inclusion criteria. Data were extracted by one author and verified by another. Conclusion A number of patients showed positive treatment outcomes, and the adverse effects of both electrical stimulation (ES) and acupuncture have been reported as mild and transient. In patients who have undergone radiotherapy, acupuncture is shown to increase salivation. However, in patients with Sjogren's syndrome, the effects of ES devices seem to be elusive. Moreover, due to the instability of the findings in relation to longevity of clinical effect, patient satisfaction, quality of life, and clinical effectiveness of such treatments, the results remain vague.

Treatment of patients with radiation-induced xerostomia using saliva substitutes as an integral part of complex substitution therapy

BACKGROUND: Dry mouth (xerostomia) can be a symptom of various diseases of human organs and systems and caused by prolonged intake of medications as well as chemoradiation treatment of malignant tumors of the maxillofacial area. Xerostomia treatment remains a challenging task.
 AIM: This study aimed to improve the treatment methods of patients with xerostomia.
 MATERIAL AND METHODS: Fifty patients with xerostomia were treated and distributed into two groups. Group 1 consisted of 23 patients treated with Hiposalix spray (France). Group 2 included 27 patients treated using the Xerostom (Spain) saliva substitute. All patients underwent sialometry, sialography, and study of the secretion viscosity before and after treatment.
 RESULTS: At 1 month after treatment, 22 (96%) patients of group 1 noted an improvement. At the same time, an objective increase in the secretion level was detected in 2 (9%) patients. All patients of group 2 noted significant improvement in the condition of the oral cavity. However, sialometry showed that the level of saliva secretion remained the same.
 CONCLUSIONS: Thus, the use of saliva substitutes produced by Hiposalix and Xerostom significantly reduced or prevented the subjective sensation of dry mouth without an objective increase in saliva secretion.

Assessment of Salivary Changes in Patients on Poly-pharmacy Medications: A Pilot Study

Saliva is a biological fluid with multifactorial functional applications with regards to the maintenance of general health. Collection of saliva is non-invasive, easy and cost-effective. Xerostomia, a subjective sensation of dry mouth is one of the most common complaints in elderly and patients on polypharmacy as it is proven as a risk factor. Polypharmacy is the simultaneous use of multiple drugs by a patient for more than one systemic disease. The aim of the study was to assess the salivary changes in patients on polypharmacy. Unstimulated saliva samples were collected from 20 individuals who reported to the Department of Special Care Dentistry at Saveetha Dental College between November to December 2019. The collected samples were then processed for analysis of three salivary parameters-Salivary glucose, amylase and pH. The data were recorded and statistically analyzed. Out of the 20 samples,12 male (60%) and 8 female(40%) with mean age group as 41.2 years. Independent t test showed statistically significant (p<0.05) values for salivary parameters in patients on polypharmacy medication. This study has shown a significant increase in salivary parameters and further studies relating the salivary changes, systemic disease and the medication involved salivary analysis can be suggested as one of the investigations in patients on polypharmacy.

Xerostomia and Hyposalivation in Patients with Physical and Psychological Disabilities

Disabilities are complex, dynamic, multidimensional and also contested; one or more key functions of the organism can be affected so to diminish an individual�s freedom of expression and of action. The transition from an individual, medical perspective to a structural, social perspective was described as a shift from a medical model to a social model where individuals are more likely considered disabled by the society then by their own bodies. Disabilities represent a part of the human condition due to its bidirectional connection with poverty: the existence of disabilities can increase the risk of poverty, and poverty can increase the risk of disability. The experience of disability that results from the interaction of the state of health, personal factors and environmental factors varies greatly. Stress, anxiety or different unpleasant moments can cause a temporary decrease in salivary flow but a constant decrease can indicate the existence of a serious health problem. Xerostomia represents the subjective sensation of dry mouth. It can be accompanied by hyposalivation, an objective phenomenon but this is not always the case. Even if the patient declares the existence of xerostomia, this does not necessarily imply the existence of hyposalivation. Xerostomia can be determined by modifications in the oral cavity, as the sensitivity level to moistening, adverse reactions to certain drugs (anti-depressants, inhibitors of the conversion enzyme). The handicap, now called disability represents a special condition of the individual, reason why he must benefit of the support of the society and of those around him. Dental treatment in patients with psychiatric disabilities must consider the general and local involutive modifications, the existent overlay polypathologies that can influence the dental treatment. The study was conducted practically and included the direct interaction as part of the medical team and the registration of 145 patients presented on request with various types of psychological disorders, sometimes covered by the mask of somatic disorders, indicating a masked depression, or a physical depression, where the emotional condition of yesterday and today differ very much. Pointing out the role of the dentist in approaching patients with physical and psychical disabilities, motivating and making them aware of the necessity of adopting a proper oral hygiene for preventing oral disorders. The dramatic impact on the psyche and the well-chosen words stressed by the clinician increase patient awareness and motivation in order to make him collaborate during the treatment.

P-24 A clinical audit of xerostomia assessment and treatment practices amongst advanced cancer patients in a palliative care setting

Background Xerostomia is the subjective sensation of dry mouth. It is the fourth most common symptom in advanced cancer patients and impacts negatively on physical and psychosocial wellbeing. Older age and polypharmacy are risk factors for dry mouth and are common in advanced disease. This study aims to evaluate prevalence of xerostomia, as well as compliance with assessment and treatment practices. Methods A retrospective chart audit was conducted on 173 admissions from an in-patient palliative care unit. Data were collected pertaining to patient demographics, cancer diagnosis, medications, oral health assessment and xerostomia treatment. Audit standards were based on local policy as follows: Oral Health Assessment Tool (OHAT) completed on all patients; OHAT completed within one day of admission; oral care plan completed if problem diagnosed; xerostomia treatment prescribed where necessary. Descriptive statistics were used to report compliance with standards. Cohen’s Kappa and Intraclass Correlation Coefficient were used for inter- and intra-rater reliability based on a 10% sample of the dataset. Results Palliative in-patients were significantly more likely than the general population to experience dry mouth (p Conclusions Results indicate that oral health is evaluated in the majority of patients, however treatment appears low. This may be partly due to poor instrument design, where non-prescription treatments or ‘treatment unnecessary’ cannot be documented. Existing tools could be amended to reflect patient care needs more accurately. A change project is currently underway within the care setting to improve practice as a result of the study.

Evaluation of Sialometric Analysis of Patients Suffering from Depressive Disorders.

Depressive disorders, worldwide, may rank second by the year 2020. In India; about 10 million people suffer from depressive disorders, the prevalence rate being recorded as 31.2 for every 1000 individuals. A significant impairment of all personal hygiene may occur due a depressive episode which in turn may result in altered salivary flow. The present study was a hospital- based clinical cross-sectional study which was conducted in Bhopal, the heart of Madhya Pradesh, India. It was done to assess the relationship of bring about a comparison of sialometric alterations between normal and subjects with depressive disorders. The survey period extended over a period of one year and two months, from May 2009 to July 2010. It was conducted in Bhopal, Madhya Pradesh, Central India. A sample size of 150 individuals, 50 of each group, was taken in the study. Whole salivary flow rates were determined by gravimetric method (i.e., in millilitres per minute). The Tenovuo criterion was used, to which numerical scores (SFI) were attributed. Results showed that the unstimulated salivary flow rates between patients of Group I and Group III (p< 0.0001) and between Group II and Group III (p < 0.0001) were statistically significant. The study also showed statistically significant relation between subjective and objective oral dryness (chi 2= 55.789, df= 6 and p< 0.0001). It was observed that subjective sensation of dry mouth may exist even in the presence of normal salivary flow rates. This might be acknowledged as a psychophysiological expression of depression and may not necessarily reflect actual salivary gland function. The lack of secreted mucins rather than the quantity of saliva may play a role in the genesis of xerostomia.

Xerostomia and its impact on oral health-related quality of life

Dry mouth is a frequently occurrence in elderly people and causes numerous clinical and social problems. To investigate the quality of life in geriatric patients living in nursing homes depending on the subjective sensation of dry mouth and associated oral parameters. A total of 62 male and female elderly patients living in 7 cooperating nursing homes were interviewed employing questionnaires with regard to their oral health-related quality of life (GOHAI) and their subjective perception of dry mouth (sXI-D). Dental status, drinking habits and current medication were documented. The mean GOHAI score was 53.6 and the mean sXI-D score was 7.9. Oral health-related quality of life was significantly influenced by the subjective sensation of dry mouth (p < 0.001), whereas no significant impact of the number of residual teeth or implants or the character of prosthetic restorations could be identified. Xerostomia was significantly influenced by the number of medications consumed (p = 0.039). Xerostomia has a significant impact on the oral health-related quality of life of elderly people living in nursing homes. Thus, dental treatment should focus on the alleviation of xerostomia to improve the oral health-related quality of life in the elderly population.

Xerostomia: An overview

Xerostomia is a subjective sensation of dry mouth with objective evidence of decreased salivary flow. It is a multifactorial condition which increases the risk of oral diseases and has a significant effect on the person's quality of life. So, these patients need special care for maintenance of oral and general health. We, being oral health care professionals, it is our responsibility to diagnose and treat the condition accordingly using a multidisciplinary approach. This paper enlightens the etiology and management of xerostomia.

The subjective meaning of xerostomia—an aggravating misery

Xerostomia, the subjective sensation of dry mouth, is associated with qualitative and quantitative changes of saliva. Poor health, certain medications and radiation therapy constitute major risk factors. To gain further understanding of this condition the present study explored the main concern of xerostomia expressed by afflicted adults. Qualitative interviews were conducted with 15 participants and analysed according to the grounded theory method. An aggravating misery was identified as the core category, meaning that the main concern of xerostomia is its devastating and debilitating impact on multiple domains of well-being. Professional consultation, search for affirmation and social withdrawal were strategies of management. The findings reveal that xerostomia is not a trivial condition for those suffering. Oral impairment as well as physical and psychosocial consequences of xerostomia has a negative impact on quality of life. There is an obvious need to enhance professional competence to improve the compassion for and the support of individuals afflicted by xerostomia.

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.

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.

Xerostomia and associated factors in a community-dwelling adult population.

Xerostomia is the subjective sensation of dry mouth. Estimates on the occurrence of xerostomia in community-dwelling adults have ranged from 10% among persons over age 50 to 40% for persons over age 65. Virtually no data are available for persons under age 50. To begin to establish a database on the occurrence of xerostomia and factors associated with it, a cross-sectional assessment of self-reported symptoms and salivary function was conducted across a broad age-range of generally healthy community-dwelling adults. A convenience sample of 710 adults who ranged from 19 to 88 years of age was drawn from various sources in the greater-Rochester, New York area. Study volunteers were administered a standardized questionnaire on general and oral health, which included questions on the symptoms of xerostomia, and were provided an oral screening examination, which included measurement of unstimulated and stimulated whole saliva flow rates. Overall, the observed prevalence of xerostomia was 24% among females and 18% among males. While xerostomia was more commonly observed in women than men, this association was only clear after age 50. Xerostomia was associated with: use of medications with hyposalivatory side-effects; difficulty with dry foods; cracked lips; dry eyes; difficulty swallowing; and, among males, current cigarette smoking. Results indicated a tendency for salivary flow rates to be lower for older persons, particularly the stimulated flow rate. There was a tendency in the younger cohorts for flow rates to be lower among individuals who reported sensation of dry mouth than among those who did not. This tendency was not apparent among older persons, suggesting that younger persons may be more likely to experience symptoms of oral dryness when salivary flow was low while older persons may relate symptoms of dry mouth to a more complex constellation of factors where salivary flow is only one component. These findings need to be examined further.