Determining the relationship among stress, xerostomia, salivary flow rate, and the quality of life of undergraduate dental students

Abstract

Objective Xerostomia may result in several oral conditions, which ultimately affect oral health-related quality of life (OHRQOL). This study aims to evaluate the relationship of stress, xerostomia, salivary flow rate, and OHRQOL among young adults. Method We invited 72 participants to complete three validated questionnaires including the Perceived Stress Scale-10 (PSS-10), a shortened version of the Xerostomia Inventory (SXI), and the shortened Oral Health Impact Profile (S–OHIP). Unstimulated saliva was collected, and flow rate was determined. Based on the SXI scores and hyposalivation, the participants were categorised into four groups: subjective xerostomia, subjective and objective xerostomia, objective xerostomia, and true non-xerostomia. Based on the median PSS score, participants were categorised into high stress and low stress groups. Data were analysed using the Mann–Whitney U test, Kruskal–Wallis H test, and Spearman's correlation coefficient. A p value of 0.05 was set for all tests. Results A significant difference was observed in the unstimulated salivary flow rate (χ 2 (3) = 26.677, p < 0.001) and PSS scores (X 2 (3) = 8.552, p = 0.036) between xerostomia groups, while OHIP scores were not statistically different (X 2 (3) = 5.488, p = 0.139). A significant correlation was observed between SXI and S–OHIP scores ( r = 0.348, p = 0.003) and unstimulated salivary flow rate and PSS ( r = −0.259, p = 0.028). Conclusion This study shows that perceived stress can influence salivary flow rate. Among the xerostomia groups, stress scores and salivary flow rates varied significantly. Additionally, subjective xerostomia has an impact on OHRQOL.

Salivary aquaporin-3 as a screening biomarker for xerostomia in patients with periodontal disease and the effects of xerostomia on oral health-related quality of life

“…Current understanding distinguishes subjective xerostomia from hyposalivation as xerostomic individuals may report normal or even high salivary flow rates [34]. This study, in line with earlier investigations, found no correlation between unstimulated salivary flow rate and SXI [70]. Others have reported a weak correlation between flow rate and xerostomia [71,72].…”

Correlation of depression, anxiety and stress symptoms with xerostomia symptoms among medical and dentistry students in pre-clinical and clinical phase

“…2 Other studies investigating xerostomia among dentistry students also found that majority of their student have some form of xerostomia. 4,6 We also observed that medical and dentistry students have similar pattern of depression and anxiety where the severe symptoms only reported by the smallest percentage of students. Knipe et al also compared among medical and dentistry students but found that dentistry students have higher depression and anxiety risk.…”

“…1-4 Depression, anxiety and stress have been implicated with oral health disturbances, such as xerostomia. 5,6 Xerostomia has been known to poses some risks to gingivitis in young adults. 4,7,8 This study was conducted to investigate whether symptoms of depression, anxiety and stress correlates with symptoms of xerostomia among young adults attending medical and dentistry school.…”

Prosthodontic implications of saliva and salivary gland dysfunction

“…Multiple medications (polypharmacy) were found to induce morphological changes in minor salivary glands consisting of fatty replacement contributing to the observed hypofunction 21 ; whether similar medication‐induced changes contribute to major salivary gland hypofunction is still unclear. In some populations, xerostomia was found to be more prevalent in females than males regardless of medication status, likely as a result of hormonal changes; however, factors such as anxiety and stress could not be totally factored out in examined study cohorts 22,23 …”