Xerostomia and hyposalivation in orthogeriatric patients with fall history and impact on oral health-related quality of life

Abstract

PurposeFalls are a common cause of morbidity and mortality in older people, and identification of risk indicators and risk factors to prevent falling is essential. Dry mouth (xerostomia and hyposalivation) can exacerbate conditions known to be fall risk indicators, such as nutritional status and sarcopenia. But there is little evidence regarding whether it is an independent risk factor for falling. We explored xerostomia prevalence and intensity and objective salivation rates in hospitalized geriatric patients to determine whether they were associated with an increased risk of falling.Patients and methodsHospitalized geriatric patients with and without a fall history were compared. We investigated several oral health issues including xerostomia, stimulated and unstimulated salivation rates, total number of teeth and prosthetics, periodontal status, and oral health-related quality of life.ResultsForty patients were included, 28 in the fall history group and 12 in the control group. All patients had oral health issues that impacted on their oral health-related quality of life. However, there were no significant differences between the groups, including xerostomia and hyposalivation, apart from increased dysphagia and less flavor in food in patients with a fall history.ConclusionDry mouth does not appear to be an independent risk factor for falling in this population, but oral health was impaired. Thus, it is important that dentists and geriatricians are aware of and investigate these conditions in their patients and that appropriate action is taken to reduce the consequences of impaired oral health, including a potential reduction in falls.

Prevalence of hyposalivation in older people: A systematic review and meta‐analysis

“…The 13 included studies investigated hyposalivation prevalence in a total of 3,885 individuals. The sample size (n) ranged between 28 and 800 participants, 18,23 with ages between 60 and 100 years. Samples were obtained from Brazil, 21 Croatia, 2,3 Finland, 22 Germany, 4,18 Japan, 5,20,23 Saudi Arabia, 1 Australia, 24 USA 9 and Sweden 19 .…”

“…The range to determine hyposalivation was UnS ≤ 0.05 to 0.9 mL/min 1,9 . Beside the wide range found in the included studies, most of them varied in a lower length of UnS < 0.1 to 0.2 mL/min 2,3,18,19,21,22,24 . The salivary flow rate using the stimulated saliva (SS) method was evaluated in seven studies 4,5,9,18‐20,22 .…”

“…One study 5 extended the collection time between 10:00 AM and 15:00 PM. Seven studies did not provide details about saliva collection time 4,9,18,21‐24 …”

Relationship between Mortality and Oral Function of Older People Requiring Long-Term Care in Rural Areas of Japan: A Four-Year Prospective Cohort Study

“…This study’s findings did not show an association between number of medications and the occurrence of death; however, oral dryness is a symptom frequently noted in older adults who take multiple medications, experience dehydration, or have diabetes mellitus [ 31 , 32 ]. In addition, oral dryness also causes dysphagia [ 33 , 34 ] and induces a vicious cycle of conditions, such as undernourishment [ 35 ], decreased metabolism, susceptibility to infection, further dehydration, circulatory failure, and cardiac strain [ 36 ]. Thus, oral dryness may an important symptom that reflects overall health among older adults.…”

Efficacy of a newly developed mouth gel for xerostomia relief—A randomized double‐blind trial

“…Xerostomia is defined as a subjective feeling of dry mouth that is often, but not always, the result of hyposalivation (de Almeida Pdel, Gregio, Machado, de Lima, & Azevedo, ). Xerostomia may be caused by many medical issues and influencing factors, and has a broad impact on many functions (Barbe, ; Barbe et al, ), including difficulties in speaking, swallowing or eating, a reduced or altered taste sensation, atrophy of mucosal tissue with pain, demineralization of the teeth and occurrence of secondary infections (Epstein & Stevenson‐Moore, ). Xerostomia also negatively impacts on quality of life (Barbe et al, ; Davies, ; Dirix, Nuyts, Vander Poorten, Delaere, & Bogaert, ).…”