Objective
The goal of this article is to review existing research on the prevalence and etiology
of dry mouth in the vulnerable elders and identify knowledge gaps.
Study Design
Vulnerable elders (VE) are persons aged >65 years who have any or all of the following:
limited mobility, limited resources, or complex health status. A systematic search
was conducted of PubMed sources from 1989 to May 2010. Evidence was evaluated on the
prevalence and etiology of xerostomia and salivary gland hypofunction (SGH) in VE.
Results
The search identified 1,422 publications. The inclusion/exclusion criteria yielded
348 articles, 80 of which are cited herein.
Conclusions
Research has showed a high prevalence of xerostomia and SGH in VE. Common etiologies
include medications, poor general health, female gender, and age. Gaps still exist
in the evaluation of dry mouth in VE. Nonetheless, oral dryness will remain an important
health issue as life expectancy increases.
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References
- The xerostomia inventory: a multi-item approach to measuring dry mouth.Community Dent Health. 1999; 16: 12-17
- Dry mouth and its effects on the oral health of elderly people.J Am Dent Assoc. 2007; 138: 15S-20S
- Dry mouth: aging and oral health.Compend Contin Educ Dent. 2002; 23: 41-48
- Age and medication are significant risk factors for xerostomia in an English population, attending general dental practice.Gerodontology. 2001; 18: 21-24
- Prevalence of perceived symptoms of dry mouth in an adult Swedish population—relation to age, sex and pharmacotherapy.Community Dent Oral Epidemiol. 1997; 25: 211-216
- Mouth dryness as reported by older Floridians.Community Dent Oral Epidemiol. 1993; 21: 390-397
- Dry eyes or mouth—an epidemiological study in Swedish adults, with special reference to primary Sjogren's syndrome.J Autoimmun. 1989; 2: 521-527
- A 15-yr longitudinal study of xerostomia in a Swedish population of 50-yr-old subjects.Eur J Oral Sci. 2009; 117: 13-19
- Prevalence of symptoms of dry mouth and their relationship to saliva production in community dwelling elderly: the SEE project.J Rheumatol. 1998; 25: 486-491
- Xerostomia and associated factors in a community-dwelling adult population.Community Dent Oral Epidemiol. 1996; 24: 312-316
- Subjective reports of oral dryness in an older adult population.Community Dent Oral Epidemiol. 1993; 21: 165-168
- Salivary conditions and cariogenic microorganisms in 55, 65, and 75-year-old Swedish individuals.Scand J Dent Res. 1990; 98: 197-210
- Self-perceived oral function in elderly residents in a suburban area of Stockholm, Sweden.Oral Health Prev Dent. 2004; 2: 195-201
- The occurrence of xerostomia and salivary gland hypofunction in a population-based sample of older South Australians.Spec Care Dentist. 1999; 19: 20-23
- Hyposalivatory drug use, whole stimulated salivary flow, and mouth dryness in older, long-term care residents.Spec Care Dentist. 1989; 9: 12-18
- Xerostomia, xerogenic medications and food avoidances in selected geriatric groups.J Am Geriatr Soc. 1995; 43: 401-407
- Socio-medical condition and oral functional status in an older institutionalised population.Gerodontology. 1999; 16: 21-28
- Medication and perception of dry mouth in a population of institutionalised elderly people.N Z Med J. 1993; 106: 219-221
- Oral health conditions of community-dwelling cognitively intact elderly persons with disabilities.Gerodontology. 2007; 24: 67-76
- Associations between self-assessed masticatory ability, nutritional status, prosthetic status and salivary flow rate in hospitalized elders.Oral Dis. 1999; 5: 32-38
- Caries activity and associated risk factors in elderly hospitalised population—15-months follow-up in French institutions.Gerodontology. 1999; 16: 47-58
- Oral and nutritional status in frail elderly.Spec Care Dentist. 2003; 23: 209-215
- Salivary flow and its relation with oral symptoms in terminally ill patients.Cancer. 2000; 88: 984-987
- Xerostomia in patients with advanced cancer.J Pain Symptom Manage. 2001; 22: 820-825
- Oral health status of 207 head and neck cancer patients before, during and after radiotherapy.Clin Oral Investig. 2008; 12: 19-24
- The dental awareness and needs of a Parkinson's disease population.Gerodontology. 1995; 12: 99-103
- Xerostomia, hyposalivation, and oral microbiota in type 2 diabetic patients: a preliminary study.J Med Assoc Thai. 2009; 92: 1220-1228
- Associations between xerostomia and health status indicators in the elderly.J R Soc Promot Health. 2006; 126: 79-85
- A quantitative study of histological changes in the human parotid gland occurring with adult age.J Oral Pathol. 1987; 16: 505-510
- Salivary gland hypofunction in elderly patients.J Calif Dent Assoc. 1994; 22: 62-68
- Principles of surgical risk assessment of the elderly patient.J Oral Maxillofac Surg. 1990; 48: 972-979
- Is reduced salivary flow normal in old people?.Lancet. 1990; 336: 1507
- Association between salivary flow rate and the use of systemic medication among 76-, 81-, and 86-year-old inhabitants in Helsinki, Finland.J Dent Res. 1992; 71: 1875-1880
- Evaluation of unstimulated whole saliva flow rate and stimulated parotid flow as confirmatory tests for xerostomia.Clin Exp Rheumatol. 1989; 7: 127-129
- Xerostomia in older adults: a longitudinal study.Gerodontology. 1995; 12: 18-25
- Parotid gland–sparing 3-dimensional conformal radiotherapy results in less severe dry mouth in nasopharyngeal cancer patients: a dosimetric and clinical comparison with conventional radiotherapy.Radiother Oncol. 2005; 75: 204-209
- Elderly Canadians residing in long-term care hospitals: part I.J Can Dent Assoc. 2002; 68: 353-358
- A longitudinal study of medication exposure and xerostomia among older people.Gerodontology. 2006; 23: 205-213
- A reference guide to drugs and dry mouth.Gerodontology. 1986; 5: 75-99
- Risk indicators and risk markers for periodontal disease experience in older adults living independently in Ontario, Canada.J Dent Res. 1993; 72: 9-17
- Longitudinal study of stimulated whole saliva in an elderly population.Scand J Dent Res. 1992; 100: 340-345
- A comparison of prescription medication use by nursing home and homebound dental patients.Spec Care Dentist. 1990; 10: 152-155
- Xerostomia: prevalence and pharmacotherapy.Swed Dent J Suppl. 1996; 116: 1-70
- Salivary gland hypofunction in elderly patients attending a xerostomia clinic.Gerodontology. 1995; 12: 67-72
- Salivary flow rate and clinical characteristics of patients with xerostomia according to its aetiology.J Oral Rehabil. 2010; 37: 185-193
- The establishment of a xerostomia clinic: a prospective study.Br J Oral Maxillofac Surg. 1997; 35: 96-103
- Xerostomia secondary to Sjogren's syndrome in the elderly: recognition and management.Drugs Aging. 2005; 22: 887-899
- Subjective and clinical oral symptoms in patients with primary Sjogren's syndrome.Clin Exp Rheumatol. 1995; 13: 725-731
- Evaluation of palatal saliva flow rate and oral manifestations in patients with Sjogren's syndrome.Oral Dis. 2006; 12: 480-486
- Oral health status of southern Chinese following head and neck irradiation therapy for nasopharyngeal carcinoma.J Dent. 1999; 27: 21-28
- Importance of the initial volume of parotid glands in xerostomia for patients with head and neck cancers treated with IMRT.Jpn J Clin Oncol. 2005; 35: 375-379
- Patients with head and neck cancer cured by radiation therapy: a survey of the dry mouth syndrome in long-term survivors.Head Neck. 2002; 24: 737-747
- Partial irradiation of the parotid gland.Semin Radiat Oncol. 2001; 11: 234-239
- Oral dryness and peripheral neuropathy in subjects with type 2 diabetes.J Diabetes Complications. 2003; 17: 192-198
- Dental care habits and knowledge of oral health in insulin-dependent diabetics.Scand J Dent Res. 1989; 97: 207-215
- A longitudinal analysis of salivary flow in control subjects and older adults with type 2 diabetes.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 91: 166-173
- Longitudinal study on oral health in subjects with Alzheimer's disease.J Am Geriatr Soc. 1994; 42: 57-63
- Salivary hypofunction in patients with familial amyloidotic polyneuropathy.Oral Surg Oral Med Oral Pathol. 1992; 74: 742-748
- The relationship between dental disease and cerebral vascular accident in elderly United States veterans.Ann Periodontol. 1998; 3: 161-174
- Impact of xerostomia on oral complaints in a group of elderly Turkish removable denture wearers.Arch Gerontol Geriatr. 2009; 49: 263-267
- Low unstimulated salivary flow and subjective oral dryness: association with medication, anxiety, depression, and stress.J Dent Res. 2000; 79: 1652-1658
- Hepatitis C infection and associated oral health problems.Aust Dent J. 2000; 45: 108-114
- Xerostomy, dental caries and periodontal disease in HIV+ patients.Braz J Infect Dis. 2009; 13: 13-17
- Stimulated parotid salivary flow rates in normotensive, hypertensive, and hydrochlorothiazide-medicated.J Oral Pathol Med. 1994; 23: 280-283
- Dental health status of liver transplant candidates.Liver Transplant. 2007; 13: 280-286
- Effects of estrogen status and aging on salivary flow rates in healthy Caucasian women.Gerontology. 1998; 44: 32-39
- Chronic sialadenitis in patients with nodal osteoarthritis.Br J Rheumatol. 1997; 36: 1312-1317
- Prevalence and early detection of oral fungal infection: a cross-sectional controlled study in a group of Swedish end-stage renal disease patients.Scand J Urol Nephrol. 2009; 43: 325-330
- Characteristics of rheumatoid arthritis patients with self-reported sicca symptoms: evaluation of medical, salivary and oral parameters.Oral Dis. 1997; 3: 254-261
- Factors associated with oral problems among adults with spinal cord injury.J Spinal Cord Med. 2009; 32: 408-415
- Xerostomia after acute stroke.Cerebrovasc Dis. 2009; 28: 624-626
- Oral and ocular sicca symptoms and findings are prevalent in systemic lupus erythematosus.J Oral Pathol Med. 1999; 28: 317-322
- Xerostomia in systemic sclerosis: systematic evaluation by salivary scintigraphy and lip biopsy in thirty-four patients.Arthritis Rheum. 1994; 37: 439-441
- Comparison of the GOHAI and OHIP-14 as measures of the oral health–related quality of life of the elderly.Community Dent Oral Epidemiol. 2001; 29: 373-381
- Detection of mild hyposalivation in elderly people based on the chewing time of specifically designed disc tests: diagnostic accuracy.J Am Geriatr Soc. 2009; 57: 691-696
- Using the modified Schirmer test to measure mouth dryness: a preliminary study.J Am Dent Assoc. 2005; 136: 164-170
- Evaluation of some electrical methods for objective assessment of oral mucosal dryness.Scand J Dent Res. 1990; 98: 520-528
- Preliminary results of moisture checker for mucus in diagnosing dry mouth.Oral Dis. 2005; 11: 405-407
- Light microscopy of dried saliva in the evaluation of xerostomia of the sicca syndrome.J Rheumatol. 1992; 19: 1390-1392
- Issues in the epidemiological investigation of dry mouth.Gerodontology. 2005; 22: 65-76
Article info
Publication history
Published online: May 07, 2012
Accepted:
November 15,
2011
Received in revised form:
November 9,
2011
Received:
March 13,
2011
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
