Translation, validation, and construct reliability of a Portuguese version of the Xerostomia Inventory

Oral Diseases (2012) 18 , 293–298 Objectives: To generate and validate at pretest level a cross‐culturally adapted Portuguese version of Xerostomia Inventory (XI), a 11‐item questionnaire designed to measure specific xerostomia rating of patients complaints. Methods: The original English version of the XI was translated into Portuguese following the guidelines for cross‐cultural adaptation of health‐related quality of life measures. Thirty patients with primary Sjögren syndrome were recruited for this study. The questionnaires were administered by trained and calibrated dental doctors to each patient. XI properties were examined including reliability, internal consistency, and test‐retest reliability, using Cronbach’s alpha, total and inter‐item correlation, and intra‐class correlation coefficients (ICC), respectively. Construct validity supported by objective measurements of xerostomia intra‐oral signs and salivary secretion was investigated. Alpha was set at 0.05. Informed consents and local ethical committee clearance were obtained. Results: Internal consistency and test‐retest reliability were excellent (Cronbach’s α = 0.9; ICC range = 0.79–0.94). Scatterplot interpolation and Pearson correlation coefficient suggested the presence of a strong, negative, and significant correlation between salivation and the XI scores indicating construct validity. Conclusion: The Portuguese version of the XI can be considered a reliable and valid instrument to measure patients’ xerostomia symptoms.     

Self-reported oral and general health related to xerostomia,hyposalivation, and quality of life among caries active younger adults

Abstract

Objective: The aim was to study prevalence of xerostomia, hyposalivation and quality of life among caries active younger adults.

Materials and methods: A questionnaire regarding oral and general health, xerostomia and quality of life was mailed to 134 caries active (CA) and 40 caries inactive (CI) patients, 25–50 years of age (mean age 39.9?±?6.2 years) treated at a Swedish Public Dental Service clinic, regarding oral and general health, xerostomia and quality of life. Caries data and unstimulated whole salivary flow rates were obtained from dental records.

Results: The overall response rate was 69%. Dental records confirmed that CA patients had more decayed teeth over time than CI patients (p?<?.001). The CA group reported worse oral health (p?<?.001) and general health (p?<?.01), more xerostomia (p?<?.001) and lower salivary flow rate (p?<?.01) compared to CI patients. Xerostomia was inversely related to unstimulated whole salivary flow rates as well as to oral and general health (p?<?.01). There were no differences between groups in quality of life.

Conclusion: Younger caries active adult patients reported significantly more xerostomia and hyposalivation compared to caries inactive patients. Xerostomia and hyposalivation were inversely related to perceptions of oral and general health, but not to quality of life.     

Self‐reported dry mouth among ageing people: a longitudinal,cross‐national study

Focusing on Swedish and Norwegian cohorts of community‐dwelling older adults between age 65 and 70, this study aimed to identify predictors of the prevalence and incident cases of daytime and night‐time xerostomia. It was hypothesized that the prevalence increases with increasing age and is higher in women than in men and that the prevalence of persistent xerostomia and the 5‐yr‐incident cases are higher in people with consistent use of medication and need for health care. Of the Norwegian participants who completed the 2007 survey (age 65 yr), 70% (n = 2,947) participated in 2012. Individuals participating in both 2007 and 2012 constituted the Swedish panel (80%, n = 4,862). The prevalence of xerostomia was higher in women than in men and increased from age 65 to age 70, most markedly in the Swedish cohort. The risk of persistent xerostomia was greatest for participants with consistent use of medication (OR = 1.3) and contact with a physician (OR = 2.3). The risk of incident cases of xerostomia during daytime was greatest for participants with recent and consistent use of medication and recent contact with a physician. Dental professionals should identify patients with xerostomia, emphasize early prevention, and alleviate oral symptoms in collaboration with physicians.     

A clinical trial of a novel emulsion for potential use as a saliva substitute in patients with radiation‐induced xerostomia

Researchers have recently developed a novel oily formulation for potential use as a saliva substitute for the treatment of dry mouth. The aim of this randomised, crossover study was to compare this new formulation to a currently available saliva substitute and a control of water on measures of mastication, subjective feeling of oral dryness and product acceptability. Forty participants treated with radiotherapy to the head and neck and experiencing xerostomia were invited to participate in the trial. Each participant trialled all three products in a randomised order. The effect of each product was measured using the Test of Masticating and Swallowing Solids (TOMASS), the Shortened Xerostomia Inventory (SXI) and a questionnaire designed to test patient acceptability of each product. Outcome data were gathered in a single session after the first administration of each product to evaluate immediate effects and after 7 days of use to evaluate longer‐term effects. Statistical analyses consisted of repeated‐measures analysis of variance and mixed models. There was no evidence that application of the three formulations had an effect on any of the TOMASS measures, either immediately or after one week of use (P > 0·05). There was a significant main effect of formulation on the SXI score (P = 0·02). Application of the novel emulsion resulted in a clinically small but significant improvement in SXI score (P < 0·01); however, application of methylcellulose (P = 0·21) and water (P = 0·81) resulted in no significant difference. There was no difference in participant acceptability between the three products (P = 0·32). The novel oily emulsion showed no clinically significant benefit over two existing products for relief of xerostomia. Indeed, none of the three products demonstrated significant change in patient outcomes.     

Should short‐term use of alcohol‐containing mouthrinse be avoided for fear of worsening xerostomia?

This study aimed to assess the short‐term effect of alcohol‐containing mouthrinse versus mouthrinse without alcohol on xerostomia scores reported by Xerostomia Inventory (XI ) scores and short version of the Xerostomia Inventory (SXI ). This study was a two‐group parallel‐arm randomised controlled trial where participants were randomly allocated to twice a day for 7 days use of either alcohol‐containing or alcohol‐free mouthrinse. Allocation was concealed. The participants, the outcome assessors and the statistician were blinded to the allocation status. A total of 163 participants completed the pre‐and post‐intervention data collection. There were no statistically significant differences between the study groups with respect to demographics or other measured independent variables. After adjusting for age and gender, regression coefficient (95% CI ) for XI was 0.02 (?1.72‐2.29) and that for SXI was 0.03 (?0.54‐0.83). Both adjusted and unadjusted models showed no significant differences in change in XI or SXI . The mean difference in scores between the groups for XI was ?0.45 (?2.45‐1.55) and for SXI was 0.05 (?0.65‐0.75). There was no significant difference in the change in xerostomia levels as a result of short‐term exposure to alcohol‐containing mouthrinse, when compared to those exposed to alcohol‐free mouthrinse. Short‐term use of alcohol‐containing mouthrinse does not result in worsening xerostomia.     

Prevalence of Candida spp., xerostomia,and hyposalivation in oral lichen planus – A controlled study

Objective

To determine the frequency of Candida spp., xerostomia, and salivary flow rate (SFR) in three different groups: patients with OLP (OLP group), patients with oral mucosal lesions other than OLP (non‐OLP group), and subjects without oral mucosal lesions (control group).

Material and methods

Xerostomia as well as SFR was investigated in the three groups. Samples for isolation of Candida spp. were collected from OLP lesions (38 patients), non‐OLP lesions (28 patients), and healthy subjects (32 subjects).

Results

There was no statistically significant difference regarding the frequency of xerostomia and hyposalivation among the three groups (P > 0.05). A higher prevalence for colonization by Candida spp. was found in the healthy subject as compared to that of patients with OLP (P = 0.03) and non‐OLP (P = 0.02) groups. Low SFR was not a factor for colonization by Candida spp.

Conclusions

Xerostomia and hyposalivation occur with similar frequency in subjects with and without oral lesions; also, the presence of oral lesions does not increase the susceptibility to colonization by Candida spp. It seems that any study implicating Candida spp. in the malignant transformation of oral lesions should be carried out mostly on a biochemical basis, that is, by testing the capability of Candida spp. to produce carcinogenic enzyme.     

Sicca symptoms,and lacrimal and salivary flow in Albanian patients with rheumatoid arthritis

J Oral Pathol Med (2010) 39 : 651–656 Background: Rheumatoid arthritis affects primarily the synovial joints, but is often accompanied by extra‐articular manifestations, including lacrimal and salivary gland involvement. The aim of the present study was to estimate the prevalence of ocular and oral sicca symptoms and reduced lacrimal and salivary flow in rheumatoid arthritis and the relation between sicca symptoms and objective measures of lacrimal and salivary flow. Methods: We examined 88 consecutive hospitalized patients with rheumatoid arthritis and 88 age‐ and gender‐matched healthy controls. The examination included the standardized questionnaire for keratoconjunctivitis sicca and xerostomia which forms part of the European criteria for Sjögren’s syndrome, the Schirmer’s I test and measurement of unstimulated whole salivary flow rate. Results: A significantly higher proportion of patients (40.9%) reported ocular sicca symptoms than healthy matched controls (8.0%). Further, a significantly higher proportion of patients (44.3%) reported oral sicca symptoms compared to controls (13.6%). 48.9% of the patients had low Schirmer I score, compared to 20.5% of controls. Reduced salivary flow was found in 27.3% of patients, compared to 9.1% of controls. The differences in lacrimal and salivary flow between patient and control group were statistically significant. The minimum prevalence of secondary Sjögren’s syndrome was 14.8%. Weak association was observed between sicca symptoms and the objective measures of lacrimal and salivary flow in patients, and no association was detected in control subjects. Conclusions: Sicca symptoms and reduced lacrimal and salivary flow were common manifestations in rheumatoid arthritis and should be given adequate consideration during management of patients with rheumatoid arthritis.     

Salivary interleukin-6 and tumor necrosis factor alpha in patients with drug-induced xerostomia

It is well known that cytokines are involved in the homeostasis of oral cavity and that altered levels of either serum and/or salivary cytokines have been found in certain oral/systemic diseases. So far, cytokines in connection with xerostomia have been investigated in patients with Sjögren's syndrome. We wanted to find out whether drugs themselves influence salivary glands, which would result in altered cytokine level or whether xerostomia itself of different causes leads to the changes in salivary cytokine levels. Therefore, the aim of this study was to evaluate levels of salivary interleukin‐6 (IL‐6) and tumor necrosis factor (TNF)‐α in 30 patients with drug‐induced xerostomia, age range 29–84 and mean 63.9 years. Control group consisted of 30 healthy participants, age range 30–82 years and mean age 65.2 years. Enzyme‐linked immunoassay was performed on commercially available kits. Statistical analysis was performed by use of Student's test. No significant differences in salivary IL‐6 and TNF‐α between patients with drug‐induced xerostomia when compared with the healthy controls were found (P < 0.05). We might conclude that drugs do not induce damage to the salivary glands which could be seen in altered salivary IL‐6 and TNF‐α levels and that xerostomia itself, induced by drugs does not alter levels of the investigated salivary cytokines.     

Dental patients' self-reports of xerostomia and associated risk factors

BackgroundMost studies regarding xerostomia focus on elderly people. Therefore, the authors conducted a study of dental patients 18 years or older to determine the prevalence of self-reported xerostomia and associated risk factors.MethodsThe authors sent a total of 2,200 questionnaires to four dental clinics to assess patients’ self-reported xerostomia. They also collected sociodemographic data and information regarding personal behavior. They used logistic regression models to estimate odds ratios (OR) and 95 percent confidence intervals (CI) to explore the relationship between self-reported xerostomia and risk factors that reasonably might be expected to be associated with self-reported xerostomia.ResultsThe overall prevalence of xerostomia in participants was 7 percent. Participants with burning-mouth sensations were associated with having higher odds of experiencing dry mouth (OR, 2.1; 95 percent CI, 0.9–5.2). Participants 51 years or older were significantly more likely to report having dry mouth than were younger participants (P < .04). The prevalence of self-reported xerostomia increased with increasing numbers of medications patients reported using.ConclusionThe authors found that medication use and age were highly significant risk factors for dental patients reporting xerostomia.Clinical ImplicationsClinicians should interview their patients carefully regarding their use of medications and provide proper oral health care to improve xerostomia resulting from medication use.     

Self-reported dry mouth in 50- to 80-year-old Swedes: Longitudinal and cross-sectional population studies

Xerostomia is a common condition among elderly. The objectives were to examine prevalence, persistence, progression, yearly incidence of xerostomia, associated background factors and its influence on oral impacts on daily performances (OIDP) in 50- to 80-year-old people. In 1992, a questionnaire was sent to all 50-year-old (n = 8888) and in 2007 to all 75-year-old persons (n = 5195) living in two Swedish counties. In 2012, the same questionnaire was sent to both age cohorts, now 70- and 80-year-old. Response rate was for the 50-, 70- 75- and 80-year-old groups 71.4%, 72.2%, 71.9% and 66.4%, respectively. In the 50- to 70-year-old sample, 40.3% of the participants answered all five examinations and in the 75-80 group 49.5% (intact samples). In all age groups, xerostomia was significantly more prevalent in women than in men. At age 80, “often mouth dryness at night” was reported by 24.3% and 16.2% of women and men, respectively. Prevalence increased with age and was more frequent at night-time. Persistence of xerostomia was reported by 61.4%-77.5%, progression by 11.5%-33.0% and remission by 5.7%-11.3%. Average yearly incidence was 0.99%-3.28%. Xerostomia was more prevalent in those who reported a negative impact on OIDP. Highest odd ratios for xerostomia were burning mouth (OR 12.0), not feeling healthy (OR 5.1) and medicine usage (OR 3.9). Xerostomia is common in older age, persistence is high and progression common. The comorbidity between xerostomia, oral health problems and impaired general health needs to be taken into consideration when providing dental care to elderly patients.     

Randomized-controlled trial: effect of a reservoir biteguard on quality of life in xerostomia

BACKGROUND: To assess the effect of a reservoir biteguard for artificial saliva on the oral health-related quality of life of patients with xerostomia. METHODS: Double-blind randomized placebo-controlled trial among 86 adults with xerostomia. Study group received the trial biteguard. Control group received a conventional biteguard. Outcomes were number of impacts and total scores as recorded by oral impacts on daily performances (OIDP). RESULTS: At 1-month follow up 84 people remained in the trial. The median number of impacts in the study and control groups was 3 and 4 respectively. The median total score was 6 and 12 respectively. In ANCOVA receipt of the reservoir biteguard reduced the number of impacts recorded by OIDP but there was no difference in the total score. CONCLUSIONS: Reservoir biteguards improved the quality of life of people with xerostomia by reducing the number of impacts on daily life.     

Utility of two oral health-related quality-of-life measures in patients with xerostomia

OBJECTIVES: The study compared the validity of the short form of the Oral Health Impact Profile (OHIP) and Oral Impacts on Daily Performance (OIDP) as measures of oral health-related quality of life in patients with xerostomia in the UK. METHODS: A cross-sectional comparison of OHIP14 and OIDP with measures of clinical indicators, xerostomia symptom status, speech function, global oral health ratings and psychological well-being, in 85 patients attending outpatient clinics. RESULTS: Both OHIP14 and OIDP had excellent internal reliability, and good criterion and construct validity when used in this population of xerostomia patients. In regression analyses, salivary gland condition and xerostomia symptom status significantly predicted oral health-related quality of life (OHRQoL), accounting for 29% and 14% of the variance in OHIP and OIDP scores respectively. In turn, OHRQoL predicted global ratings of oral health (26% of variance) and psychological well-being (depression) scores (15%). Sex, ethnicity and age were associated with clinical presentation and patient-reported symptoms. Clinical presentation, OHRQoL (as measured by the OIDP) and speech function were related to duration of symptoms. CONCLUSION: Both OHIP14 and OIDP have good psychometric properties and appear useful measures of OHRQoL in xerostomia. Overall, the OHIP14 performed better than did OIDP. For both measures, the additive scoring method may be more relevant for this population that the number of impacts.     

Salivary flow rate and clinical characteristics of patients with xerostomia according to its aetiology

Summary The purpose of the present study was to investigate the differences in salivary flow rates and dry mouth‐related subjective symptoms and behaviours in patients with xerostomia according to its aetiology. One hundred and forty patients (24 men and 116 women, mean age, 58·1 ± 13·3 years) with a chief complaint of xerostomia were included. The patients were divided into five groups; Sjögren’s syndrome (n = 34), post‐radiation therapy in the head and neck region (n = 16), antipsychotic medications (n = 30), systemic diseases or medications affecting salivary flow (n = 35), and unknown aetiology (n = 25). The patients were asked a standardized series of questions concerning dry mouth, and their whole salivary flow rates were measured. Patients with a history of radiation therapy displayed the most decreased values of salivary flow rates and the most severe associated symptoms and behaviours while patients with unknown aetiology displayed the least decreased values of salivary flow rates and relatively favourable symptoms and behaviours. A burning sensation in the mouth was the most prevalent in patients with systemic diseases or those who were taking medications while altered taste perception was the most prevalent in patients taking antipsychotics. In conclusion, patients with xerostomia displayed various degrees of discomfort related to the quality of life according to the aetiology of their conditions.     

Evaluation of the clinical efficacy of a betaine-containing mouthwash and an intraoral device for the treatment of dry mouth

J Oral Pathol Med (2012) 41 : 201–206 Objective: An evaluation is made of the efficacy and safety of an intraoral device with a betaine (BET)‐containing mouthwash in treating xerostomia. Methods: A total of 105 patients with dry mouth (xerostomia) were included in a randomized, non‐blinded, parallel‐group, controlled clinical trial. The patients were assigned to one of the three groups: A (night guard), B (mouthwash), or C (night guard and mouthwash). A xerostomia questionnaire was administered, and unstimulated salivary flow was measured. The Oral Health Impact Profile (OHIP) – 14 was assessed. All measurements were taken before and after treatment, which had a duration of 4 weeks. The patients in turn completed a treatment satisfaction questionnaire. Results: Ninety patients (eight men and 82 women) completed the study. All three treatments alleviated the symptoms of xerostomia, with improvement in the OHIP‐14 scores and sialometry findings. There were no adverse effects. Patient satisfaction with the treatment received showed no statistically significant differences among the three groups; though, the patients in group A considered treatment to have been extremely beneficial in 10% of the cases, while 43% considered it to have been beneficial. Conclusions: The daily use of a night guard and BET‐containing mouthwash was seen to improve dry mouth during the 4‐week duration of the study.     

Sleep quality in patients with xerostomia: a prospective and randomized case-control study

Objectives To investigate sleep quality, anxiety/depression and quality-of-life in patients with xerostomia. Materials and methods This prospective, observational, cross-sectional study was conducted among a group of xerostomia patients (n?=?30) compared with 30 matched control subjects. The following evaluation scales were used to assess the psychological profile of each patient: the Hospital Anxiety and Depression Scale, the Oral Health Impact Profile-14 (OHIP-14), the Xerostomia Inventory, the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Results The PSQI obtained 5.3 3?±?1.78 for patients with xerostomia compared with 4.26?±?1.01 for control subjects (p?=?0.006); ESS obtained 5.7?±?2.1 for test patients vs 4.4 0?±?1 for control subjects (p?=?0.010). Statistical regression analysis showed that xerostomia was significantly associated with depression (p?=?0.027). Conclusions Patients with xerostomia exhibited significant decreases in sleep quality compared with control subjects.     

Antiseptic mouthwashes could worsen xerostomia in patients taking polypharmacy

Abstract

Objective. Polypharmacy is a common cause of xerostomia. This study aimed to investigate whether xerostomia could be an adverse drug event of mouthwashes, when they are used for longer than 2 weeks by patients taking polypharmacy. Materials and methods. This cross-sectional observational study included 120 hospitalized patients (60 middle-aged and 60 elderly patients), taking polypharmacy (≥4 drugs daily) and at risk of drug-induced xerostomia. Xerostomia was assessed by questioning participants. Results. A total of 62.5% of patients complained of xerostomia. In the middle-aged group (mean age = 44.0 (8.7) years; 35.0% women) xerostomia seemed independently associated to mouthwashes, at the limit of significance (OR = 5.00, 95% CI = 0.99–25.3, p = 0.052). Active principles in mouthwashes were mainly quaternary ammonium compounds (91.9%). Mouthwashes may disturb the healthy balance of the biofilm moisturizing the oral mucosa. The biofilm contains mucins, salivary glycoproteins with oligosaccharides side chains able to sequester water and endogenous bacteria surrounded by a glycocalyx. Oral bacteria are fully susceptible to quaternary ammonium (chlorhexidine, hexetidine, cetylpyridinium chloride) and to other antiseptics used in mouthwashes, such as betain, resorcin, triclosan, essential oils and alcohol. However, caregivers currently recommend such dental plaque control products to patients suffering from xerostomia in order to reduce the risk of caries and periodontitis. Conclusion. This study is the first report that use of antiseptic mouthwashes for more than 2 weeks could worsen xerostomia in patients taking polypharmacy. Oral care protocols should avoid this iatrogenic practice, particularly when xerostomia alters the quality-of-life and worsens malnutrition.     

Prevalence of xerostomia in population-based samples: a systematic review

The consequences of xerostomia on oral health have been studied for decades; however, the actual prevalence of this disorder on the general population remains controversial. The purpose of this systematic review was to determine the prevalence of xerostomia in population-based samples. Electronic databases were screened for relevant articles and reference lists of pertinent articles were also hand-searched. Thirteen articles meeting the final inclusion criteria were identified. Based on the definition of xerostomia used in this review, only publications including a subjective diagnosis of the disorder were included. All of the self-reported diagnoses were achieved through a questionnaire either by mail, telephone, interview or self-administered by the patient. There was a variation across papers regarding number and content of the questions as well as guidelines for the diagnosis of xerostomia (i.e. answer yes to one or more than one question). The prevalence of xerostomia in the selected articles ranged from 0.9% to 64.8%. The majority of these studies were performed in Scandinavia. In 9 of the articles, the studied samples were 50 years and older. None of the studies evaluated the prevalence xerostomia among individuals younger than 18 years. Based on these observations, it can be concluded that there is a need for population-based studies on prevalence of xerostomia in regions other than Scandinavia. A standardized protocol to diagnose xerostomia needs to be developed. Patient-perceived treatment needs and impact on quality of life should be included to have a complete picture of public health implications of the disease.     

Efficacy of a 1% malic acid spray for xerostomia treatment: A systematic review and meta-analysis

Objectives

To assess the efficacy of topical sialogogue spray containing malic acid 1% for treating xerostomia.

Methods

We searched PubMed, Cochrane Library, Embase, ClinicalTrials.gov and Web of Science databases. Literature search, screening, study selection, data collection, data extraction and assessment of bias risk were independently conducted by two reviewers. The study appraisal was performed by Cochrane Collaboration's tool for assessing bias risk. The systematic review registration number was PROSPERO-CRD42021241322. All statistical analyses were performed using Review Manager version 5.4.

Results

Five original articles involving 244 patients with xerostomia who received topical sialogogue spray (malic acid 1%) or placebo for two weeks were included in this review. Based on the questionnaire survey, the topical sialogogue spray (malic acid 1%) improved the symptoms of dry mouth significantly better than the placebo, which was reflected in the Dry Mouth Questionnaire (DMQ), Xerostomia Inventory (XI) and Visual Analogue Scale (VAS) scores. Regarding the increase in unstimulated and stimulated saliva flow rates, the intervention group was also better than the placebo group after a two-week course of treatment.

Conclusions

Although the included studies are limited, our results show that topical sialogogue spray (malic acid 1%) is an effective method for the treatment of xerostomia. Additional randomised controlled trials in the future are needed to provide high-quality evidence of this therapy and to improve clinical practice guidelines.     

Association between xerostomia,oral and general health,and obesity in adults. A cross-sectional pilot study

Background The objective of this study was to analyse the association between oral and general health variables and obesity indicators with the sensation of dry mouth or xerostomia as evaluated on the Xerostomia Inventory (XI).Material and Methods A total of 354 randomly selected subjects participated in this cross-sectional pilot study and completed an anonymous questionnaire. Anthropometric, clinical, and xerostomic variables were evaluated. Kruskal-Wallis, ANOVA and Bonferroni test were used for multiple comparisons. ROC curves and multinomial logistic regression were used to determine the (OR) risk of xerostomia.Results A total of 30.7 % of respondents reported xerostomia based on XI. The dry mouth question, the XI taken as a “gold standard”, showed a diagnostic sensitivity of 70.37 %, and a specificity of 83.27 % (AUC=0.768, p<0.001). Logistical regression showed the highest xerostomia OR was associated to patients with bad self-perceived health, 6.31 (CI 95% 2.89-13.80, p<0.001). In the model adjusted for tooth mobility, bone or respiratory diseases, and the consumption of anxiolytics and antidepressants, the OR was 3.46 (CI 95% 1.47-8.18, p=0.005).Conclusions a high prevalence of xerostomia was found in this cross-sectional pilot study, which was significantly more frequent in women, and increased with age. Xerostomia was associated to several systemic diseases, psychological conditions, and oral functional disorders such as tooth mobility.These preliminary results can serve as the basis for developing guidelines for the application of innovative measures designed to improve the quality of life of individuals with xerostomia. Key words:Xerostomia, systemic pathology, oral health, obesity, geriatrics.     

A 15-yr longitudinal study of xerostomia in a Swedish population of 50-yr-old subjects

The aim of this study was to determine the changes in prevalence of xerostomia in subjects from 50 to 65 yr of age. Questionnaires were sent to all subjects who were born in 1942 and were living in two Swedish counties in 1992, 1997, 2002, and 2007. The analyses focused on those who answered the questionnaires both in 1992 and in 2007. The response rate was 71.4% ( n  = 6,346) in 1992 and 73.1% ( n  =   6,078) in 2007. Of those who answered the questionnaire in 1992, 74.3% ( n  =   4,714) also responded in 2007. There was an almost linear increase in the prevalence of xerostomia at the four study time-points (i.e. when the subjects were 50, 55, 60, and 65 yr of age). Xerostomia was more prevalent at night than during the day. The pooled prevalence of night-time and daytime xerostomia was 6% at 50 yr of age and 15% at 65 yr of age, and it was higher in women than in men on both occasions. Logistic regression analyses showed that impaired health and smoking were significantly associated with daytime xerostomia but not with night-time xerostomia. Despite the increase in prevalence of xerostomia from 50 to 65 yr of age, there was considerable variation during the observation period. The incidence rate was 13% (507/4,015) and the disappearance rate was 42% (104/250) (dichotomized answers).