Oral Medicine
Prevalence of subjective dry mouth and burning mouth in hospitalized elderly patients and outpatients in relation to saliva, medication, and systemic diseases*

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Abstract

Objective: The purpose of this study was to investigate the prevalence of self-reported symptoms of dry mouth and burning mouth in the frail elderly. We expected to find the studied symptoms more frequently in the frail elderly than in those who were healthier. Study Design: We examined 175 home-living elderly patients (mean age with SD, 82 ± 5.7 years) hospitalized because of sudden worsening of their general health. For comparison, 252 elderly outpatients (mean age with SD, 77 ± 5.7 years) from the same community were studied. The subjects' medical diagnoses and prescribed drugs used daily were recorded, their oral health examined, and saliva samples taken for analyses of flow rates, yeasts, and a variety of biochemical factors. Results: The results showed that 63% of the hospitalized patients and 57% of the outpatients complained of dry mouth. The respective percentages of burning mouth were 13% in the hospitalized and 18% in the outpatients. The dentate status affected the feeling of dry mouth and burning mouth, but there were no consequent differences in concentrations of salivary biochemical constituents, yeast counts, and buffering capacity between patients with or without the symptoms except that hospitalized patients complaining of dry mouth more often had low salivary buffering than those without the symptom. Dry mouth was also more prevalent among the hospitalized patients who used several drugs daily, whereas no such association was found with the burning-mouth symptom. Use of analgesics appeared to safeguard against both the symptoms. Dry mouth and burning mouth were seldom reported simultaneously, although low salivary flow rate was a common finding in patients with burning mouth. The strongest explanatory factors for burning mouth were psychiatric disease among the outpatients (OR 8.7, CI 1.4-54.1, P <.05) and use of psychiatric drugs among the hospitalized (OR 4.2, CI 0.9-20.0, P =.07). For dry mouth, the strongest explanatory factors were respiratory disease in the outpatients (OR 2.0, CI 1.0-3.8, P <.05) and low salivary flow rate in the hospitalized elderly (OR 3.7, CI 1.4-10, P <.05). In all patients (n = 427), use of psychiatric drugs was the strongest explanatory factor for dry mouth (OR 2.1, CI 1.2-3.5, P <.01), whereas analgesic medication was found to protect against burning mouth (OR 0.5, CI 0.3-0.9, P <.05). Conclusion: The subjective feelings of dry mouth and burning mouth appeared to be a complex issue among the elderly population studied. The 2 symptoms were seldom reported at the same time. The appearance of symptoms did not directly correlate with general health, except in the case of psychiatric diseases and medications, which should be taken into account. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:641-9)

Section snippets

Hospitalized patients

The first part of this cross-sectional study was carried out at an acute geriatric ward of the Harjula Hospital, Kuopio City Health Center, Finland, on 201 formerly home-living elderly patients who had been referred and admitted to the hospital because of sudden worsening of their general health. The assessment was made by a doctor or nurse on house call. The final group consisted of 175 patients (55 men and 120 women; mean age with SD, 82.0 ± 5.7 years). Sixteen patients were excluded because

Distribution of the patients with and without the symptoms

Table I shows that 110 of the hospitalized patients and 144 of the outpatients complained of the subjective feeling of dry mouth. Dry mouth was reported by 64% of the edentulous hospitalized patients and 53.3% of the edentulous outpatients. Further details with respect to the distribution of the characteristics of the patients with or without dry mouth are given in Table I.

Burning-mouth sensation was reported by 12.6% of the hospitalized patients and 18.3% of the outpatients. Table I gives

Discussion

The prevalence of the subjective oral symptoms investigated was high in our patients—as expected. However, we had anticipated to record distinctly more complaints among the hospitalized patients than in the outpatients in this respect. This, however, was not the case in the present study. It is possible that because our hospitalized patients represent home-living elderly who were taken to the hospital because of sudden worsening of their general health, they had other things on their mind than

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    *

    Reprint requests: Hanna Pajukoski, DDS, MSc, University of Helsinki, Institute of Dentistry, P.O. Box 41, FIN-00014

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