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BACKGROUND: Symptom assessment is key to effective symptom management and palliative care for patients with advanced cancer. Symptom prevalence and severity estimates vary widely, possibly dependent on the assessment tool used. Are symptoms specifically asked about or must the patients add them as additional symptoms? This study compared the prevalence and severity of patient-reported symptoms in two different versions of a multi-symptom assessment tool. In one version, three symptoms dry mouth, constipation, sleep problems were among those systematically assessed, while in the other, these symptoms had to be added as an Other problem. METHODS: This retrospective cross-sectional study included adult patients with advanced cancer at an inpatient palliative care unit. Data were collected from two versions of the Edmonton Symptom Assessment System (ESAS): modified (ESAS-m) listed 11 symptoms and revised (ESAS-r) listed 9 and allowed patients to add one Other problem. Seven similar symptoms were listed in both versions. RESULTS: In 2013, 184 patients completed ESAS-m, and in 2017, 156 completed ESAS-r. Prevalence and severity of symptoms listed in both versions did not differ. In ESAS-m, 83% reported dry mouth, 73% constipation, and 71% sleep problems, but on ESAS-r, these symptoms were reported by only 3%, 15% and

Objective: Xerostomia (or oral dryness) is most commonly caused by medications that affect saliva secretion, and is often accompanied by symptoms of orofacial pain. Medication-induced xerostomia may or may not be associated with objectively de-monstrable hyposalivation. The present study attempted to systematically identify an association between medication-induced xerostomia and orofacial pain. Method and materials: A systematic search was conducted using the following databases: WoS, PubMed, SCOPUS, and MEDLINE. The search terms used were: xerostomia OR "dry mouth" AND medication AND ("oral pain" OR "orofacial pain" OR "craniofacial pain" OR "burning mouth" OR "glossodynia") NOT Sjogren's NOT cancer. Inclusion criteria were medication-induced xerostomia and reported symptoms of orofacial pain. Four researchers performed the selection process and quality assessment and two researchers conducted data extraction. Results: Seven studies with a total of 1,029 patients were included. These studies were conducted between 2009 and 2022 and consisted of cross-sectional studies, case-control studies, and one randomized crossover trial. The studies consisted of a total of 1,029 participants. All studies included male and female participants whose mean ages ranged from 43 to lOOyears. Conclusions: A positive association was found between medication-induced xerostomia and orofacial pain. No associations were found between salivary flow measurements (hyposalivation) and medication use. Future research should focus on saliva flow measurements, standardized assessment of medication-induced xerostomia, as well as the inclusion of accompanying orofacial pain diagnosis in the medical history to allow for higher level of evidence in establishing reliable predictors of medication- induced oral health damage to facilitate clinical prevention and management. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Materials and Methods Results Conclusion Studying dentists' knowledge of dry mouth management is crucial for effective diagnosis and treatment, improving patient outcomes and oral health. This study aimed to evaluate their knowledge and awareness of dry mouth and its predictors.A pre‐validated online survey was administered to a convenience sample of dentists across six countries. The questionnaire evaluated knowledge in various domains, including predisposing factors, diagnosis, clinical signs and symptoms, and management of dry mouth.A total of 884 dentists participated. Knowledge and awareness of dry mouth management varied significantly between countries (p < 0.05). Overall, 34.3% of participants demonstrated good knowledge, while 53.7% had moderate knowledge. Regarding management awareness, 55.4% had good awareness and 35.5% had moderate awareness. A majority (69.2%) showed good knowledge of common signs, symptoms, and consequences of dry mouth. Significant predictors of better knowledge and awareness included the country of practice and attendance at continuing education courses on dry mouth.The findings suggest that dentists in the surveyed countries require improved education on dry mouth and its management. Dental educators and healthcare planners can use this data to design targeted continuing education activities to enhance knowledge and awareness of dry mouth. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Methods Results Conclusion To analyse different background factors that may serve as predictors for acquiring symptoms of severe COVID‐19 disease.A postal questionnaire was sent to the total population of individuals born between 1942 (80 years, n = 6299) and 1932 (90 years, n = 1904) living in the Örebro and Östergötland counties, Sweden, in 2017 and repeated in 2022. Tentative predictive factors for self‐reported severe COVID‐19 disease were based on the responses from the 2017 questionnaire related to general and oral health and prior to the outbreak of the COVID‐19 pandemic.Response rate to the main questionnaire in 2022 was 66% (5375/8203), and 577 reported having been sick with COVID‐19 out of which 359 agreed to answer a separate questionnaire on COVID‐19. This questionnaire was returned by 278/359 of the participants corresponding to a response rate of 77%. Information gleaned from the 2017 pre‐COVID‐19 survey revealed a relatively large number of associations between severity of subsequently self‐reported COVID‐19 disease and several diverse tentative related factors found in unadjusted regression analyses. Based on statistically significant correlations in the adjusted regression analysis, significant predictive factors (based on self‐reports from 2017) for contracting severe COVID‐19 were in decreasing order of odds ratios (OR): reported removable partial or complete denture usage (OR 6.2, CI 2.2–17.2); reported periodontal problems in the past year (OR 3.4, CI 1.1–10.4); and reported daytime dry mouth (OR 2.5, CI 1.2–5.2).Removable dentures, periodontal problems and daytime dry mouth were predictors for developing symptoms of severe COVID‐19 disease. [ABSTRACT FROM AUTHOR]

At University Hospitals Plymouth NHS Trust (UK), patients with xerostomia after head and neck radiotherapy for whom local measures have not been successful are referred to the acupuncture clinic. This has been offered for the last ten years and preliminary data has shown that it can provide symptomatic relief to patients. This article documents a service evaluation of 45 patients who attended the acupuncture clinic from August 2020 to August 2021. Treatment was carried out at three points in each ear as well as a point on the distal radial aspect of each index finger. Each session lasted for 30 minutes and sessions were carried out weekly for four weeks. Patients filled out a modified 10-item Likert scale to measure their response at the initial and fourth visit. Median improvement in dryness ratings was two points (of a range of zero to five). A response occurred in 37 patients (82 per cent) and 28 patients (62 per cent) received an improvement of two points or greater on the Likert Scale. No adverse reactions to treatment were documented. The authors therefore conclude that acupuncture shows promise in the management of xerostomia in patients. [ABSTRACT FROM AUTHOR]

Purpose: Evaluate the clinical efficacy of "Oriza tablet" (OT) for patients with neurologic bladder or overactive bladder affected by xerostomia due to receiving antimuscarinic drugs. Material and methods: This was a randomized clinical trial. Twenty-eight patients (median age = 64 years) with xerostomia were divided into two groups: OT (intervention group) and placebo (control) group. Both groups comprised 14 patients each. Objective: We assessed severity using a questionnaire for the subjective evaluation of xerostomia. Objective evaluation was undertaken for the stimulated salivary flow rate (SSFR). Xerostomia evaluation took place before treatment (baseline) as well as 2 weeks and 4 weeks after treatment. Results: The xerostomia score decreased significantly (p < 0.05) in the OT group compared to the placebo group, with scores of 2.75 versus 4.4 at 2 weeks and 2.19 versus 4.13 at 4 weeks, respectively. The SSFR increased significantly (p < 0.05) in the OT group compared to the placebo group, with SSFR of 2 versus 1.2 at 2 weeks and 1.85 versus 1.1 at 4 weeks, respectively. Throughout the trial, no patient discontinued taking antimuscarinic medications. There were no adverse effects noted. Conclusion: Continuous daily use of OT for 4 weeks reduced xerostomia symptoms and increased saliva production in patients suffering from neurologic bladder or overactive bladder who received antimuscarinic medications. Clinical trial registration: The study was registered with The Thai Clinical Trials Registry (TCTR). ID: TCTR20240715015. [ABSTRACT FROM AUTHOR]

Aim: The study aims to synthesize current research on oral xerostomia and identify measures that can be taken to prevent it. Materials and methods: We have researched literature data on oral xerostomia using the PubMed database. We also consulted exclusively publications in English, published in the 1963 –2022 time frame, using search keywords such as oral xerostomia, salivary glands, hyposalivation, and dry mouth. We have selected from the PubMed database only original articles that match the search keywords and that provide solid evidence of the research activity on oral xerostomia, thus making an exhaustive review of the specialized literature focused on the subject of the study. Articles that were selected based on keywords by the database search engine and to which we had access only to the summary, conference summaries, and letters to the editor were excluded. Results: We examined 117 articles. The distribution according to the type of articles showed 85.41% presence of clinical trials. The distribution according to the keywords in the search engine showed a percentage of 65 % for xerostomia. Conclusions: The present article reviews the current literature reviewing the current approach to xerostomia, starting from the articles present in the scientific literature. More studies on large batches of patients are still needed to be able to obtain the most correct systematization of treatments and to establish a treatment protocol for dentists.

Purpose: A MASCC/ISOO Clinical Practice Statement (CPS) is aimed at generating a concise tool for clinicians that concentrates practical information needed for the management of oral complications of cancer patients. This CPS is focused on the clinical assessment of salivary gland hypofunction and xerostomia in cancer patients. Methods: This CPS was developed based on a critical evaluation of the literature followed by a structured discussion of a group of leading experts, members of the Oral Care Study Group of MASCC/ISOO. The information is presented in the form of succinct bullets and tables to generate a short manual about the best standard of care. Results: The objective assessment of saliva secretion involves an extra- and intra-oral clinical examination while the subjective assessment involves eliciting information on the patient’s complaint of xerostomia and its impact on daily functioning. This CPS summarizes the common investigator- and patient-reported instruments used in clinical practice for assessing salivary gland hypofunction and xerostomia in cancer patients. Conclusion: There is a range of tools to assess salivary gland function in patients undergoing cancer therapy, patients recovering from cancer therapy, or cancer survivors. Clinicians should ideally conduct both objective and subjective measurements to ensure a clear understanding about the status of the patients in order to provide the most appropriate treatment. [ABSTRACT FROM AUTHOR]

Purpose: A MASCC/ISOO Clinical Practice Statement (CPS) is aimed at generating a concise tool for clinicians that concentrates practical information needed for the management of oral complications of cancer patients. This CPS is focused on the management of salivary gland hypofunction and xerostomia in cancer patients. Methods: This CPS was developed based on critical evaluation of the literature followed by a structured discussion of a group of leading experts, members of the Oral Care Study Group of MASCC/ISOO. The information is presented in the form of succinct bullets and tables to generate a short manual about the best standard of care. Results: Salivary gland hypofunction and xerostomia in cancer patients are managed by (i) stimulating saliva production of salivary glands with residual secretory capacity or (ii) artificial wetting of the oral and lip surfaces which can be achieved by pharmacological or non-pharmacological interventions. Pharmacological interventions encompass the use of sialagogues and sialolytics, while non-pharmacological interventions involve the use of moistening agents, mechanical, gustatory, or electrostimulation of the salivary glands. Additional treatment modalities may be incorporated in practice based on local availability and the clinician’s experience. Conclusion: The information presented in this CPS offers clinicians convenient access to the dosages and regimens of different interventions for managing salivary gland hypofunction or xerostomia to facilitate clinical efficiency and conserve valuable time for clinicians. [ABSTRACT FROM AUTHOR]

Background: Immune checkpoint inhibitors (ICIs) are FDA‐approved for various cancers, yet their orofacial immune‐related adverse events (irAEs) remain poorly understood. Our two‐center retrospective study aims to better understand the prevalence and nature of these orofacial irAEs. Methods: We retrospectively collected demographics, ICI details, and onset of orofacial irAEs in ICI‐treated patients at University of California San Francisco and City of Hope (2013–2021). Orofacial irAEs were identified by ICD‐10 codes and data categorized as dry mouth/xerostomia, oral mucosal lesions, and orofacial neuropathies. Patients with pre‐existing orofacial conditions resembling the reported irAEs were excluded. Results: Among 3768 ICI‐treated patients, 408 (10.8%) developed 467 orofacial irAEs: oral mucosal diseases (41.4%), dry mouth/xerostomia (41.0%), and orofacial neuropathies (17.6%). Notably, head and neck cancers had the highest incidence of orofacial irAEs. Conclusions: Orofacial irAEs are relatively common in patients receiving ICIs, necessitating careful monitoring and management of these complications during and after the treatment. [ABSTRACT FROM AUTHOR]

Objectives: Radiation‐induced dry mouth negatively impacts patients' oral health and quality of life. Currently, evidence‐based recommendation for non‐pharmacologic interventions is still lacking. This study aimed to systematically review clinical trials evaluating the efficacy of non‐pharmacologic interventions in cancer patients with radiation‐induced dry mouth. Methods: Randomized controlled trials from 2000 were searched from 4 databases, including MEDLINE, Cochrane, Embase via OVID, and SCOPUS, up to December 16th, 2022 (PROSPERO registration CRD42022378405). The risk of bias was assessed using the revised Cochrane risk of bias assessment tool. Results: Twenty‐one studies were included: 11 on artificial saliva, 4 on electrical nerve stimulation (TENS), 2 on acupuncture, and one study each on low‐level laser therapy, stem cells, chewing gum, and probiotics. Overall bias was low, medium, and high in 33%, 48%, and 19% of the studies, respectively. Certain artificial saliva products and TENS were shown to improve dry mouth symptoms and salivary flow rate (SFR). One study showed that stem cell transplantation significantly increased SFR. Conclusions: The evidence suggested that certain artificial saliva products and TENS are promising management. However, the evidence was still limited due to heterogeneity of interventions and outcome measurements. Thus, future studies using standard measurements and long‐term follow‐up are warranted. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between rheumatoid arthritis (RA) and oral hypofunction (OHF) using propensity score matching (PSM) to adjust for differences between older adults with RA and the general older adult population. Methods: We conducted a cross‐sectional survey among 189 older adults with RA in 2019 (mean age, 71.9 ± 3.6) and 47 178 independent older adult residents in 2016 (mean age, 71.6 ± 4.0), respectively. The questionnaire covered information on socio‐demographic characteristics and OHF for both groups. Age, sex, educational level and smoking history were used to determine PSM. Prevalence ratios (PRs) and 95% confidence intervals (CIs) of self‐reported OHF (fewer remaining teeth, decreased masticatory function, deterioration of swallowing function and oral dryness) were estimated using Poisson regressions. Result: OHF was observed in 44.4% of patients with RA and 27.5% of residents. Before PSM, the prevalence of OHF among patients with RA was higher than that of residents (PR, 1.75; 95% CI, 1.50–2.05). After PSM, there were 189 patients with RA and residents, and the prevalence of OHF among patients with RA was still higher (PR, 1.61; 95% CI, 1.22–2.13). Poisson regression showed that the prevalence of 19 or fewer teeth (PR, 1.06; 95% CI, 0.82–1.36), difficulties eating tough foods (PR, 1.18; 95% CI, 0.90–1.55), difficulties swallowing tea or soup (PR, 1.77; 95% CI, 1.19–2.63), and dry mouth (PR, 2.79; 95% CI, 1.90–4.07) was higher among patients with RA than residents. Conclusion: Compared with the general older adult population, patients with RA have a higher prevalence of self‐reported OHF. [ABSTRACT FROM AUTHOR]

Background: Drug-induced dry mouth is an adverse reaction that can significantly affect the quality of life and mental state of patients. In this study, we aimed to identify the most common drugs associated with dry mouth using data from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) database. Methods: We accessed data from the FAERS database between the first quarter of 2004 and the first quarter of 2024. The Medical Dictionary for Regulatory Activities was used to identify reports of dry mouth, and disproportionality analyses (reporting odds ratio, proportional reporting ratio, Bayesian confidence propagation neural network, and multi-item gamma Poisson shrinker) were performed to examine the risk signals for dry mouth and its causative drugs. Results: A total of 75,899 adverse event reports were related to dry mouth. Tiotropium bromide monohydrate (2080 cases) was associated with the majority of dry mouth cases. Disproportionality analysis revealed that the top five drugs with the highest reporting odds ratio (ROR) were darifenacin, solifenacin succinate, fesoterodine fumarate, tolterodine tartrate, and niraparib. Moreover, eight of the top 19 drugs that caused dry mouth were not identified as having major side effects in the package inserts. Conclusion: Tiotropium bromide monohydrate was the most frequently reported drug for dry mouth, whereas darifenacin had the highest ROR. Collectively, our findings emphasize the necessity for improved recognition and management of drug-induced dry mouth, particularly for medications not adequately flagged for this side effect in their labels.

Objectives: Xerostomia, or dry mouth, is a condition that results from the reduction or absence of saliva flow secondary to the use of certain medications. The objective of the present study was to analyze the relationship between xerostomia patients and the consumption of serotonin norepinephrine reuptake inhibitors (SNRIs). Method and materials: The University of Florida (UF) Integrated Data (IDR) i2b2, for the period of June 2015 to September 2022, was used based on aggregates of the International Classification of Diseases 10th edition (ICD-10) diagnoses of dry mouth and use of SNRI. MedCalc Software was used to calculate odds ratios. Results: The odds ratio for dry mouth in the SNRI group was 5.95 (95% CI 5.47 to 6.48, P < .0001). The odds ratio for dry mouth in females on SNRI was 5.48 (95% CI 4.97 to 6.02, P < .0001), for males 5.48 (95% CI 4.56 to 6.95), P < .0001), for children 2.87 (95% CI 1.19 to 6.96, P = .0192), and for adults 4.46 (95% CI 4.09 to 4.86, P < .0001). When the different SNRIs were analyzed separately, the odds ratio for dry mouth with the use of venlafaxine was 5.83 (95% CI 5.12 to 6.6, P < .0001), duloxetine 6.97 (95% CI 6.33 to 7.67, P <.0001), desvenlafaxine 5.24 (95% CI 3.65 to 7.52, P < .0001), and milnacipran 9.61 (95% CI 5.66 to 16.31, P < .0001). Conclusion: According to the present study, patients who are taking SNRIs are five-fold more likely to develop dry mouth compared to those not on medications. The results could be informative to medical professionals who prescribe SNRIs and who are not currently aware of the effect they have on salivary production and therefore quality of life, as well as the dental practitioners treating these patients with dry mouth sequalae. [ABSTRACT FROM AUTHOR]

Abstract Background Mouth dryness increases the risk of some oral health-related conditions. Furthermore, it is unclear if patients with dry mouth engage in appropriate oral health-related behaviours. The study examined oral health, related behaviours, and perceived stress in dry-mouth patients and compared them to matched controls without mouth dryness. Methods Information about 182 dry-mouth patients and 302 age- and sex-matched subjects was retrieved. Three dry mouth groups: xerostomia, Sicca syndrome and Sjögren’s syndrome, were formed based on patient self-reported and objectively assessed symptoms. The World Health Organization’s Oral Health for Adults and Perceived Stress Scale (PSS-10) questionnaires inquired about sociodemographic characteristics, oral health-related behaviours, and self-perceived stress. Clinical oral health assessments included: caries experience measured as total numbers of decayed (DS), missing (MS), filled surfaces (FS), number of remaining teeth, erosive tooth wear and extent of periodontal pocketing. Data were analyzed using bivariate and multivariable tests. Results The dry-mouth participants had higher mean (SD) DMFS scores than their matched controls: xerostomia patients vs. controls: 74.6 (34.4) and 66.3 (35.4), Sicca syndrome patients vs. controls: 88.3 (34.0) and 70.1 (33.9), and Sjögren’s syndrome patients vs. controls: 95.7 (31.5) and 74 (33.2). In comparison to controls, individuals with Sicca and patients with Sjögren’s syndromes had lower mean (SD) number of remaining teeth, 15.9 (10.1) vs. 21.7 (8.4) and 13.8 (10.0) vs. 20.1 (9.2), and a lower mean (SD) extent of periodontal pocketing, 20.7 (28.6) vs. 41.1 (31.0), and 21.2 (24.1) vs. 34.8 (34.2), respectively. Xerostomia, Sicca syndrome and Sjögren’s syndrome patients had higher odds of using fluoridated toothpaste; OR 1.8 (95%CI 1.1–2.9), OR 5.6 (95%CI 1.7–18.3) and OR 6.9 (95%CI 2.2–21.3), respectively. Participants with Sjögren’s syndrome had lower odds of the last dental visit being within the last year; OR 0.2 (95%CI 0.1–0.8). Conclusions Dry-mouth patients had higher caries experience and fewer teeth than comparison groups but a lower extent of periodontal pocketing. Even though more participants with dry mouth used fluoridated toothpastes, their oral health-related behaviours were not optimal.

Abstract Background Symptom assessment is key to effective symptom management and palliative care for patients with advanced cancer. Symptom prevalence and severity estimates vary widely, possibly dependent on the assessment tool used. Are symptoms specifically asked about or must the patients add them as additional symptoms? This study compared the prevalence and severity of patient-reported symptoms in two different versions of a multi-symptom assessment tool. In one version, three symptoms dry mouth, constipation, sleep problems were among those systematically assessed, while in the other, these symptoms had to be added as an “Other problem”. Methods This retrospective cross-sectional study included adult patients with advanced cancer at an inpatient palliative care unit. Data were collected from two versions of the Edmonton Symptom Assessment System (ESAS): modified (ESAS-m) listed 11 symptoms and revised (ESAS-r) listed 9 and allowed patients to add one “Other problem”. Seven similar symptoms were listed in both versions. Results In 2013, 184 patients completed ESAS-m, and in 2017, 156 completed ESAS-r. Prevalence and severity of symptoms listed in both versions did not differ. In ESAS-m, 83% reported dry mouth, 73% constipation, and 71% sleep problems, but on ESAS-r, these symptoms were reported by only 3%, 15% and

OBJECTIVE: This study aimed to evaluate the efficacy and safety of total glucosides of paeony (TGP) in patients with primary Sjögren's syndrome (pSS). PATIENTS AND METHODS: This study included 236 patients with pSS, including 118 TGP users and 118 non-users. Propensity score matching and Binary logistic regression analyses were used to minimize confounding factors and determine the association between TGP treatment and clinical variables. RESULTS: The baseline indexes of TGP users and non-users were basically the same. The median time of follow-up in the two groups was also similar (p < 0.05). Compared with non-users, TGP users showed higher rates of improvement in dry mouth and eyes and musculoskeletal involvement, as well as more significant reductions in serum alanine aminotransferase (ALT) and direct bilirubin (DBIL) levels after treatment. Logistic regression confirmed that the use of TGP was negatively correlated with the increase of ALT and DBIL in pSS patients, and the reduction in these variables was more pronounced after 2 years of treatment. The incidence of adverse reactions in the TGP users was 11.9%, which was compatible with those in non-users. CONCLUSIONS: TGP is often a safe option for treating pSS patients with musculoskeletal features and abnormal ALT levels. Besides, it can help improve dry mouth and dry eyes and decrease DBIL levels. [ABSTRACT FROM AUTHOR]

Objectives: Natural enzymes mouthwash has been proposed as salivary substitutes to treat xerostomia. This study aims to evaluate the efficacy of the mouthwash to treat xerostomia. Materials and methods: A double-blind, parallel group randomised control clinical trial involving N = 49 adult participants with xerostomia was carried out. Intervention group received natural enzymes moisturising mouthwash (with active ingredients lactoferrin, lysozyme, lactoperoxidase and glucose oxidase); while control group received benzydamine mouthwash. Mouthwashes were repacked, labelled with specific code, and were given to participants by third-party. Subjects were instructed to rinse with the mouthwash 4 times per day at a specific period, for 2 weeks. Symptoms of xerostomia were assessed using Xerostomia Inventory at day 0 and 14; together with the assessment of Clinical Oral Dryness Score (CODS), and measurement of resting and stimulated salivary flow rate. Results: 48 participants completed the clinical follow-up, and n = 1 had lost of follow-up. From the 48 participants, n = 23 received natural enzymes mouthwash, while n = 25 received benzydamine mouthwash. Intervention group achieved reduction in symptoms of xerostomia from baseline. Intervention group also showed significantly better improvements in the cognitive perception of dry mouth and oromotor function such as chewing, swallowing and speech of the participants; and reduction in waking up at night to drink water (p < 0.05). The CODS and resting salivary flow rate were also significantly improved in intervention group (p < 0.05). Conclusion: Use of natural enzymes mouthwash improved signs and symptoms of xerostomia. Clinical relevance: Natural enzymes mouthwash is potentially effective to treat xerostomia, well-tolerated and safe to be used by xerostomia patients. Clinical trial registration number: This study was retrospectively registered in ClinicalTrials.gov ID NCT05640362 on 7 December 2022. [ABSTRACT FROM AUTHOR]

Background: Mouth dryness increases the risk of some oral health-related conditions. Furthermore, it is unclear if patients with dry mouth engage in appropriate oral health-related behaviours. The study examined oral health, related behaviours, and perceived stress in dry-mouth patients and compared them to matched controls without mouth dryness. Methods: Information about 182 dry-mouth patients and 302 age- and sex-matched subjects was retrieved. Three dry mouth groups: xerostomia, Sicca syndrome and Sjögren's syndrome, were formed based on patient self-reported and objectively assessed symptoms. The World Health Organization's Oral Health for Adults and Perceived Stress Scale (PSS-10) questionnaires inquired about sociodemographic characteristics, oral health-related behaviours, and self-perceived stress. Clinical oral health assessments included: caries experience measured as total numbers of decayed (DS), missing (MS), filled surfaces (FS), number of remaining teeth, erosive tooth wear and extent of periodontal pocketing. Data were analyzed using bivariate and multivariable tests. Results: The dry-mouth participants had higher mean (SD) DMFS scores than their matched controls: xerostomia patients vs. controls: 74.6 (34.4) and 66.3 (35.4), Sicca syndrome patients vs. controls: 88.3 (34.0) and 70.1 (33.9), and Sjögren's syndrome patients vs. controls: 95.7 (31.5) and 74 (33.2). In comparison to controls, individuals with Sicca and patients with Sjögren's syndromes had lower mean (SD) number of remaining teeth, 15.9 (10.1) vs. 21.7 (8.4) and 13.8 (10.0) vs. 20.1 (9.2), and a lower mean (SD) extent of periodontal pocketing, 20.7 (28.6) vs. 41.1 (31.0), and 21.2 (24.1) vs. 34.8 (34.2), respectively. Xerostomia, Sicca syndrome and Sjögren's syndrome patients had higher odds of using fluoridated toothpaste; OR 1.8 (95%CI 1.1–2.9), OR 5.6 (95%CI 1.7–18.3) and OR 6.9 (95%CI 2.2–21.3), respectively. Participants with Sjögren's syndrome had lower odds of the last dental visit being within the last year; OR 0.2 (95%CI 0.1–0.8). Conclusions: Dry-mouth patients had higher caries experience and fewer teeth than comparison groups but a lower extent of periodontal pocketing. Even though more participants with dry mouth used fluoridated toothpastes, their oral health-related behaviours were not optimal. [ABSTRACT FROM AUTHOR]

Objective: To assess the combination of salivary gland intraductal irrigations (IG) followed by sialoendoscopy irrigations (SI) of the parotid gland on the improvement of salivary gland secretory dysfunction (SGSD). Methods: We retrospectively analyzed the records of SGSD patients who underwent major salivary gland IG followed by SI during 2014–2020. Records included demographics, systemic background, signs, and symptoms. Improvement was assessed by comparing the mean unstimulated and stimulated whole salivary flow rate (UWSF, SWSF) from the baseline point (before IG procedure) to the last point (after SI) using repeated measures. The between‐subjects effects of various factors and covariants were analyzed using repeated measures ANCOVA. Results: One hundred patients were included with an age range of 15–83 years (mean age of 60.1 ± 13.1 years). Improvement was detected on UWSF measurements (p = 0.031, F = 3.83), but not on SWSF measurements (p = 0.165, F = 1.85). The between‐subjects effects on UWSF measurements were statistically significant for sex (p = 0.003, F = 9.526) and salivary gland manipulators use (p < 0.001, F = 15.107) and for the interaction between sex and salivary gland manipulators use (p‐ = 0.002, F = 9.709). Results of long‐term follow‐up for 10.87 ± 11.79 months after the SI procedure demonstrated sustained improvement in UWSF measurements (p = 0.011, F = 4.91). Conclusions: The combination of IG followed by SI increases UWSF salivary secretion in SGSD patients for a relatively extended duration. [ABSTRACT FROM AUTHOR]

Dry mouth, also known as xerostomia, is a condition in which insufficient or ineffective saliva does not provide sufficient oral lubrication. The severity of this condition can vary from a mild discomfort to a debilitating condition that greatly impairs patients' lives. Xerostomia arises as a side effect of various medications, diseases, radiation therapy, chemotherapy, or nerve damage. Various aqueous dispersions of macromolecules have been proposed to assist or replace the saliva in these patients. It is vital that these macromolecules have ample lubricity and water retention properties while showing long-lasting efficacy. The emphasis of this review is to provide a general overview on lubricating macromolecules that have been clinically used or reported in the literature as potential replacements for saliva. These include various natural or synthetic polymers, proteins, peptides, and lipids that are used in the form of solutions, gels, emulsions, and colloids. Perspectives into the future of macromolecular oral lubricants in the treatment of xerostomia are also provided. [ABSTRACT FROM AUTHOR]

Background: Diabetes Mellitus is a chronic disease characterized by uncontrolled blood sugar levels, which lead to end-organ damage. While the diagnosis and treatment of its complications have been extensively studied, the effect of Hyperbaric Oxygen Therapy (HBO2) on diabetes-related oral complications remains unexplored. Aim: This prospective clinical study aims to investigate the effect of HBO2 on diabetes-related oral complications. Methods: Twenty patients diagnosed with diabetic foot ulcers and scheduled for HBO2 were included in this study. We recorded stimulated and unstimulated saliva pH, buffering capacity, flow rate, and subjective symptoms such as dry mouth, halitosis, taste loss, difficulty swallowing, and clinical examination findings before HBO2 and after the 21st session. Results: Upon comparing the findings, we observed a significant decrease in dry mouth and halitosis, periodontal disease severity, and healing of candida-related stomatitis and angular cheilitis. Despite not reaching statistical significance for other saliva parameters, the unstimulated salivary flow rate increased to normal limits (0.3-0.4 ml/min) in 6 out of 8 patients with a flow rate of less than 0.25 ml/min. Conclusion: Our study investigated the effect of HBO2 on diabetes-related oral complications for the first time, highlighting symptomatic relief for dry mouth and halitosis. Although our results are insufficient to report a definitive benefit, they underscore the need for further research on the oral health effects of HBO2. [ABSTRACT FROM AUTHOR]

This article provides a review of current research on oral xerostomia, or dry mouth, and its therapeutic management. The authors conducted a literature search and examined 117 articles, primarily clinical trials, to discuss the causes and effects of xerostomia on oral health and quality of life. They emphasize the need for further research to establish effective treatment protocols for dentists. The article also discusses the association between xerostomia and oral candidiasis, as well as various treatment options, highlighting the importance of identifying the underlying cause of xerostomia for appropriate treatment. The document is a list of references that explore the causes, effects, and treatment of xerostomia in different populations, providing a comprehensive overview of current research on the topic. [Extracted from the article]

Objective: To evaluate the effectiveness of topical sialogogue spray containing 1% malic acid in the treatment of xerostomia in patients with type 2 diabetes mellitus. Material and Methods: A randomized double‐blind controlled clinical trial was conducted on 52 patients with type 2 diabetes mellitus suffering from xerostomia. Patients were assigned equally to test group who received a topical sialogogue spray containing 1% malic acid and control group who received a placebo spray. Both groups were instructed to use the spray on demand for 2 weeks. The Summated Xerostomia Inventory‐Dutch Version questionnaire (SXI‐D) and the unstimulated salivary flow rate were evaluated for all patients at baseline, 2 and 4 weeks after malic acid/placebo application. Results: At 2 week's follow‐up, the unstimulated salivary flow rate increased significantly from 0.059 ± 0.024 to 0.191 ± 0.064 and from 0.055 ± 0.026 to 0.078 ± 0.032 for test and control groups, respectively, with a statistically significant difference favoring the test group. SXI‐D scores showed a significant decrease from 10.73 ± 2.22 to 8.38 ± 2.28 in the test group (p < 0.05), while in the control group it decreased from 10.62 ± 1.75 to 10.23 ± 1.48 (p > 0.05). Conclusion: A sialogogue spray containing 1% malic acid increased the unstimulated salivary flow rate in patients with type 2 diabetes mellitus suffering from xerostomia. [ABSTRACT FROM AUTHOR]

Objective. To assess the construct validity of the novel Outcome Measures in Rheumatology (OMERACT) ultrasound (US) semiquantitative scoring system for morphological lesions in major salivary glands by comparing it with magnetic resonance imaging (MRI) and unstimulated whole salivary flow rates (U-WSFRs) in patients with primary Sjögren syndrome (pSS). Methods. Nine sonographers applied the OMERACT 0-3 grayscale scoring system for parotid (PGs) and submandibular glands (SMGs) in 11 patients with pSS who also had MRIs performed. These were evaluated by 2 radiologists using a semiquantitative 0-3 scoring system for morphological lesions. The agreement between US and MRI and the association between U-WSFRs and imaging structural lesions was determined. A score ≥ 2 for both US and MRI was defined as gland pathology. Results. The prevalence of US morphological lesions in 11 patients with a score ≥ 2 was 58% for PGs and 76% for SMGs, and 46% and 41% for PGs and SMGs, respectively, for MRI. The agreement between OMERACT US scores and MRI scores was 73-91% (median 82%) in the right PG and 73-91% (median 91%) in the left PG, 55-91% (median 55%) in the right SMG and 55-82% (median 55%) in the left SMG. When relations between the presence of hyposalivation and an US score ≥ 2 were examined, agreement was 91-100% (median 83%) in both PGs and 55-91% (median 67%) in both SMGs. Conclusion. There is moderate to strong agreement between the OMERACT US and MRI scores for major salivary glands in patients with pSS. Similar agreement ratios were observed between the higher OMERACT US scores and presence of hyposalivation. [ABSTRACT FROM AUTHOR]

Key Clinical Message Several reports of suspected oral and ocular manifestations of coronavirus disease 2019 (COVID‐19) has prompted investigations into ocular signs, symptoms, and transmission (5).11.2% of patients with COV19 infection had ocular symptoms, including ocular pain, conjunctivitis, dry eye, and floaters, meanwhile, many studies had documented oral symptoms such as dry mouth and dysgeusia in these patients. Our case reported a 39‐year‐old male, presented with symptoms of dry mouth and dry eye lasting more than 3 months. The patient had recovered from (PCR‐confirmed) COVID‐19 which lasted 10 days, 4 months ago. The physical examination was normal. Ocular findings include conjunctival hyperemia and superficial punctate keratitis. The anti‐nuclear antibody (ANA) was weekly positive at 1/80. Schirmer test considered positive. He continued on 200 mg/day of hydroxychloroquine, along with tear drops until now with remission. Sicca symptoms may be a sequel of COVID‐19 infection, and physicians should be aware of this sequel. The sequela of this infection is not understood, with limited data in the literature. Future prospective cohort studies are needed to reveal the impact of these features on oral health.

Abstract Recent literature indicates that post-COVID-19 patients suffer from a plethora of complications, including chemosensory dysfunction. However, little attention has been given to understand the interactions between chemosensory, trigeminal, and salivary dysfunctions in these patients. The aims of this study were (1) to investigate the prevalence and combinations of chemosensory, trigeminal, and salivary dysfunctions, (2) to identify the odorants/tastants that are compromised, and (3) to explore possible associations between the four dysfunctions in post-COVID-19 patients. One hundred post-COVID-19 patients and 76 healthy controls (pre-COVID-19) were included in this cross-sectional, case-controlled study. Participants' smell, taste, trigeminal, and salivary functions were assessed. The patients had a significantly higher prevalence of parosmia (80.0%), hyposmia (42.0%), anosmia (53.0%), dysgeusia (34.0%), complete ageusia (3.0%), specific ageusia (27.0%), dysesthesia (11.0%) and dry mouth (18.0%) compared to controls (0.0% for all parameters, except 27.6% for hyposmia). Complete loss of bitter taste was the most prevalent specific ageusia (66.7%) and coffee was the most common distorted smell (56.4%). Seven different combinations of dysfunction were observed in the patients, the most common being a combination of olfactory and gustatory dysfunction (48.0%). These findings indicate that post-COVID-19 patients experience a range of chemosensory, trigeminal, and salivary disturbances, occurring in various combinations.

Abstract Background Decreased salivary secretion is not only a risk factor for carious lesions in Sjögren’s disease (SD) but also an indicator of deterioration of teeth with every restorative replacement. This study determined the longevity of direct dental restorations placed in patients with SD using matched electronic dental record (EDR) and electronic health record (EHR) data. Methods We conducted a retrospective cohort study using EDR and EHR data of Indiana University School of Dentistry patients who have a SD diagnosis in their EHR. Treatment history of patients during 15 years with SD (cases) and their matched controls with at least one direct dental restoration were retrieved from the EDR. Descriptive statistics summarized the study population characteristics. Cox regression models with random effects analyzed differences between cases and controls for time to direct restoration failure. Further the model explored the effect of covariates such as age, sex, race, dental insurance, medical insurance, medical diagnosis, medication use, preventive dental visits per year, and the number of tooth surfaces on time to restoration failure. Results At least one completed direct restoration was present for 102 cases and 42 controls resulting in a cohort of 144 patients’ EDR and EHR data. The cases were distributed as 21 positives, 57 negatives, and 24 uncertain cases based on clinical findings. The average age was 56, about 93% were females, 54% were White, 74% had no dental insurance, 61% had public medical insurance,

Abstract Background Despite the high prevalence of oral dryness and awareness of its complications, there is limited research on the clinical management of patients with oral dryness in general dental care. Purpose To (1) describe and compare awareness among dental care professionals regarding saliva functions, potential causes and complications of oral dryness, and patient management (2) Investigate if the length of professional experience influences these aspects. Methods A digital self-administrated survey was sent to 2668 dental care professionals working in the general dental care, Public Dental Service, in Sweden. Twelve dental care professionals reviewed the questionnaire prior to its distribution. The questionnaire comprised 32 questions about patient management, awareness of saliva functions, causes and complications of oral dryness, and self-assessment queries. Results The response rate was 18.6% (241 dentists and 257 dental hygienists). Older adults (65+) were asked more often about dry mouth (93.0%) compared to those aged 18–23 years (50.0%) and those under 18 years (24.9%). Dental hygienists encountered individuals with oral dryness more frequently (61.1%) than dentists (48.5%) (p

Key Clinical Message: Several reports of suspected oral and ocular manifestations of coronavirus disease 2019 (COVID‐19) has prompted investigations into ocular signs, symptoms, and transmission (5).11.2% of patients with COV19 infection had ocular symptoms, including ocular pain, conjunctivitis, dry eye, and floaters, meanwhile, many studies had documented oral symptoms such as dry mouth and dysgeusia in these patients. Our case reported a 39‐year‐old male, presented with symptoms of dry mouth and dry eye lasting more than 3 months. The patient had recovered from (PCR‐confirmed) COVID‐19 which lasted 10 days, 4 months ago. The physical examination was normal. Ocular findings include conjunctival hyperemia and superficial punctate keratitis. The anti‐nuclear antibody (ANA) was weekly positive at 1/80. Schirmer test considered positive. He continued on 200 mg/day of hydroxychloroquine, along with tear drops until now with remission. Sicca symptoms may be a sequel of COVID‐19 infection, and physicians should be aware of this sequel. The sequela of this infection is not understood, with limited data in the literature. Future prospective cohort studies are needed to reveal the impact of these features on oral health. [ABSTRACT FROM AUTHOR]

Introduction: Saliva is essential for maintaining homeostasis in the oral cavity through its various components. A decrease in Salivary Flow Rate (SFR) has various deleterious effects on the oral tissues. Several factors can alter salivary flow, and one such factor is smoking. Therefore, this study aims to evaluate the effect of smoking on salivary flow. Aim: To assess xerostomia and hyposalivation using the Modified Schirmer Test (MST) and the spitting method among smokers and compare the results with non-smokers in the Saudi population. Materials and Methods: A cross-sectional study was conducted at the Institutional Diagnostic Clinic at the College of Dentistry, King Khalid University in the Aseer region of Saudi Arabia from February 2023 to March 2023. A total of 200 subjects were divided into two groups of 100 each. Group-I consisted of individuals with a smoking habit history for 10 years, while Group-II comprised healthy subjects with no smoking history. All subjects underwent screening for xerostomia and hyposalivation using the spitting method and MST. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 20.0, and a p-value of

Abstract Background One of the main clinical features of Sjögren’s Syndrome is oral dryness, which is associated with an increased risk of oral diseases and a lower oral life quality. Dentists have a key role to play in the Sjögren’s Syndrome diagnosis and specific management. In parallel, many patients rely on patient associations, which offer opportunities for members to seek information about their disease and share their experiences. We aimed to evaluate patients experience with dry mouth and the importance of dentists in Sjögren’s Syndrome diagnosis and its management. Methods We carried out a cross-sectional survey in 2020 based on a questionnaire drafted in collaboration with clinicians specializing in Sjögren’s Syndrome and patient members of a patient association. The survey consisted of 27 questions divided into the six sections: the patient’s profile, their experience with dry mouth and treatments used to manage, characteristics of experienced oral-health problems, effects of dry mouth and its consequences on the quality of life, evaluation of the dentist role in the screening of Sjögren’s Syndrome, and its management by the dentist. Recruitment was carried out via the patient association’s newsletter, website, and social networks. Sjögren’s diagnosis was self-reported. Results One thousand four hundred fifty-eight patients fully responded to the survey. Most respondents were women over 50 and were mainly concerned with primary Sjögren’s Syndrome. Overall, 86.97% of respondents reported experiencing frequent or constant dry mouth and 69.01% declared having had oral problems (candidiasis, oral pain, loss or alteration of taste, bad breath, gastro-esophageal reflux). We found a positive correlation between the frequency of dry mouth and each of these disorders and between the frequency of dry mouth and alterations in life quality dimensions. Finally, 74.9% of patients did not report having dry mouth to their dentist prior to being diagnosed with Sjögren’s Syndrome and 58% had not been informed about the oral risks associated with it by their dentist and sought information themselves or from their physician. Conclusions We confirm the significant consequences of dry mouth on oral quality of life, as well as its association with oral health problems. Sjögren’s Syndrome screening by dentists should be increased, as well as prevention of the associated oral health risks.

Chronic kidney disease (CKD) patients have a higher tendency to have oral diseases such as periodontitis, saliva flow changes, bleeding gums, dry mouth, and bad breath. Malnutrition, oxidative stress, and vitamin deficiency, such as complex vitamin B and vitamin C, are the main factors that may cause oral changes. This study aimed to evaluate the subjective oral health of a sample of 90 patients with chronic renal failure (CRF) in dialysis and determine the relationship between renal failure and oral changes. As a result, the most frequent answer was dry mouth after dialysis at around 73.3% of the patients, whereas 41.1% had tooth decay, 52% had bad breath, 35% had gingival bleeding and 22.2% have noticed tooth coloring. The comparison between male and female patients found significant differences in uremic fetor: male patients had an average score of 1.58, while female patients had 1.36 (P=0.0371). Another significant difference was found for tooth discoloration: the average score for males was 1.67 and for females, 1.90 (p=0.0082). Patients in urban areas had an average score for caries after dialysis of 1.40, while those in rural areas had 1.68 (P=0.01). Patients with CRF should get multidisciplinary treatment. These patients require special consideration not only about dental treatment but also because of the side effects of the treatments they receive. A detailed evaluation and provision of good oral care after diagnosis of end-stage renal disease is more than necessary.

Recent literature indicates that post-COVID-19 patients suffer from a plethora of complications, including chemosensory dysfunction. However, little attention has been given to understand the interactions between chemosensory, trigeminal, and salivary dysfunctions in these patients. The aims of this study were (1) to investigate the prevalence and combinations of chemosensory, trigeminal, and salivary dysfunctions, (2) to identify the odorants/tastants that are compromised, and (3) to explore possible associations between the four dysfunctions in post-COVID-19 patients. One hundred post-COVID-19 patients and 76 healthy controls (pre-COVID-19) were included in this cross-sectional, case-controlled study. Participants' smell, taste, trigeminal, and salivary functions were assessed. The patients had a significantly higher prevalence of parosmia (80.0%), hyposmia (42.0%), anosmia (53.0%), dysgeusia (34.0%), complete ageusia (3.0%), specific ageusia (27.0%), dysesthesia (11.0%) and dry mouth (18.0%) compared to controls (0.0% for all parameters, except 27.6% for hyposmia). Complete loss of bitter taste was the most prevalent specific ageusia (66.7%) and coffee was the most common distorted smell (56.4%). Seven different combinations of dysfunction were observed in the patients, the most common being a combination of olfactory and gustatory dysfunction (48.0%). These findings indicate that post-COVID-19 patients experience a range of chemosensory, trigeminal, and salivary disturbances, occurring in various combinations. [ABSTRACT FROM AUTHOR]

Sjögren's syndrome (SS) is characterised as keratoconjunctivitis sicca (dry eyes), xerostomia (dry mouth) commonly associated with salivary gland enlargement, and is referred to as Primary Sjögren's syndrome. It is known as Secondary Sjögren's syndrome when it occurs in patients, with connective tissue disease, such as rheumatoid arthritis, systemic lupus erythematosus, polyarthritis nodosa, polymyositis, and systemic sclerosis. SS has also been associated with chronic graft-versus-host disease after allogeneic bone marrow transplantation, human immunodeficiency syndrome (AIDS), hepatitis C infection (HCV), chronic biliary cirrhosis, neoplastic and myeloplastic syndromes, fibromyalgia, and chronic fatigue syndrome. [ABSTRACT FROM AUTHOR]

Background: Despite the high prevalence of oral dryness and awareness of its complications, there is limited research on the clinical management of patients with oral dryness in general dental care. Purpose: To (1) describe and compare awareness among dental care professionals regarding saliva functions, potential causes and complications of oral dryness, and patient management (2) Investigate if the length of professional experience influences these aspects. Methods: A digital self-administrated survey was sent to 2668 dental care professionals working in the general dental care, Public Dental Service, in Sweden. Twelve dental care professionals reviewed the questionnaire prior to its distribution. The questionnaire comprised 32 questions about patient management, awareness of saliva functions, causes and complications of oral dryness, and self-assessment queries. Results: The response rate was 18.6% (241 dentists and 257 dental hygienists). Older adults (65+) were asked more often about dry mouth (93.0%) compared to those aged 18–23 years (50.0%) and those under 18 years (24.9%). Dental hygienists encountered individuals with oral dryness more frequently (61.1%) than dentists (48.5%) (p < 0.01), and more often asked individuals in the age groups 18–23 years (p = 0.003), 24–40 years (p = 0.045), and 41–65 years (p = 0.031) about dry mouth. A higher proportion of dental hygienists (88.3%) than dentists (51.0%) had measured salivary secretion rate, (p < 0.001) and more often suggested preventive dental care 3–4 times a year, (42.5% vs. 30.5%) (p < 0.007). Dentists had a higher awareness of saliva functions, while dental hygienists had a higher awareness about causes and complications of oral dryness. Higher proportions of dentists and dental hygienists with over 10 years of professional experience had measured salivary secretion rate (69.1% vs. 95.7%) compared to their counterparts with less than 10 years of professional experience (35.9% vs. 79.5%) (p < 0.001 for both). Conclusion: Compared to dentists, dental hygienists were more attentive to patients with oral dryness as they encountered these individuals more often, asked more age-groups, suggested frequent preventive measures, and had higher awareness of the causes and complications of oral dryness. Length of professional experience could improve both the management of patients with oral dryness and awareness of its causes, particularly for dental hygienists. [ABSTRACT FROM AUTHOR]

Objectives: Salivary proteins, acidic glycoproteins, and free calcium might take part in oral mucosal defence against inflammation in oral lichen planus (OLP). The study aimed to investigate whether the levels of sulfated and sialylated glycoproteins, total protein, and free calcium in saliva from patients with OLP differ from those of individuals without oral mucosal diseases. Material and Methods: Patients diagnosed with OLP (n = 25) and two control groups without any oral mucosal disease; age- and gender-matched controls (n = 25, 65.6 ± 2.9 years), and younger controls (n = 25, 41.8 ± 2.5 years) were included. Subjective dry mouth (xerostomia) was assessed by asking a single-item question. Chew-stimulated whole saliva was collected to measure sulfated and sialylated glycoproteins by the Alcian Blue method. The total protein was determined spectrophotometrically, and the free calcium measured using an electrode. Results: The output of salivary sulfated and sialylated glycoproteins in the OLP group (21.8 ± 2.4 µg/min) was lower than in the age- and gender-matched controls (43.0 ± 2.9 µg/min, p = 0.0002), whereas the total protein and calcium output did not differ between the three groups (p > 0.05). The prevalence of xerostomia was significantly higher in the OLP group compared to both control groups (p = 0.038). Conclusions: Patients with OLP showed a high prevalence of xerostomia and lower levels of salivary acidic type glycoproteins compared to the individuals without oral mucosa disease. Clinical relevance: It is relevant to investigate the role of acidic glycoproteins in the pathogenesis of OLP. [ABSTRACT FROM AUTHOR]

Morning dry mouth, commonly seen in Obstructive Sleep Apnea (OSA) patients, is absent in current OSA screening tools. This study evaluated the link between morning dry mouth and OSA's clinical symptoms and complications, aiming to determine its viability as a screening indicator. This research analyses baseline data from a prospective cohort study (the PIFCOPD study). Demographic information, medical history, and the presence of morning dry mouth symptoms were collected. The STOP-Bang questionnaire was performed for OSA screening. Logistic regression analyses were employed to establish the correlations between morning dry mouth and the clinical symptoms and comorbidities of OSA. 1291 participants (62.1±7.5 years; 501 males, 790 females) were included, of which 416 reported morning dry mouth (32.2%). 42.6% in the high-risk OSA group and 22.1% in the low-risk group reported morning dry mouth. Individuals with morning dry mouth also showed higher STOP-Bang scores (3.3±1.6 vs. 2.3±1.4, P<0.01). Significant associations were found between morning dry mouth and loud snoring, observed sleep apnea, daytime fatigue, and hyperlipidemia (P<0.01), but not with alcohol consumption, tea consumption, diabetes, or hypertension. Morning dry mouth is associated with increased OSA risk and its clinical signs, suggesting its potential as an OSA screening symptom. This study has been registered at (registration identifier: NCT03532893) on 21 May 2018. [ABSTRACT FROM AUTHOR]

Xerostomia is a subjective sign of dry mouth t may or may not be accompanied by objective signs of hyposalivation. The condition of xerostomia has been associated with increasing age in line with the aging process, with a global prevalence of 30%. in the elderly aged 65 years and above. This can have an impact on the health and quality of life of the elderly. Also, xerostomia is the most common symptom in patients during periods of anxiety, stress, depression, radiotherapy, chemotherapy, and systemic diseases, as well as in individuals who have a history of polypharmacy or who use certain drugs. This study aimed to review the most recent available evidence regarding the most common causes of xerostomia in the elderly. The PCC strategy (population, context, and concept) was used as a guide for retrieving the relevant articles for this scoping review. Two databases were systematically searched using PubMed and Scopus. The draft of the scoping review and assessment of the methodological quality of the trials was carried out following the criteria of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). A total of 12 trials were identified that met the previously defined selection and quality criteria; 9 related to medicine, and 4 included populations in which xerostomia was a systemic disease, rheumatic disease, radiation therapy to the head or neck region, nutrition, and psychological factors. The common precipitating factor of xerostomia in the elderly is medicine. Drugs that are more commonly found to cause xerostomia are gastrointestinal drugs, psychotropic drugs, and antihypertensive drugs. [ABSTRACT FROM AUTHOR]

The symptom of dry mouth has multiple potential etiologies and can be a diagnostic clue to the presence of common systemic diseases encountered in rheumatology practice. The presence of decreased saliva flow (i.e. salivary hypofunction) defines a subset of dry mouth patients in whom there may be reversible drug effects, an iatrogenic insult such as head and neck irradiation, or a disease that directly involves the salivary glands (e.g. Sjögren's disease). The assessment of salivary hypofunction includes sialometry, salivary gland imaging, salivary gland biopsy, and an assessment for relevant systemic diseases. Optimal management of dry mouth requires accurate definition of its cause, followed by general measures that serve to alleviate its symptoms and prevent its complications. Through a literature search on xerostomia and salivary hypofunction, we provide an overview of the causes of dry mouth, highlight the potential impact of salivary hypofunction on oral and systemic health, detail routine evaluation methods and treatment strategies, and emphasize the importance of collaboration with oral health care providers. Our Expert Opinion is provided on unmet needs in the management of dry mouth and relevant research progress in the field. [ABSTRACT FROM AUTHOR]

Background: One of the main clinical features of Sjögren's Syndrome is oral dryness, which is associated with an increased risk of oral diseases and a lower oral life quality. Dentists have a key role to play in the Sjögren's Syndrome diagnosis and specific management. In parallel, many patients rely on patient associations, which offer opportunities for members to seek information about their disease and share their experiences. We aimed to evaluate patients experience with dry mouth and the importance of dentists in Sjögren's Syndrome diagnosis and its management. Methods: We carried out a cross-sectional survey in 2020 based on a questionnaire drafted in collaboration with clinicians specializing in Sjögren's Syndrome and patient members of a patient association. The survey consisted of 27 questions divided into the six sections: the patient's profile, their experience with dry mouth and treatments used to manage, characteristics of experienced oral-health problems, effects of dry mouth and its consequences on the quality of life, evaluation of the dentist role in the screening of Sjögren's Syndrome, and its management by the dentist. Recruitment was carried out via the patient association's newsletter, website, and social networks. Sjögren's diagnosis was self-reported. Results: One thousand four hundred fifty-eight patients fully responded to the survey. Most respondents were women over 50 and were mainly concerned with primary Sjögren's Syndrome. Overall, 86.97% of respondents reported experiencing frequent or constant dry mouth and 69.01% declared having had oral problems (candidiasis, oral pain, loss or alteration of taste, bad breath, gastro-esophageal reflux). We found a positive correlation between the frequency of dry mouth and each of these disorders and between the frequency of dry mouth and alterations in life quality dimensions. Finally, 74.9% of patients did not report having dry mouth to their dentist prior to being diagnosed with Sjögren's Syndrome and 58% had not been informed about the oral risks associated with it by their dentist and sought information themselves or from their physician. Conclusions: We confirm the significant consequences of dry mouth on oral quality of life, as well as its association with oral health problems. Sjögren's Syndrome screening by dentists should be increased, as well as prevention of the associated oral health risks. [ABSTRACT FROM AUTHOR]

Introduction: Saliva is essential for maintaining homeostasis in the oral cavity through its various components. A decrease in Salivary Flow Rate (SFR) has various deleterious effects on the oral tissues. Several factors can alter salivary flow, and one such factor is smoking. Therefore, this study aims to evaluate the effect of smoking on salivary flow. Aim: To assess xerostomia and hyposalivation using the Modified Schirmer Test (MST) and the spitting method among smokers and compare the results with non-smokers in the Saudi population. Materials and Methods: A cross-sectional study was conducted at the Institutional Diagnostic Clinic at the College of Dentistry, King Khalid University in the Aseer region of Saudi Arabia from February 2023 to March 2023. A total of 200 subjects were divided into two groups of 100 each. Group-I consisted of individuals with a smoking habit history for 10 years, while Group-II comprised healthy subjects with no smoking history. All subjects underwent screening for xerostomia and hyposalivation using the spitting method and MST. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 20.0, and a p-value of <0.05 was considered statistically significant. Mean SFRs by the spitting method and MST were calculated, and the means were compared using an unpaired t-test. Pearson correlation analysis was used to assess the correlation between the two methods. Results: A statistically significant decrease in SFR was observed in smokers compared to healthy subjects using both methods (p<0.001). There was an excellent correlation between the two estimation methods (p<0.001). The prevalence of xerostomia in Group-I was 45 (45%), and in Group-II, it was 14 (14%), while the prevalence of hyposalivation in Group-I was 73 (73%) and in Group-II, it was 10 (10%). Conclusion: Salivary flow was lower in smokers compared to non-smokers in the Saudi population. There is an excellent correlation between the two assessment methods, and based on the study experience, the MST can be considered a reliable, objective, inexpensive, easy-to-perform, and well-tolerated test for assessing hyposalivation. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of this project was to review the literature on dry mouth / xerostomia in patients with advanced cancer, with the objectives being to determine its prevalence, clinical features, and complications. Methods Standard methodology was used to conduct this scoping review. Detailed searches of the Medline, Embase, CINAHL, and PsycInfo databases were conducted to identify relevant studies: eligible studies had to include patients with advanced cancer, and to contain details of clinical features and/or complications of xerostomia. Commercial bibliographic / systematic review software was used to support the process. Results Forty-three studies were discovered from the database and hand searches. The studies included 23 generic symptom studies, eight “symptom cluster” studies, nine oral symptom / problem studies, and three xerostomia-specific studies. In depth data is described on the clinical features and complications of xerostomia, and on the “symptom clusters” including xerostomia, in this cohort of patients. Conclusion This review discovered a relatively small number of focused studies (involving a similarly small number of patients). Nonetheless, it demonstrates that xerostomia is a very common problem in patients with advanced cancer and is often associated with significant morbidity (and impairment of quality of life).

Background and purpose: This study investigated the relationship between oral health related quality of life and hyposalivation and dry mouth in patients with chronic renal failure (CRF) undergoing hemodialysis. Materials and methods: This descriptive-analytical study was conducted in 200 patients with CRF undergoing hemodialysis attending the dialysis department in Sari Imam Khomeini Hospital, 2021. Patients completed oral health-related quality of life questionnaires (OHIP-14) with additive and simple count assessment methods. To diagnose dry mouth, unstimulated saliva was collected and patients were asked nine questions, of which five positive answers indicated dry mouth. Data analysis was done in SPSS V18. Pearson's or Spearman's correlation coefficient were applied to investigate the association between quality of life score and unstimulated salivary flow, and t-test or Mann-Whitney test were used to compare the quality of life scores between the groups with and without dry mouth. Results: Hyposalivation was observed in 66 patients (33%). The OHIP-14 score was significantly higher in both additive and simple count methods in patients with dry mouth and hyposalivation (P

The number of cancer survivors are increasing and so are the oral toxicities from cancer therapy. Most patients receiving treatment for cancer develop some form of oral adverse events including, but not limited to, mucositis, opportunistic infections, dry mouth, and/or osteonecrosis of the jaw. One of the most common complications from head and neck cancer radiation therapy is salivary gland dysfunction (SGD). SGD is an umbrella term that includes the subjective sensation of dry mouth (xerostomia) and hyposalivation (objective reduction of the salivary flow rate). Dry mouth in cancer patients may lead to functional defects (e.g., eating, speaking, and swallowing), increase the risk of dental caries and oral candidiasis, and can have a negative effect on the nutritional and psychological status of the patients. The aim of this mini review was to summarize the current criteria for diagnosis and management of SGD associated with cancer treatment.