Factors Associated with Hyposalivation in Brazilian Adults

Authors

  • Handerson Nunes de Carvalho
  • Yuri Lins dos Santos
  • Kenio Costa de Lima
  • Ítalo de Macedo Bernardino
  • Ana Flávia Granville-Garcia
  • Ramon Targino Firmino
  • Edja Maria Melo de Brito Costa

Keywords:

Prevalence, Epidemiology, Salivation, Hyposalivation, Xerostomia

Abstract

Objective: To determine the occurrence of hyposalivation in Brazilian adults and its association with individual determinants, such as the use of medications, systemic conditions, smoking, and alcohol consumption. Material and Methods: A cross-sectional study with 402 adults was developed. Information was collected on sociodemographic and general health characteristics, and sialometry was performed with stimulated salivary flow. It indicated low salivary flow when ≤ 0.7 mL/min. Bivariate and multivariate analyses were conducted using a decision tree (p<0.05). Results: The sample was comprised predominantly of women (68.2%) aged ≤ 29 years (25.4%). Most participants did not use medication (56.7%). Among systemic diseases, the most cited was hypertension (25.1%). More than a third of the participants presented hyposalivation (40.3%), being associated with the following variables: age between 50 to 59 years (p=0.011), female sex (p<0.001), menopause (p=0.001), use of alcohol (p=0.033), systemic disease (p=0.002) and medication use (p<0.001). In multivariate analysis, in addition to sex (p<0.001) and hypertension (p=0.005), an association was also found between hyposalivation and diabetes (p=0.014). Conclusion: Factors associated with hyposalivation in adults were sex and the presence of hypertension or diabetes.

References

Silva IJO, Almeida ARP, Falcão NC, Freitas JAC, Bento PM, Queiroz JRC. Hyposalivation: etiology, diagnosis and treatment. RBO 2016; 7(2):140-146. https://doi.org/10.17267/2596-3368dentistry.v7i2.856

Islas-Granillo H, Borges-Yáñez A, Fernández-Barrera MÁ, Ávila-Burgos L, Patiño-Marín N, De Lourdes Márquez-corona M, et al. Relationship of hyposalivation and xerostomia in Mexican elderly with socioeconomic, sociodemographic and dental factors. Sci Rep 2017; 7(1):40686. https://doi.org/10.1038%2Fsrep40686

Nonzee V, Manopatanakul S, Khovidhunkit SOP. Xerostomia, hyposalivation and oral microbiota in patients using antihypertensive medications. J Med Assoc Thai 2012; 95(1):96-104.

Saleh J, Figueiredo MAZ, Cherubin K, Salum FG. Salivary hypofunction: an update on aetiology, diagnosis, and therapeutics. Arch Oral Biol 2015; 60(2):242-255. https://doi.org/10.1016/j.archoralbio.2014.10.004

Borges ET, Abreu JM, Suarez EP, Hernández YR. Consideraciones actuales sobre la xerostomía o síndrome de boca seca. Rev Med Electrón 2014; 36(5):583-595. [In Spanish].

Bolstad AI, Skarstein K. Epidemiology of sjögren’s syndrome - from an oral perspective. Curr Oral Health Rep 2016; 3(4):328-336. https://doi.org/10.1007%2Fs40496-016-0112-0

Cappetta K, Beyer C, Johnson JA, Bloch MH. Meta-analysis: Risk of dry mouth with second generation Antidepressants. Prog Neuropsychopharmacol Biol Psychiatry 2018; 84(1):282-293. https://doi.org/10.1016/j.pnpbp.2017.12.012

Falcão DP, Da Mota LMH, Pires AL, Bezerra ACB. Sialometry: aspects of clinical interest. Rev Bras Reumatol 2013; 53(6):525-531. https://doi.org/10.1016/j.rbr.2013.03.001

Lone MA, Shaikh S, Lone MM, Afaq A, Lone MA. Association of salivary gland hypofunction with diabetes mellitus and drugs among the elderly in Karachi, Pakistan. J Investig Clin Dent 2016; 8(2):1-6. https://doi.org/10.1111/jicd.12209

Morais EFD, Macedo RADP, Lira JADS, Lima KCD, Borges BCD. Factors related to dry mouth and low salivary flow rates in diabetic elderly: a systematic literature review. Rev Bras Geriatr Gerontol 2014; 17(2):417-423. https://doi.org/10.1590/S1809-98232014000200018

Monasterios FDL, Llabrés XR. Etiopathogenesis and diagnosis of dry mouth. Av Odontoestomatol 2014; 30(3):121-128.

Niklander S, Veas L, Barrera C, Fuentes F, Chiappini G, Marshall M. Risk factors, hyposalivation and impact of xerostomia on oral health-related quality of life. Braz Oral Res 2017; 31(1):e14. https://doi.org/10.1590/1807-3107BOR-2017.vol31.0014

Rasidi MQZBM, Varma MA. Knowledge, attitude and practice on hyposalivation in complete denture patients among dental interns in Chennai, India. J Pharm Sci & Res 2017; 9(2):225-229.

Marsh PD, Do T, Beighton D, Devine DA. Influence of saliva on the oral microbiota. Periodontol 2000 2016; 70(1):80-92. https://doi.org/10.1111/prd.12098

Velásquez N, Pérez-Ybarra L, Urdaneta CJ, Pérez-Domínguez M. Asociación de sialometría, fosfato y calcio en saliva total bajo estímulo y en líquido crevicular gingival con caries dental en escolares. Biomédica 2019; 39(1):157-169. https://doi.org/10.7705/biomedica.v39i1.4069 [In Spanish].

Assy Z, Brand HS. A systematic review of the effects of acupuncture on xerostomia and hyposalivation. BMC Complement Altern Med 2018; 18(1):57. https://doi.org/10.1186/s12906-018-2124-x

Barbe AG. Medication-induced xerostomia and hyposalivation in the elderly: Culprits, complications, and management. Drugs Aging 2018; 35(10):877-885. https://doi.org/10.1007/s40266-018-0588-5

Munemasa T, Mukaibo T, Kondo Y, Masaki C, Kusuda Y, Miyagi Y, et al. Salivary gland hypofunction in KK‐Ay type 2 diabetic mice. J Diabetes 2018; 10(1):18-27. https://doi.org/10.1111/1753-0407.12548

Varoni EM, Federighi F; Decani S, Carrassi A, Lodi G, Sardella A. The effect of clinical setting on the unstimulated salivary flow rate. Arc Oral Biol 2016; 69:7-12. https://doi.org/10.1016/j.archoralbio.2016.05.001

Carvalho HN, Santos YL, Bernardino IM, Lima KC, Granville-garcia AF, Costa EMMB. Accuracy of a questionnaire on xerostomia as a screening tool for hyposalivation. Int Dent J 2020; 70(6):427-434. https://doi.org/10.1111/idj.12586

López-lópez J, Salas EJ, Kustner EC. Prognóstico y tratamiento de la boca seca: Revisión sistematica. Med Clin 2014; 142(3):119-124. https://doi.org/10.1016/j.medcli.2013.02.036 [In Spanish].

Billings M, Dye BA, Iafolla T, Grisius M, Alevizus I. Elucidating the role of hyposalivation and autoimmunity in oral candidiasis. Oral Dis 2017; 23(3):387-394. https://doi.org/10.1111/odi.12626

Sreebny LM, Valdini A. Xerostomia. Part I. Relationship to other oral symptoms and salivary gland hypofunction. Oral Surg Oral Med Oral Pathol 1988; 66(4):451-458. https://doi.org/10.1016/0030-4220(88)90268-x

Liedberg B, Öwall B. Masticatory ability in experimentally induced xerostomia. Dysphagia 1991; 6(4):211-213. https://doi.org/10.1007/bf02493529

Ishijima T, Koshino H, Hirai T, Takasaki H. The relationship between salivary secretion rate and masticatory efficiency. J Oral Rehabil 2004; 31(1):3-6. https://doi.org/10.1111/j.1365-2842.2004.01033.x

Brasil. Ministério da Saúde. Secretaria de Políticas de Saúde. Marco legal: Saúde, um direito de adolescents. Brasília, DF; 2007. [In Portuguese].

Pina GMS, Mota CR, Silva BSF, Almeida FT. Prevalence of hyposalivation in older people: systematic review and meta-analysis. Gerodontology 2020; 37(4):317-331. https://doi.org/10.1111/ger.12497

Thomson WM. Issues in the epidemiological investigation of dry mouth. Gerodontology 2005; 22(2):65-76. https://doi.org/10.1111/j.1741-2358.2005.00058.x

Mishra R, Haider K, Rizwan R, Monga S, Pritam A, Singh P. Assessment of effect of menopause on saliva and oral health status. J Pharm Bioallied Sci 2021; 13(Suppl 2):S1535-S1537. https://doi.org/10.4103/jpbs.jpbs_276_21

Suri V, Suri V. Menopause and oral health. J Midlife Health 2014; 5(3):115-120. https://doi.org/10.4103%2F0976-7800.141187

Asplund R, Aberg HE. Oral dryness, nocturia and the menopause. Maturitas 2005, 50(2):86-90. https://doi.org/10.1016/j.maturitas.2004.04.009

Friedlander AH. The physiology, medical management and oral implications of menopause. J Am Dent Assoc 2002; 133(1):73-81. https://doi.org/10.14219/jada.archive.2002.0025

Brasil. Ministério da Saúde. Secretaria de Políticas de Saúde. Portaria Nº 761, de 21 de Junho de 2016. Brasília, DF; 2016. [In Portuguese].

Diep MT, Jensen JL, Skudutyte-rysstad R, Young A, Sodal ATT, Petrovski BÉ, et al. Xerostomia and hyposalivation among a 65-yr-old population living in Oslo, Norway. Eur J Oral Sci 2021; 129(1):e12757. https://doi.org/10.1111/eos.12757

Yamashita JM, Moura-Grec PD, Capalari MM, Sales-Peres A, Sales-Peres SDC. Oral manifestations in patients with Diabetes mellitus: A systematic review. Rev Odontol UNESP 2013; 42(3):211-220. https://doi.org/10.1590/S1807-2577201300030001

Barbe AG, Schmidt-Park Y, Hamacher S, Derman SHM, Noack MJ. Efficacy of GUM® Hydral versus Biotène® Oralbalance mouthwashes plus gels on symptoms of medication-induced xerostomia: A randomized, double-blind, crossover study. Clin Oral Investig 2018; 22(1):169-180. https://doi.org/10.1007/s00784-017-2096-0

Wémeau JL, Do Cao C, Ladsous M. Manifestations buccodentaires des maladies thyroïdiennes. Presse Med 2017; 46(9):864-868. https://doi.org/10.1016/j.lpm.2017.05.030

Lima FO, Ramalho MJP, Rummler MDCO, Rodriguez TT. Hipotireoidismo altera secreção e composição salivar em ratos sépticos. Rev Odonto Ciênc 2008; 23(1):53-57. [In Portuguese].

Uzun S, Tathpinar A, Kmal E, Keskin S, Özbeyli D, Gunes P. Histopathological changes of parotid and larynx in hypothyroid rats: experimental study. Eur Arch Otorhinolaryngol 2022; 279(3):1509-1517. https://doi.org/10.1007/s00405-021-06921-3

Agha-Hosseini F, Shirzad N, Moosavi MS. Evaluation of xerostomia and salivary flow rate in Hashimoto's thyroiditis. Med Oral Patol Oral Cir Bucal 2016; 21(1):e1-5. https://doi.org/10.4317%2Fmedoral.20559

Syed YA, Reddy BS, Ramamurthy TK, Rajendra K, Nerella NK, Krishnan M, et al. Estimation of salivary parameters among autoimmune thyroiditis patients. J Clin Diagn Res 2017; 11(7):ZC01–ZC04. https://doi.org/10.7860/jcdr/2017/26444.10128

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Published

2023-12-18

How to Cite

de Carvalho, H. N., dos Santos, Y. L., de Lima, K. C., Bernardino, Ítalo de M., Granville-Garcia, A. F., Firmino, R. T., & Costa, E. M. M. de B. (2023). Factors Associated with Hyposalivation in Brazilian Adults. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 24, e220006. Retrieved from https://revista.uepb.edu.br/PBOCI/article/view/2955

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Original Articles