Effect of Xerostomia

The impact of xerostomia on oral health in diabetic patients

Leticia Santos

Tina Ly

Lamar Institute of Technology

Dental Hygiene Program

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Effect of Xerostomia

Abstract

Xerostomia, which means dry mouth, will negatively affect the enamel of the teeth and oral

mucous, causing severe damage if not treated properly. According to the statistics, about 11% of

people in the United States of America have diabetes; xerostomia is common in both T1DM and

T2DM diabetic patients (Molania et al.,2017). Xerostomia can increase plaque retention,

cavities, and infections in the oral mucosa, triggering poor nutrition by being unable to chew and

swallow correctly. That is why all dental health professionals must be considerate and attentive

to any changes to provide patients with the necessary care they should take to improve and

maintain their dental health in the best state.

Keywords: Xerostomia, Diabetes, dry mouth

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Effect of Xerostomia

The impact of xerostomia on oral health in diabetic patients

Xerostomia, a dry mouth sensation, results in caries development and oral mucosa decay.

Xerostomia is linked to diabetes, one of the most common diseases in the United States of

America, which is a common metabolic disorder that negatively intervenes with the way the

body usually turns blood glucose into energy and can cause different complications, such as

xerostomia, increasing the risk of caries and periodontal disease, increased tendency for infection

like candidiasis, altered tastes, poor lesion healing capacity. That’s why the salivary function is

critical for oral and systemic health maintenance, including digestion, mastication, taste, speech,

and oral soft tissue protection. However, diabetic patients may not have all these because of

decreased saliva secretion probability. Therefore, dental professionals must be informed and

knowledgeable about this condition to provide our patients with the best dental treatment and

care.

According to the statistics, about 11% of people in the United States of America have

diabetes, 76.4% of diabetic patients reported the condition of xerostomia (Molania et al.,2017).

Due to the standard and high prevalence of oral complication disease, especially xerostomia,

many studies and research have been conducted to evaluate xerostomia and hyposalivation in

diabetic patients. According to the research “Artificial Saliva in Diabetic Xerostomia,” there is a

difference between xerostomia and hyposalivation (Sinjari et al., 2020). Xerostomia is not

defined based on the salivary flow rate measurement; instead, it is an individual’s subjective

feeling of dry mouth based on the presence or absence of dry mouth sensation. On the other

hand, hyposalivation is defined wholly based on a reduced salivary flow rate as an objective

sign. Hyposalivation means the patient has an unstimulated saliva flow rate of <0.1 mL/min.

Furthermore, there is an increasing incidence and frequency of xerostomia and hyposalivation

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Effect of Xerostomia

with age. According to many studies and research, patients with type 2 diabetes appears to have

xerostomia was reported as 76.4%, which was higher compared with patients with type 1

diabetes (Sinjari et al., 2020).

Therefore, dental professionals must be aware and acknowledge the signs and symptoms

of xerostomia and how to determine if the patients have xerostomia so that we can prevent its

progression or use other additional supplements to support the condition. Dental professionals

have to ask specific important questions and examine during the medical dental history inquiry,

such as if the patients have a problem with dry mouth sensation or a sticky feeling in the mouth

causing difficulty speaking and swallowing with an altered taste sensation. Moreover, xerostomia

can be determined by using four clinical measures besides the previous and present symptoms,

including the evaluation of the dryness of the lip and buccal mucosa and salivary production

absence by gland palpation. Furthermore, dental professionals can also utilize practical questions

about saliva production, swallowing difficulty, if they have to drink water to help in swallowing

dry food, if they have to get up at night to drink, the dryness of other parts of the body, including

eye, skin, and inside of the nose (Kapourani at al., 2022).

While xerostomia can happen to healthy and unhealthy people, it is three times

significantly higher for dietetic patients, according to the article “Comparison of the

Unstimulated Whole Saliva Flow Rate in Diabetics.” (Ahadian et al., 2014). About 83% of

people with diabetes have xerostomia compared to 28.4% of healthy people who have

xerostomia, which is a statistically significant difference. However, the critical problem and

urgent concern is that most people are not aware of the relationship between diabetes and

xerostomia, even to prevent or alleviate and lessen the xerostomia condition. Hence, dental

health professionals must be adequately aware of signals and symptoms related to xerostomia to

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Effect of Xerostomia

assist our patients in preventing tissue and tooth decay. Once we identify and detect the

underlying etiology, we can figure out the most suitable approach to implement to establish

appropriate preventative ways to lessen the symptoms of xerostomia and improve salivary

production function in our diabetic patients.

First, every diabetic patient who has xerostomia has to pay close attention to preventative

measures in order to prevent the complications and development of oral infections associated

with the disorder. For instance, they should have regular dental care and checkups by scheduling

a dental appointment every four to six months with diligent oral hygiene care. It is essential for

dental professionals to inform patients about the significant role of dietary sugars and refined

carbohydrates in the development of caries; therefore, they should suggest that the patient

minimize the intake to prevent the complication of xerostomia. Furthermore, we could assist

them by applying a topical application of fluorides to prevent decay for diabetic patients with

xerostomia problems since it could increase the risk of tooth decay in diabetic patients. Besides

these previously preventative and assisting ways to help our diabetic patients with xerostomia,

we also have numerous saliva substitutes invented and produced to lessen the dry mouth

condition. In addition, we can use artificial saliva gel with different dosage forms, such as gels,

lozenges, and sprays, to reduce xerostomia as it will act as an oral lubricant, maintaining mucosa

moisture and lubrication. Nevertheless, it is necessary to know that the action of saliva

substitutes will only be effective for a limited duration; therefore, we would need to apply them

frequently (Sinjari et al., 2020).

Because of the adverse impact of xerostomia on many people, especially diabetic

patients, there should be more research and further studies to be conducted to demonstrate the

relation between diabetes control levels and xerostomia. Finally, it can be concluded that the

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Effect of Xerostomia

hyposalivation in patients who have diabetes with poor metabolic function has increased

significantly in recent years, which can create more severe complications associated with their

oral health (Molania et al., 2017). Therefore, dental professionals must be knowledgeable about

this condition to provide our patients with the best dental treatment and care.

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Effect of Xerostomia

References

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Effect of Xerostomia

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