A high-anticholinergic burden was associated with low-unstimulated salivary secretion and xerostomia.

Aim To study whether dental caries, periodontal disease, and stomatitis, and the related inflammatory burden associate with diagnosed Alzheimer's disease (AD) and dementia among older people. Methods The study population included 170 individuals aged ≥75 years. The primary outcome was diagnosed AD and the secondary outcome was any types of diagnosed dementia. Information about participants’ oral diseases and the related inflammatory burden was based on the clinical oral examination. Relative risks (RRs) and confidence intervals (CIs) were estimated using regression models. Results Dental caries, the presence of ≥3 carious teeth (RR: 3.47, 95% CI: 1.09–11.1) and the number of carious teeth (RR: 1.24, CI: 1.11–1.39), and inflammatory burden (RR: 1.44, CI: 1.04–2.01) were associated with a higher likelihood of having AD. Also, periodontal disease and stomatitis were associated, although nonstatistically, with AD and dementia. The risk estimates for any type of dementia were in most cases lower than for AD. Conclusion Oral diseases and the related inflammatory burden were in most cases associated more strongly with diagnosed AD than dementia in general. Of the oral diseases studied, the strongest association was between dental caries and AD.

Introduction: Anticholinergic burden refers to the cumulative effect of taking 1 or more drugs with anticholinergic properties. At the moment, little is known about the association between the anticholinergic burden and dry mouth. Objectives: The objective of this article was to study, whether an anticholinergic burden is associated with dry mouth among middle-aged people. Methods: The study population included 1,345 people aged 46 y from the Northern Finland Birth Cohort 1966 (NFBC1966) study, who took part in a clinical medical and dental examination during 2012–2013. Medication data comprised both self-reported drug use and information obtained from the national register. Anticholinergic burden was measured using 10 different anticholinergic scales. Dry mouth was defined on the basis of having either a subjective feeling of dry mouth (xerostomia) or objectively measured low unstimulated or stimulated whole salivary flow rates (hyposalivation). Poisson regression models with robust error variance were used to estimate relative risk (RR). Regression models were adjusted for sex, smoking, diabetes, rheumatoid diseases, depressive symptoms, anxiety, total number of drugs, and antihypertensive drugs. Results: Approximately 14% of the participants reported having xerostomia and about 2% had hyposalivation. The RRs of different anticholinergic scales for xerostomia varied from 1.05 to 1.68. The scales’ RRs were between 0.89 and 2.03 for low unstimulated whole salivary flow (<0.1 mL/min) and between 0.59 and 1.80 for low stimulated whole salivary flow (<0.7 mL/min). Seven of 10 studied anticholinergic scales associated statistically significantly with dry mouth, either with xerostomia or hyposalivation. Conclusion: Most of the anticholinergic scales were associated with dry mouth, either with xerostomia or hyposalivation. There was considerable variation in the strength of the associations between anticholinergic scales and dry mouth. Knowledge Transfer Statement: The findings of this study suggest that dentists should take notice of the use of drugs with anticholinergic properties and their harmful effects among middle-aged people. Dentists should provide these patients with necessary guidance on how to cope with dry mouth and give them prophylactic measures against oral diseases associated with dry mouth.

Sedative load is strongly related to hyposalivation and to a lesser extent with xerostomia. The adverse effects of drugs on saliva secretion are specifically related to drugs with sedative properties.