How Common is Dry Mouth? Systematic Review and Meta-Regression Analysis of Prevalence Estimates

Abstract

The aim of this paper is to systematically review the literature to estimate the overall prevalence of xerostomia/hyposalivation in epidemiological studies. An electronic search was carried out up to February 2018 with no language restrictions. A total of 5760 titles were screened and just twenty-nine papers were included in review and the meta-analysis after a two independently reviewers applied the selection criteria. Data were extracted from PubMed and Web of Science databases. Eligibility criteria included original investigations from observational population-based studies that reported the prevalence of xerostomia or data that allowed the calculation of prevalence of xerostomia and/or hyposalivation. Studies conducted in samples with specific health conditions, literature reviews, case reports and anthropological studies, as conferences or comments were excluded. Sample size, geographic location of the study, study design, age of the studied population, diagnosis methods, and evaluation criteria used to determine xerostomia e/or hyposalivation were extracted for meta-analysis and meta-regression. Multivariate meta-regression analysis was performed to explore heterogeneity among studies. The overall estimated prevalence of dry mouth was 22.0% (95%CI 17.0-26.0%). Higher prevalence of xerostomia was observed in studies conducted only with elderly people. Despite diverse approaches to the condition’s measurement, just over one in four people suffer from xerostomia, with higher rates observed among older people. Moreover, the measurement methods used currently may over- or underestimate xerostomia. These findings highlight the need for further work on existing and new clinical measure and will be useful to determine which one is more reliable in clinical and epidemiological perspectives.

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“…Xerophthalmia and xerostomia are very common symptoms. The prevalence in the general population is 5-30% and 0.02-40%, respectively, with an increase correlated with the age of the population [13,14].…”

Prevalence of xerostomia in women during breast cancer chemotherapy

“…Xerostomia is defined by some authors as a subjective sensation of dry mouth, usually associated with decreased salivary flow, which may arise during chemotherapy, when radiotherapy is applied in or near the oral cavity (5)(6) .…”

“…This fact, when observed in the oral cavity, on average from the 7th to the 10th day after the administration of chemotherapy, presents a predisposition to the appearance of dry mouth and oral infections such as candidiasis, in addition to halitosis, the appearance of lesions, burning mouth, difficulties in chewing, swallowing and speech, as well as decreased taste. All of this has consequences for general health, such as poor nutrition, problems in social relationships and sleep, compromising quality of life (5,(7)(8)(9) .…”

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“…For example, in many instances, the risk of malnourishment is exacerbated by impaired dental status and loss of natural teeth (Toniazzo et al 2018). There are many factors which influence tooth loss; it is strongly associated with older age, typically caused by increased rates of dental caries, periodontal disease and dry mouth, all commonly observed in older age (Agostini et al 2018; National Institute of Dental and Craniofacial Research 2018; Lopez et al 2017). Although global prevalence of tooth loss is poorly reported, total tooth loss (i.e.…”