Prevalence of subjective dry mouth and burning mouth in hospitalized elderly patients and outpatients in relation to saliva, medication, and systemic diseases

Objective. The purpose of this study was to investigate the prevalence of self-reported symptoms of dry mouth and burning mouth in the frail elderly. We expected to find the studied symptoms more frequently in the frail elderly than in those who were healthier. Study design. We examined 175 home-living elderly patients (mean age with SID, 82 +/- 5.7 years) hospitalized because of sudden worsening of their general health. For comparison, 252 elderly outpatients (mean age with SID, 77 +/- 5.7 years) from the same community were studied. The subjects' medical diagnoses and prescribed drugs used daily were recorded, their oral health examined, and saliva samples taken for analyses of flow rates, yeasts, and a variety of biochemical factors. Results. The results showed that 63% of the hospitalized patients and 57% of the outpatients complained of dry mouth. The respective percentages of burning mouth were 13% in the hospitalized and 18% in the outpatients. The dentate status affected the feeling of dry mouth and burning mouth, but there were no consequent differences in concentrations of salivary biochemical constituents, yeast counts, and buffering capacity between patients with or without the symptoms except that hospitalized patients complaining of dry mouth more often had low salivary buffering than those without the symptom. Dry mouth was also more prevalent among the hospitalized patients who used several drugs daily, whereas no such association was found with the burning-mouth symptom. Use of analgesics appeared to safeguard against both the symptoms. Dry mouth and burning mouth were seldom reported simultaneously, although low salivary flow rate was a common finding in patients with burning mouth. The strongest explanatory factors for burning mouth were psychiatric disease among the outpatients (OR 8.7, Cl 1.4-54.1, P < .05) and use of psychiatric drugs among the hospitalized (OR 4.2, Cl 0.9-20.0, P = .07). For dry mouth, the strongest explanatory factors were respiratory disease in the outpatients (OR 2.0, Cl 1.0-3.8, P < .05) and low salivary flow rate in the hospitalized elderly (OR 3.7, Cl 1.4-10, P < .05). In all patients (n = 427), use of psychiatric drugs was the strongest explanatory factor for dry mouth (OR 2.1, Cl 1.2-3.5, P < .01), whereas analgesic medication was found to protect against burning mouth (OR 0.5, C1 0.3-0.9, P < .05). Conclusion. The subjective feelings of dry mouth and burning mouth appeared to be a complex issue among the elderly population studied. The 2 symptoms were seldom reported at the same time. The appearance of symptoms did not directly correlate with general health, except in the case of psychiatric diseases and medications, which should be taken into account.