Guidelines for Management of Oral Dryness (Xerostomia) in the Elderly: A 2 Cases Report
Keywords:
Elderly, Dry mouth, Management of dry mouth, Roi-et hospital, Radio therapyAbstract
Background and Objective: Oral dryness in the elderly was often found and caused by various combination factors. The purpose of this study was to study how to take care for oral dryness in the elderly patients that affected from chronic disease, radiation therapy, and medication.
Methods: This study performed in 2 cases of patients with oral dryness. Case 1, 65 years-old Thai male patient with oral dryness that came for an appointment for follow-up 1 month after receiving radiotherapy (in December 2021). This case had a congenital disease with Type 2 diabetes and intraoral examination was diagnosed with severe dryness. Provide treatment and follow-up of treatment until 3 months. Case 2, 64year-old Thai woman, was referred for treatment and follow-up due to dry mouth in 2021. The patient had congenital disease with hypertension and type 2 diabetes and Intraoral examination was diagnosed with moderate dryness. Provide treatment and follow-up of treatment until 3 months. Both patients used Clinical oral dryness score (CODS) for diagnosis.
Results: Patient 1, after 3 months of treatment, the patient felt the mouth was moister, less soreness in the mouth, easier to swallow, the CODS score was decreased from 7 to 5, so pilocarpine was reduced to 5-10 mg once a day with oral moisturizing Jelly. Make an appointment for an oral health examination and fluoride coating once a month until the 6th month after treatment and follow-up. It was found that the patient felt that mouth was moister. In the oral examination, there was an increase in saliva. There is no burning sensation in the mouth at all, easier to swallow, and eat more. Patient 2, after 3 months of treatment, the patient felt that the mouth was moister, no burning sensation in the mouth, easier to swallowed, wake up less late at night. The oral examination found moist tissue, saliva was relatively clear, the CODS score decreased from 4 to 2 points. Due to the patient's had good oral condition, the oral examination was planned and fluoride coating every 6 months.
Conclusion: The results of the treatment and care guidelines for dry mouth treatment in both elderly patients showed that patients were improvement in symptoms. The patient felt that the mouth was moister, no burning sensation in the mouth, easier to swallowed, eat more, and decreased CODS scores.
References
Nathita Yookhum. Prevalence of xerostomia in the elderlyat mueang roiet district. Res Develop Health Sys J 2022;15(1):129-41.
Millsop JW, Wang EA, Fazel N. Etiology, evaluation, and management of xerostomia. Clin Dermatol 2017;35(5):468-76.
Villa A, Connell CL, Abati S. Diagnosis and management of xerostomia and hyposalivation. Ther Clin Risk Manag 2015;11:45-51.
Mercadante V, Al Hamad A, Lodi G, Porter S, Fedele S. Interventions for the management of radiotherapy-induced xerostomia and hyposalivation: A systematic review and meta-analysis. Oral Oncol 2017;66:64-74
López-Pintor RM, Casañas E, González-Serrano J, Serrano J, Ramírez L, de Arriba L, et al. Xerostomia, Hyposalivation, and Salivary Flow in Diabetes Patients. J Diabetes Res 2016;2016:4372852.
Barbe AG. Medication-Induced Xerostomia and Hyposalivation in the Elderly: Culprits, Complications, and Management. Drugs Aging 2018;35(10):877-85.
Thorne I, Sutcliffe N. Sjögren's syndrome. Br J Hosp Med (Lond) 2017;78(8):438-42.
Santiago PHR, Song Y, Hanna K, Nair R. Degrees of xerostomia? A Rasch analysis of the Xerostomia Inventory. Community Dent Oral Epidemiol 2020;48(1):63-71.
Jager DHJ, Bots CP, Forouzanfar T, Brand HS. Clinical oral dryness score: evaluation of a new screening method for oral dryness. Odontology 2018;106(4):439-44.
Higashi T, Hijikuro M, Yamagata K, Ogawa S. Influence of saliva flow rate stimulated by gum-chewing on salivary concentrations of catecholamine metabolites. Clin Chim Acta 2012;414: 248-52.
Das P, Challacombe SJ. Dry Mouth and Clinical Oral Dryness Scoring Systems. Prim Dent J 2016 ;5(1):77-79. Xerostomia: Etiology, Complications, and Medical Management. Dent Clin North Am 2016;60(2):435-43.
Zunt SL. Xerostomia/Salivary Gland Hypofunction: Diagnosis and Management. Compend Contin Educ Dent 2018;39(6):365-9.
Dental Innovation Foundation under Royal Patronage. Research and development of innovative product oral moisturizing jelly project. Annual report; 2016:57-64.
Dalodom S, Lam-ubol A, Jeanmaneechotechai S, Takamfoo L, Intachai W, Duangchada K, et al. Influence of oral moisturizing jelly as a saliva substitute for the relief of xerostomia in elderly patients with hypertension and diabetes mellitus. Geriatric Nursing 2016;37:101-9.
Somjai Ornlaied. Health literacy a ssociated with health behavior among elderly with active aging in Nakhon Pathom province. Res Develop Health Syst J 2021;14(3):333-45.
Thour A, Marwaha R. Amitriptyline. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. [Cited May 15, 2022]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537225/
Fornari CB, Bergonci D, Stein CB, Agostini BA, Rigo L. Prevalence of xerostomia and its association with systemic diseases and medications in the elderly: a cross-sectional study. Sao Paulo Med J 2021;139(4):380-7.
Fernandes MS, Castelo PM, Chaves GN, Fernandes JPS, Fonseca FLA, Zanato LE, et al. Relationship between polypharmacy, xerostomia, gustatory sensitivity, and swallowing complaints in the elderly: A multidisciplinary approach. J Texture Stud 2021;52(2):187-196.
Kuthasema P, Putwatana P, Junhavat D. Experience of xerostomia, management, and outcomes in patients with head and neck cancer post radiation. Rama Nurs J 2010;16(1):40-53.
Gil-Montoya JA, Silestre FJ, Barrios R, Silvestre-Rangil J. Treatment of xerostomia and hyposalivation in the elderly: a systemstic review. Med Oral Patol Oral Cir Bucal 2016;21: e355-66.
Strojan P, Hutcheson KA, Eisbruch A, Beitler JJ, Langendijk JA, Lee AWM, et al. Treatment of late sequelae after radiotherapy for head and neck cancer. Cancer Treat Rev 2017;59:79-92.
Lovelace TL, Fox NF, Sood AJ, Nguyen SA, Day TA. Management of radiotherapy-induced salivary hypofunction and consequent xerostomia in patients with oral or head and neck cancer: meta-analysis and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2014;117(5):595-607.
Siladlao S, Chusuton S, Mekwimon Kingkaew W, Somporn K, Songsin N. Factors affecting the quality of life of elderly clubs in Bang Nok Kwak Bang Tee district, Samut Songkhram Province. Res Develop Health Syst J 2021;14(3):298-309.
Thatreenaranon S. The efficacy of oral moisturizing jelly in alleviating symptoms of xerostomia in psychiatric patients. J Mental Health Thai 2018;26(2):129-41.
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