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The Effect of Xerostomic Medication on Oral Health in Persons With Dementia.

Authors
  • Lexomboon, Duangjai1
  • Tan, Edwin Ck2
  • Höijer, Jonas3
  • Garcia-Ptacek, Sara4
  • Eriksdotter, Maria5
  • Religa, Dorota5
  • Fastbom, Johan6
  • Johnell, Kristina6
  • Sandborgh-Englund, Gunilla7
  • 1 Department of Health Science, Karlstad University, Karlstad, Sweden; Academic Center for Geriatric Dentistry, Stockholm, Sweden. Electronic address: [email protected] , (Sweden)
  • 2 Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Australia; Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden. , (Australia)
  • 3 Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. , (Sweden)
  • 4 Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Neurology Section, Department of Internal Medicine, Södersjukhuset, Stockholm, Sweden. , (Sweden)
  • 5 Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Aging, Karolinska University Hospital, Stockholm, Sweden. , (Sweden)
  • 6 Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden. , (Sweden)
  • 7 Academic Center for Geriatric Dentistry, Stockholm, Sweden; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden. , (Sweden)
Type
Published Article
Journal
Journal of the American Medical Directors Association
Publication Date
Dec 01, 2018
Volume
19
Issue
12
Identifiers
DOI: 10.1016/j.jamda.2018.05.014
PMID: 29983362
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Medication-induced hyposalivation can increase the risk for oral complications, including dental caries and tooth loss. This problem is particularly important in people with dementia because of their declining ability to maintain oral care. The objective of this study was to describe the association between the number of xerostomic medications used and tooth loss and restorative and dental preventive treatment in a population of persons with dementia. A longitudinal population-based register study with a 3-year follow-up was conducted. Data were extracted from the Swedish Dementia Registry (SveDem), the Swedish Prescribed Drug Register (SPDR), the Swedish National Patient Register (SNPR), and the Dental Health Register (DHR). Participants were persons with dementia who were registered in the SveDem at the time of their dementia diagnosis. The exposure was continuous use of xerostomic medications over the 3 years prior to dementia diagnosis (baseline). The outcomes were the incidence of tooth extractions, tooth restorations, and dental preventive procedures. Poisson regression models were used to estimate incidence rate ratios (IRRs) for the association between the exposure and outcomes, adjusting for relevant confounders. A total of 34,037 persons were included in the analysis. A dose-response relationship between the exposure and tooth extractions was observed. Compared with nonusers of xerostomic medication, the rate of tooth extractions increased with increasing number of xerostomic medications used (IRR = 1.03, 1.11, and 1.40 for persons using an average >0-1, >1-3, and >3 xerostomic medications, respectively). However, the risk for having new dental restorations and receiving preventive procedures did not differ between groups. Continuous use of xerostomic medications can increase the risk for tooth extraction in people with dementia. This study highlights the importance of careful consideration when prescribing xerostomic medications to people with dementia, and the need for regular and ongoing dental care. Copyright © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

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