Xerostomic medications and oral health: the Veterans Dental Study (part I).
OBJECTIVE
To quantify the adverse effects of the number of xerostomic medications on dental caries, oral mucosa, and periodontal disease.


METHODS
Secondary analysis of a cross-sectional study of the Veterans Dental Study.


METHODS
Four New England area VA outpatient clinics.


METHODS
The sample consists of 345 male veterans participating in The Veteran's Dental Study who also had pharmacy records.


METHODS
Oral health data included total surfaces of coronal caries, a modification of the root caries index, mean oral mucosa scores, and Community Periodontal Index of Treatment Need (CPITN). Oral health parameters were measured and recorded in clinical dental examinations.


METHODS
Intake of xerostomic medications 14-385 days prior to the dental examination.


METHODS
The relationships between exposure and outcome were analyzed via linear and logistic regression methods adjusting for possible confounding factors such as disease burden index, alcohol consumption, dental care, and smoking status.


RESULTS
Veterans who were taking at least one xerostomic medication were almost three times more likely to have mean mucosa scores in the worst 25 percentile than veterans taking no xerostomic medications, OR = 2.63 (confidence interval [CI] 1.34, 5.16, p = 0.03) after adjusting for age, number of teeth, disease burden index, income, smoking and alcohol use. Participants who were taking at least one xerostomic medication experienced higher but non-significant increases in coronal (OR = 1.21; CI. 0.66, 2.25) and root caries (OR = 1.10 CI. 0.54, 2.24) measured by numbers of total decayed surfaces.


CONCLUSIONS
There were significant deleterious effects of xerostomic medications on oral mucosa. However, xerostomic medications do not appear to increase coronal caries, or periodontal index measured by CPITN among ambulatory, community dwelling participants who were able to perform routine preventive oral care.
Janket
Sok-Ja
SJ
VA Medical Center, Dental Service, Bedford, MA, USA. sjanket@hsph.harvard.edu
Jones
Judith A
JA
Rich
Sharron
S
Meurman
Jukka
J
Garcia
Raul
R
Miller
Donald
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001900:Boston / Q000453:epidemiology; D015897:Comorbidity; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology*; D003753:Dental Health Surveys; D004358:Drug Therapy / Q000706:statistics & numerical data; D064420:Drug-Related Side Effects and Adverse Reactions; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012463:Saliva / Q000378:metabolism; D012472:Salivation / Q000187:drug effects; D012636:Secretory Rate; D014728:Veterans / Q000706:statistics & numerical data*; D014987:Xerostomia / Q000139:chemically induced* / Q000453:epidemiology*