title: Managing the care of patients with Sjögren syndrome and dry mouth: comorbidities, medication use and dental care considerations.
abstract: BACKGROUND
  As North Americans live longer, have more chronic conditions and take more medications, adverse oral events are likely to increase and aggravate the symptoms of Sjögren syndrome (SS).
  
  
  METHODS
  A total of 151 adults who self-reported having SS and who had a mean (standard deviation [SD]) age of 65.8 (11.5) years completed a survey that included questions about basic demographic information, current medical conditions, medications used (prescription and over the counter [OTC]) and the use of oral products to manage SS symptoms. Owing to the self-reporting process in our survey, the term "SS" in our study population represented a mixture of people with SS and people with dry mouth symptoms.
  
  
  RESULTS
  The mean (SD) number of daily medications recorded as prescription, OTC and oral care products were 4.9 (3.5), 4.5 (2.8) and 4.6 (1.4), respectively. Participants with four or more comorbid medical conditions (n = 74; 49.0 percent) had significant differences (P < .05) in oral symptoms compared with those who had fewer than four (n = 75; 49.7 percent). Participants who were taking fewer than four prescription and OTC medications daily (n = 61; 40.4 percent) has significant differences (P < .05) in voice hoarseness compared with those taking four or more prescription and OTC medications daily (n = 54; 35.8 percent).
  
  
  CONCLUSIONS
  The survey results indicated that medication use and comorbid medical conditions demonstrated significant differences and may have had a substantial impact on the oral symptoms in adults who self-reported having SS.
authors.affiliation: Dr. Donaldson is the director, Pharmacy Services, Kalispell Regional Healthcare, 310 Sunnyview Lane, Kalispell, Mont. 59901-3199, e-mail mdonaldson@krmc.org. Address correspondence to Dr. Donaldson.
authors.forename: Mark
authors.initials: M
authors.lastname: Donaldson
authors.affiliation: Dr. Epstein is a consultant, Division of Otolaryngology and Head and Neck Surgery, City of Hope National Medical Center, Duarte, Calif.
authors.forename: Joel
authors.initials: J
authors.lastname: Epstein
authors.affiliation: Ms. Villines is the director of research, Advocate Health Care, Chicago.
authors.forename: Dana
authors.initials: D
authors.lastname: Villines
mesh_terms: D000368:Aged; D002908:Chronic Disease; D015897:Comorbidity; D017742:Dental Care for Chronically Ill / Q000379:methods*; D004358:Drug Therapy; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D012307:Risk Factors; D057566:Self Report; D012859:Sjogren's Syndrome / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D014987:Xerostomia / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*
keywords: Autoimmune disease; Sjögren syndrome; comorbid conditions; dental care; drugs; interactions; patient safety