Pajukoski H, Meurman J H, Halonen P, Sulkava R
Helsinki City Health Department, Finland.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 Dec;92(6):641-9. doi: 10.1067/moe.2001.118478.
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.
We examined 175 home-living elderly patients (mean age with SD, 82 +/- 5.7 years) hospitalized because of sudden worsening of their general health. For comparison, 252 elderly outpatients (mean age with SD, 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.
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, CI 1.4-54.1, P <.05) and use of psychiatric drugs among the hospitalized (OR 4.2, CI 0.9-20.0, P =.07). For dry mouth, the strongest explanatory factors were respiratory disease in the outpatients (OR 2.0, CI 1.0-3.8, P <.05) and low salivary flow rate in the hospitalized elderly (OR 3.7, CI 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, CI 1.2-3.5, P <.01), whereas analgesic medication was found to protect against burning mouth (OR 0.5, CI 0.3-0.9, P <.05).
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.
本研究旨在调查体弱老年人中自我报告的口干和灼口症状的患病率。我们预计体弱老年人中这些症状的出现频率会高于健康状况较好的老年人。
我们检查了175名因总体健康状况突然恶化而住院的居家老年患者（平均年龄及标准差为82±5.7岁）。为作比较，对来自同一社区的252名老年门诊患者（平均年龄及标准差为77±5.7岁）进行了研究。记录了受试者的医学诊断和每日服用的处方药，检查了他们的口腔健康状况，并采集唾液样本以分析流速、酵母菌以及多种生化因子。
结果显示，63%的住院患者和57%的门诊患者主诉口干。灼口症状的相应比例在住院患者中为13%，在门诊患者中为18%。牙齿状况影响口干和灼口的感觉，但有或没有这些症状的患者之间，唾液生化成分浓度、酵母菌计数和缓冲能力并无相应差异，只是主诉口干的住院患者唾液缓冲能力低于无此症状者。口干在每日服用多种药物的住院患者中也更为普遍，而灼口症状未发现有此类关联。使用镇痛药似乎可预防这两种症状。口干和灼口很少同时出现，尽管低唾液流速在灼口患者中很常见。门诊患者中灼口的最强解释因素是精神疾病（比值比8.7，可信区间1.4 - 54.1，P <.05），住院患者中是使用精神科药物（比值比4.2，可信区间0.9 - 20.0，P =.07）。对于口干，门诊患者中最强的解释因素是呼吸系统疾病（比值比2.0，可信区间1.0 - 3.8，P <.05），住院老年患者中是低唾液流速（比值比3.7，可信区间1.4 - 10，P <.05）。在所有患者（n = 427）中，使用精神科药物是口干的最强解释因素（比值比2.1，可信区间1.2 - 3.5，P <.01），而镇痛药可预防灼口（比值比0.5，可信区间0.3 - 0.9，P <.05）。
在本研究的老年人群中，主观的口干和灼口感觉似乎是一个复杂的问题。这两种症状很少同时出现。症状的出现与总体健康状况没有直接关联，精神疾病和药物情况除外，对此应予以考虑。
