Kakkar Mayank, Barmak Abdul Basir, Arany Szilvia
Department of Dentistry, Eastman Institute of Oral Health, University of Rochester, NY, USA.
Complex Care Center Clinic, University of Rochester Medical Center, NY, USA.
J Dent Sci. 2022 Jul;17(3):1206-1211. doi: 10.1016/j.jds.2021.12.014. Epub 2021 Dec 29.
BACKGROUND/PURPOSE: Xerostomia is the most frequent side effect of anticholinergic (AC) medications, which block the cholinergic neurotransmission of saliva secretion. As the most significant increase in AC medications' usage reported in middle-aged adults, we aimed to explore whether the level of exposure to AC medication show association with the severity of caries status of middle-aged individuals who complained about medication-induced xerostomia.
Our retrospective study included 414 individuals (between 45 and 64 years) with self-reported xerostomia. We determined caries status by the Decayed, Missing, or Filled Teeth (DMFT) index and quantified the level of AC drug exposure by the AC Drug Scale (ADS), verified through electronic medication records. Statistical analyses were performed using chi-square and ANOVA tests. Covariates were age, gender, smoking, edentulism, comorbidities, polypharmacy, number, and the type of AC medications.
In total, 54% of patients were taking five or more AC drugs. The mean number of anticholinergics was 5.41 (±3.44), most frequently antidepressants and antipsychotics, among all medications 10.63 (±5.79). Higher ADS scores were associated (p = 0.006) with a higher number of missing teeth. Multiple linear regression model showed that the number of AC medications, age, and smoking status are associated with DMFT (mean of 18.7 ± 8.96) scores.
Caries status of middle-aged xerostomia patients was found to be reflective of the level of AC exposure from medications. Our finding emphasizes the importance of assessing AC medication burden in affected dental patients to improve clinical prevention strategies and guide interdisciplinary treatment plans.
背景/目的:口干是抗胆碱能(AC)药物最常见的副作用,这类药物会阻断唾液分泌的胆碱能神经传递。鉴于中年成年人中AC药物使用量的显著增加,我们旨在探讨AC药物的暴露水平是否与主诉药物性口干的中年个体的龋齿严重程度相关。
我们的回顾性研究纳入了414名自我报告有口干症状的个体(年龄在45至64岁之间)。我们通过龋失补牙指数(DMFT)确定龋齿状况,并通过AC药物量表(ADS)量化AC药物暴露水平,该量表经电子用药记录验证。使用卡方检验和方差分析进行统计分析。协变量包括年龄、性别、吸烟、无牙状态、合并症、多种药物使用情况、AC药物的数量和类型。
总体而言,54%的患者正在服用五种或更多的AC药物。抗胆碱能药物的平均数量为5.41(±3.44),在所有药物中,最常用的是抗抑郁药和抗精神病药,平均数量为10.63(±5.79)。较高的ADS评分与更多的缺失牙数量相关(p = 0.006)。多元线性回归模型显示,AC药物的数量、年龄和吸烟状况与DMFT(平均值为18.7 ± 8.96)评分相关。
发现中年口干患者的龋齿状况反映了药物中AC的暴露水平。我们的研究结果强调了评估受影响牙科患者的AC药物负担对于改善临床预防策略和指导跨学科治疗计划的重要性。