Abstract
Objectives
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.
Design
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).
Setting and participants
Participants were persons with dementia who were registered in the SveDem at the time
of their dementia diagnosis.
Measures
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.
Results
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.
Conclusion
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.
Keywords
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Article info
Publication history
Published online: July 05, 2018
Footnotes
The authors declare no conflicts of interest.
The study is supported by the Stockholm County Council (SOF project OF11204423); the Swedish Research Council (523-2012-2291,2016-02317); the Stockholm County Council (ALF 20170190,20160336); the NHMRC-ARC Dementia Research Development Fellowship (APP1107381); the Swedish Order of Saint John; the Swedish Society for Medical Research; the Swedish Research Council for Health, Working Life and Welfare FORTE (2017-01646); the Swedish Association of Local Authorities and Regions; and the Swedish Brain Power network.
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