Abstract
Introduction
Xerostomia, also known as dry mouth, is prevalent in older populations and associated with key determinants such as continual use of medication, radiation, and chronic diseases. Xerostomia significantly increases the risk of experiencing demineralisation, dental caries, tooth sensitivity, candidiasis, and other oral conditions that may negatively affect quality of life. An effective strategy to manage the risk of dental caries for patients with xerostomia is the prescription of high-fluoride products with proven efficacy. The aim of this study was to provide evidence on the burden of xerostomia, patient characteristics, treatments, and healthcare resource use in this patient population in the United Kingdom.
Method
A retrospective observational study was conducted including all patients aged ≥16 years with a first diagnosis of xerostomia between 01/04/2015-31/03/2020 in the Optimum Patient Care Research Database, a primary care database. Patients with <12 months’ baseline and follow-up data were excluded.
Results
11,731 patients with a mean age of 67.93 years (SD 15.64) newly diagnosed with xerostomia were included. 72.27% of patients were >60 years and 65.3% were females. Patients aged ≥65 years received a median of 5 (Q1-Q3: 4-6) drug classes in the baseline period. Analgesic agents (80.6%), cardiovascular drugs (70.3%), antidepressants and antipsychotic agents (57.3%), and antihypertensive agents (47.6%) were common prescriptions reported before the diagnosis of xerostomia. Patients had 24.2 primary care visits with the associated costs of £727.66 per patient-year during follow-up. Only 2.2% of patients received high-fluoride toothpaste, whereas 99.6% of patients were prescribed artificial saliva and 16.3% received saliva stimulants.
Conclusions
The majority of patients aged ≥65 years had chronic diseases for which they received ≥4 medications in the baseline period. Although xerostomia is predominantly managed in primary care, few patients are prescribed high-fluoride toothpaste, which is a cost-effective and simple way to reduce the inevitable risk of dental caries.