Nutrient intakes and medication use in elderly individuals with and without dry mouths

  • Lee, Kyung Ah (Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University) ;
  • Park, Jung-Chul (Department of Periodontology, Dankook University College of Dentistry) ;
  • Park, Yoo Kyoung (Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University)
  • Received : 2019.08.19
  • Accepted : 2019.12.05
  • Published : 2020.04.01


BACKGROUND/OBJECTIVES: The nutrition of the elderly depends on various factors. Oral health, especially oral dryness, can be an important risk factor. In this study, we attempted to determine whether dry mouth is associated with compromised nutrient intakes. SUBJECTS/METHODS: A total of 120 participants aged 65-86 yrs (mean age: 69 ± 1 y) were included in this study. Demographic and health-related characteristics, living status, meals, number of medications, medical conditions, chewing ability, and quality of life, the Oral Health Impact Profile (the OHIP-14) were assessed. We performed one day 24-hr recall assessment for nutrient analyses. The differences of the means between the dry-mouth and non-dry-mouth groups were analyzed. Elderly subjects with xerostomia-induced dry mouth were classified as those who reported at least one dryness symptom on a questionnaire. RESULTS: A significant difference in population distribution was observed among the elderly who took medications for hypertension, diabetes and osteoporosis and was significantly higher in the dry-mouth group (70.2%) than in the non-dry-mouth group (44.4%) (P = 0.005). Compared with the non-dry-mouth group (50.8%), a significantly higher proportion (73.7%) of participants in the dry-mouth group took multiple medicines (≥ 4 medications) (P = 0.019). The intakes of vegetable fat, vitamin E, folate and water in the dry-mouth group were lower than in the non-dry-mouth group. The intakes of fluoride and ω-3 fatty acids were significantly lower in the dry-mouth group than in the non-dry-mouth group. CONCLUSION: The participants in the dry-mouth group exhibited low nutrient and water intakes. It is recommended that the elderly with dry mouth should drink sufficient water and receive targeted and specific nutritional guidance to prevent malnutrition.


  1. Statistics Korea. 2010 the Aged Statistics. Daejeon: Statistics Korea; 2010. p.1-36.
  2. Ezeh AC, Bongaarts J, Mberu B. Global population trends and policy options. Lancet 2012;380:142-8.
  3. Han P, Suarez-Durall P, Mulligan R. Dry mouth: a critical topic for older adult patients. J Prosthodont Res 2015;59:6-19.
  4. Ikebe K, Matsuda K, Morii K, Wada M, Hazeyama T, Nokubi T, Ettinger RL. Impact of dry mouth and hyposalivation on oral health-related quality of life of elderly Japanese. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103:216-22.
  5. Gerdin EW, Einarson S, Jonsson M, Aronsson K, Johansson I. Impact of dry mouth conditions on oral health-related quality of life in older people. Gerodontology 2005;22:219-26.
  6. Plemons JM, Al-Hashimi I, Marek CL; American Dental Association Council on Scientific Affairs. Managing xerostomia and salivary gland hypofunction: executive summary of a report from the American Dental Association Council on Scientific Affairs. J Am Dent Assoc 2014;145:867-73.
  7. Rusthen S, Young A, Herlofson BB, Aqrawi LA, Rykke M, Hove LH, Palm O, Jensen JL, Singh PB. Oral disorders, saliva secretion, and oral health-related quality of life in patients with primary Sjogren's syndrome. Eur J Oral Sci 2017;125:265-71.
  8. Pajukoski H, Meurman JH, Halonen P, Sulkava R. Prevalence of subjective dry mouth and burning mouth in hospitalized elderly patients and outpatients in relation to saliva, medication, and systemic diseases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:641-9.
  9. Gupta A, Epstein JB, Sroussi H. Hyposalivation in elderly patients. J Can Dent Assoc 2006;72:841-6.
  10. Iwasaki M, Yoshihara A, Ito K, Sato M, Minagawa K, Muramatsu K, Watanabe R, Manz MC, Ansai T, Miyazaki H. Hyposalivation and dietary nutrient intake among community-based older Japanese. Geriatr Gerontol Int 2016;16:500-7.
  11. Orellana MF, Lagravere MO, Boychuk DG, Major PW, Flores-Mir C, Ortho C. Prevalence of xerostomia in population-based samples: a systematic review. J Public Health Dent 2006;66:152-8.
  12. Samaranayake LP, Wilkieson CA, Lamey PJ, MacFarlane TW. Oral disease in the elderly in long-term hospital care. Oral Dis 1995;1:147-51.
  13. Ohara Y, Hirano H, Yoshida H, Obuchi S, Ihara K, Fujiwara Y, Mataki S. Prevalence and factors associated with xerostomia and hyposalivation among community-dwelling older people in Japan. Gerodontology 2016;33:20-7.
  14. Nederfors T. Xerostomia and hyposalivation. Adv Dent Res 2000;14:48-56.
  15. Thorselius I, Emilson CG, Osterberg T. Salivary conditions and drug consumption in older age groups of elderly Swedish individuals. Gerodontics 1988;4:66-70.
  16. Scully C. Drug effects on salivary glands: dry mouth. Oral Dis 2003;9:165-76.
  17. Terrie YC. Dry mouth: more common and less benign than thought. Pharm Times 2016.
  18. Mandl T, Ekberg O, Wollmer P, Manthorpe R, Jacobsson LT. Dysphagia and dysmotility of the pharynx and oesophagus in patients with primary Sjogren's syndrome. Scand J Rheumatol 2007;36:394-401.
  19. Tashbayev B, Rusthen S, Young A, Herlofson BB, Hove LH, Singh PB, Rykke M, Aqrawi LA, Chen X, Utheim OA, Utheim TP, Palm O, Jensen JL. Interdisciplinary, comprehensive oral and ocular evaluation of patients with primary Sjogren's syndrome. Sci Rep 2017;7:10761.
  20. Willett W. Issues in analysis and presentation of dietary data. In: Willett W, editor. Nutritional Epidemiology. 2nd ed. New York, NY: Oxford University Press; 1998. p.321-46.
  21. Food and Agriculture Organization of the United Nations. Dietary Assessment: a Resource Guide to Method Selection and Application in Low Resource Settings. Rome: Food and Agriculture Organization of the United Nations; 2018.
  22. Korean Nutrition Society. CAN-Pro 5.0 (Web ver.): Computer Aided Nutritional Analysis Program. Seoul: Korean Nutrition Society; 2015.
  23. Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol 1997;25:284-90.
  24. Lee SY. Development of questionnaire for evaluation of dry mouth treatments [master's thesis]. Seoul: Seoul National University; 2015.
  25. Fox PC, Busch KA, Baum BJ. Subjective reports of xerostomia and objective measures of salivary gland performance. J Am Dent Assoc 1987;115:581-4.
  26. Kim BI, Jeong SH, Chung KH, Cho YK, Kwon HK, Choi CH. Subjective food intake ability in relation to maximal bite force among Korean adults. J Oral Rehabil 2009;36:168-75.
  27. Ichikawa K, Sakuma S, Yoshihara A, Miyazaki H, Funayama S, Ito K, Igarashi A. Relationships between the amount of saliva and medications in elderly individuals. Gerodontology 2011;28:116-20.
  28. Smidt D, Torpet LA, Nauntofte B, Heegaard KM, Pedersen AM. Associations between labial and whole salivary flow rates, systemic diseases and medications in a sample of older people. Community Dent Oral Epidemiol 2010;38:422-35.
  29. Park MS, Ryu SA. Degree of dry mouth and factors influencing oral health-related quality of life for community-dwelling elders. J Korean Acad Nurs 2010;40:747-55.
  30. Johanson CN, Osterberg T, Lernfelt B, Ekstrom J, Birkhed D. Salivary secretion and drug treatment in four 70-year-old Swedish cohorts during a period of 30 years. Gerodontology 2015;32:202-10.
  31. Cassolato SF, Turnbull RS. Xerostomia: clinical aspects and treatment. Gerodontology 2003;20:64-77.
  32. Lee KW, Shin D, Song WO. Total water intake from beverages and foods is associated with energy intake and eating behaviors in Korean adults. Nutrients 2016;8:E617.
  33. Astrom AN, Lie SA, Ekback G, Gulcan F, Ordell S. Self-reported dry mouth among ageing people: a longitudinal, cross-national study. Eur J Oral Sci 2019;127:130-8.
  34. Locker D. Dental status, xerostomia and the oral health-related quality of life of an elderly institutionalized population. Spec Care Dentist 2003;23:86-93.
  35. Lee JH. Dry mouth in the Korean elderly: associate factors, and impacts on oral health related quality of life [master's thesis]. Seoul: Seoul National University; 2006.
  36. Fox PC, van der Ven PF, Sonies BC, Weiffenbach JM, Baum BJ. Xerostomia: evaluation of a symptom with increasing significance. J Am Dent Assoc 1985;110:519-25.
  37. Villa A, Polimeni A, Strohmenger L, Cicciu D, Gherlone E, Abati S. Dental patients' self-reports of xerostomia and associated risk factors. J Am Dent Assoc 2011;142:811-6.
  38. Won YS, Kim JH, Kim SK. Relationship of subjective oral health status to subjective oral symptoms for the elderly in some Seoul area. J Dent Hyg Sci 2009;9:375-80.
  39. Steele JG, Sanders AE, Slade GD, Allen PF, Lahti S, Nuttall N, Spencer AJ. How do age and tooth loss affect oral health impacts and quality of life? A study comparing two national samples. Community Dent Oral Epidemiol 2004;32:107-14.
  40. Pai S, Ghezzi EM, Ship JA. Development of a Visual Analogue Scale questionnaire for subjective assessment of salivary dysfunction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:311-6.
  41. Leslie W, Hankey C. Aging, nutritional status and health. Healthcare (Basel) 2015;3:648-58.
  42. Rodrigues HL Jr, Scelza MF, Boaventura GT, Custodio SM, Moreira EA, Oliveira DL. Relation between oral health and nutritional condition in the elderly. J Appl Oral Sci 2012;20:38-44.