Abstract
Saliva possesses many important functions including antimicrobial activity, pH balance, lubrication, remineralization and mechanical cleansing of the oral mucosa. Xerostomia results from reduced or absent saliva flow. Its prevalence increases with age and is approximately 30% in patients over 65 years. Numerous medications include xerostomia as side effect. Dry mouth has multiple oral health consequences and affects quality of life. Oral candidiasis is one of the most common oral infections seen in association with xerostomia. Methods: We recorded systematic anamnesis about swallowing difficulties, taste modification, dry mouth sensation, and results of oral dysphagia and mouth clinical examination. Results: Forty-one patients were admitted consecutively in an acute geriatric unit. Median age was 86 (range: 76–99), and 80% of the patients were female. The median number of drugs lines was 8 (range 1–17). Thirty-one patients (76%) complained of xerostomia, 19 (46%) for more than 3 months, 27 (66%) need liquids to swallow dry foods, 16 (39%) feel swallowing difficulties, while 11 (37%) had a real dysphagia screened by a speech therapist. Oropharyngeal candidiasis was found in 14 patients (34%). Patients with MNA-confirmed risk of malnutrition complained more of xerostomia. Only red depapillation had significant statistical association with candidiasis. Antibiotics, opioids and diuretics showed an increased trend to xerostomia. Conclusion: Xerostomia and oropharyngeal candidiasis can be frequently symptomatic in the elderly, who are particularly frail and challenged by polypharmacy and multiple comorbid conditions. Physicians should be aware of oral health and drug related salivation disorder.