Factors related to dry mouth and low salivary flow rates in
               diabetic elderly: a systematic literature review

Morais, Everton Freitas de; Macedo, Rômulo Augusto de Paiva; Lira, Jadson Alexandre da Silva; Lima, Kenio Costa de; Borges, Boniek Castillo Dutra

doi:10.1590/S1809-98232014000200018

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Review Article • Rev. bras. geriatr. gerontol. 17 (2) • 2014 • https://doi.org/10.1590/S1809-98232014000200018 copy

Factors related to dry mouth and low salivary flow rates in diabetic elderly: a systematic literature review

Fatores relacionados a boca seca e hipossalivação em idosos diabéticos: uma revisão

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This study aimed to perform a systematic review of studies on factors related to xerostomia and/or hyposalivation in elderly patients with diabetes. SciELO, Science Direct, Scopus, and PubMed/Medline databases were searched for articles published from January 1992 to January 2013, concerned with factors associated with/related to xerostomia or hyposalivation in elderly patients with diabetes. Five articles were selected, including four transversal studies and one longitudinal study. Some of the studies found relationship between poor glycemic control and hyposalivation. Others found that xerostomia was more frequent in patients who worked in nondomestic environments and in women. However, there was considerable variation in the methods used by the researchers in the selected studies. We could not draw definitive conclusions based on our analysis of the selected studies. Longitudinal studies with appropriate sample sizes are needed to provide more complete information about the factors related to xerostomia and hyposalivation in elderly patients with diabetes.

Xerostomia; Elderly; Diabetes Mellitus; Saliva

Search strategy	A	B	C	D
(Elderly OR older OR aged) AND (xerostomia OR “dry mouth” OR “oral dryness” OR “impaired salivary flow”) AND (diabetes OR diabetic).	0	2456	10	216
(Elderly OR older OR aged) AND (hyposalivation OR “salivary hypofunction” OR “reduced salivary flow” OR “low salivary flow” OR “decrease salivary flow”) AND (diabetes OR diabetic).	0	3047	17	177

Author	Type of study	Sample size	Type of diabetes	How was xerostomia defined?	Analyzed variables	How was hyposalivation defined?	Factors associated / related to xerostomia	Factors associated / related hyposalivation
Borges et al. (Brazil, 2010)^{8 Δ}	Cross-sectional	52* (47 ♀ e 5 ♂)	Type 2	Self-reporting of dry mouth	Socioeconomic status, patient health, use of medications	Hyposalivation was defined as flow rate values lower than 0.1 ml/min for unstimulated salivary flow and lower than 0.7 ml/min for stimulated flow.	People who work outside the house was more likely to have xerostomia	No variable was associated with hypossalivation
Chávez et al. (USA, 2000)⁹^Δ	Cross-sectional	52 (27 ♀ e 25 ♂)	Type 2	Self-reporting of dry mouth	Socioeconomic status, patient health, use of medications, disease stage, age and gender	Hyposalivation was classified as low or normal according to the flow rate (≤0.2ml/min for men and ≤0.18ml/min for women). Unstimulated salivary flow was analyzed	No variable was associated with xerostomia	Hyposalivation was related to poorly controlled patients diabetes and to the use of drug
Chavez et al. (USA, 2001)¹⁰^Δ	Longitudinal	39 (20 ♀ e 19 ♂)	Type 2	Self-reporting of dry mouth	Socioeconomic status, patient health, use of medications, disease stage, age and gender	Hyposalivation was classified as low or normal according to the flow rate (≤0.2ml/min for men and ≤0.18ml/min for women). Unstimulated salivary flow was analyzed.	No variable was associated with xerostomia	Hyposalivation was related to poorly controlled patients diabetes and to the use of drug
Shenoy et al. (Índia, 2010)¹¹^Δ	Cross-sectional	150 (51 ♀ e 99 ♂)	Type 2	Self-reporting of dry mouth	Patient health, use of medications, disease stage, age and gender	Not analyzed	The gender was associated to xerostomia. Women were more likely to have xerostomia	Not analyzed
Sandberg et al. (Switzerland, 2003)^{12 Δ}	Cross-sectional	102* (38 ♀ e 64 ♂)	Type 2	Self-reporting of dry mouth	Presence of neuropathy, patient health, use of medications, disease stage,age and gender	Not analyzed	No variable was associated with xerostomia	Not analyzed

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[1] Correspondência / Correspondence Boniek Castillo Dutra Borges E-mail: boniek.castillo@gmail.com