Anticholinergic medication and dental caries status in middle-aged xerostomia patients-a retrospective study

Abstract

Background/purpose: Xerostomia is the most frequent side effect of anticholinergic (AC) medications, which block the cholinergic neurotransmission of saliva secretion. As the most significant increase in AC medications' usage reported in middle-aged adults, we aimed to explore whether the level of exposure to AC medication show association with the severity of caries status of middle-aged individuals who complained about medication-induced xerostomia.

Materials and methods: Our retrospective study included 414 individuals (between 45 and 64 years) with self-reported xerostomia. We determined caries status by the Decayed, Missing, or Filled Teeth (DMFT) index and quantified the level of AC drug exposure by the AC Drug Scale (ADS), verified through electronic medication records. Statistical analyses were performed using chi-square and ANOVA tests. Covariates were age, gender, smoking, edentulism, comorbidities, polypharmacy, number, and the type of AC medications.

Results: In total, 54% of patients were taking five or more AC drugs. The mean number of anticholinergics was 5.41 (±3.44), most frequently antidepressants and antipsychotics, among all medications 10.63 (±5.79). Higher ADS scores were associated (p = 0.006) with a higher number of missing teeth. Multiple linear regression model showed that the number of AC medications, age, and smoking status are associated with DMFT (mean of 18.7 ± 8.96) scores.

Conclusion: Caries status of middle-aged xerostomia patients was found to be reflective of the level of AC exposure from medications. Our finding emphasizes the importance of assessing AC medication burden in affected dental patients to improve clinical prevention strategies and guide interdisciplinary treatment plans.

Keywords: Cholinergic antagonist; DMFT; Dental caries; Xerostomia.

Figure 1

Prescription frequencies among middle aged xerostomia patients; a) all medications taken, b) AC (anticholinergic) drugs.

Figure 2

Frequencies (percentage) of AC (anticholinergic) drug scores among middle-aged xerostomia patients. The AC burden is expressed as the cumulative ADS (anticholinergic drug score). Frequencies of ADS were calculated among the study participants (n = 414).