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Published in: Clinical Oral Investigations 9/2018

Open Access 01-12-2018 | Original Article

Relationship among perceived stress, xerostomia, and salivary flow rate in patients visiting a saliva clinic

Authors: Marjolein S. Bulthuis, Derk H. Jan Jager, Henk S. Brand

Published in: Clinical Oral Investigations | Issue 9/2018

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Abstract

Objective

This aimed to assess the potential role of chronic stress in saliva secretion, xerostomia, and oral health in a population attending a saliva clinic.

Materials and methods

Data of 114 patients who met the inclusion criteria and completed all questionnaires were analyzed in this study. Participants completed several validated questionnaires, including the Perceived Stress Scale, the Oral Health Impact Profile (OHIP-14), Xerostomia Inventory (XI), and Bother xerostomia Index (BI). Subsequently, the unstimulated, chewing-stimulated, and citric acid-stimulated saliva secretion rates were determined gravimetrically. Data were evaluated using Spearman’s correlation analysis and the Mann–Whitney U test.

Results

A significant correlation was observed between perceived stress and XI score (r = 0.312, p = 0.001), as well as between perceived stress and BI score (r = 0.334, p = 0.001). Stress levels also were significantly associated with OHIP-14 scores (r = 0.420, p < 0.001), but an association between experienced stress and salivary flow rate could not be established.

Conclusion

In this population, perceived chronic stress seems to be related to several aspects of dry mouth, including the perception of dry mouth, suffering from dry mouth, and the impact on quality of life. These effects were independent of the use of psychotropic medication. No actual reduction in salivary flow was found. Further studies to explore the causal linkage of stress with xerostomia seem warranted.

Clinical relevance

Perceived chronic stress seems to be related with several aspects of dry mouth. This finding might be relevant in future prevention and treatment of xerostomia.
Literature
3.
go back to reference Thomson WM, Chalmers JM, Spencer AJ, Williams SM (1999) The xerostomia inventory: a multi-item approach to measuring dry mouth. Community Dent Health 16:12–17PubMed Thomson WM, Chalmers JM, Spencer AJ, Williams SM (1999) The xerostomia inventory: a multi-item approach to measuring dry mouth. Community Dent Health 16:12–17PubMed
6.
go back to reference Villa A, Wolff A, Narayana N, Dawes C, Aframian DJ, Lynge Pedersen AM, Vissink A, Aliko A, Sia YW, Joshi RK, McGowan R, Jensen SB, Kerr AR, Ekström J, Proctor G (2016) World workshop on oral medicine VI: a systematic review of medication-induced salivary gland dysfunction. Oral Dis 22:365–382. https://doi.org/10.1111/odi.12402 CrossRefPubMed Villa A, Wolff A, Narayana N, Dawes C, Aframian DJ, Lynge Pedersen AM, Vissink A, Aliko A, Sia YW, Joshi RK, McGowan R, Jensen SB, Kerr AR, Ekström J, Proctor G (2016) World workshop on oral medicine VI: a systematic review of medication-induced salivary gland dysfunction. Oral Dis 22:365–382. https://​doi.​org/​10.​1111/​odi.​12402 CrossRefPubMed
10.
go back to reference Matos-Gomes N, Katsurayama M, Makimoto FH, Santana LLO, Paredes-Garcia E, Becker MA’Á, Dos-Santos MC (2010) Psychological stress and its influence on salivary flow rate, total protein concentration and IgA, IgG and IgM titers. Neuroimmunomodulation 17:396–404. https://doi.org/10.1159/000292064 CrossRefPubMed Matos-Gomes N, Katsurayama M, Makimoto FH, Santana LLO, Paredes-Garcia E, Becker MA’Á, Dos-Santos MC (2010) Psychological stress and its influence on salivary flow rate, total protein concentration and IgA, IgG and IgM titers. Neuroimmunomodulation 17:396–404. https://​doi.​org/​10.​1159/​000292064 CrossRefPubMed
13.
18.
go back to reference Sutton P (1966) Stress and dental caries. In: Advances in Oral Biology, volume 2 Academic Press, New York Sutton P (1966) Stress and dental caries. In: Advances in Oral Biology, volume 2 Academic Press, New York
22.
go back to reference WHO guidelines for anatomical- therapeutical-chemical classification, ATC/DDD index 2013. www.whocc.no. Accessed 19 Dec 2016 WHO guidelines for anatomical- therapeutical-chemical classification, ATC/DDD index 2013. www.​whocc.​no. Accessed 19 Dec 2016
26.
go back to reference Challacombe SJ, Osailan SM, Proctor GB (2015) Clinical scoring scales for assessment of dry mouth. In: Carpenter G (ed) Dry mouth. Springer, Berlin, Heidelberg, pp 129–131 Challacombe SJ, Osailan SM, Proctor GB (2015) Clinical scoring scales for assessment of dry mouth. In: Carpenter G (ed) Dry mouth. Springer, Berlin, Heidelberg, pp 129–131
28.
go back to reference Abraham-Inpijn L, Russell G, Abraham DA, Bäckman N, Baum E, Bullón-Fernández P, Declerck D, Fricain JC, Georgelin M, Karlsson KO, Lamey PJ, Link-Tsatsouli I, Rigo O (2008) A patient-administered medical risk related history questionnaire ( EMRRH ) for use in 10 European countries ( multicenter trial ). Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105:597–605. https://doi.org/10.1016/j.tripleo.2007.09.032 CrossRefPubMed Abraham-Inpijn L, Russell G, Abraham DA, Bäckman N, Baum E, Bullón-Fernández P, Declerck D, Fricain JC, Georgelin M, Karlsson KO, Lamey PJ, Link-Tsatsouli I, Rigo O (2008) A patient-administered medical risk related history questionnaire ( EMRRH ) for use in 10 European countries ( multicenter trial ). Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105:597–605. https://​doi.​org/​10.​1016/​j.​tripleo.​2007.​09.​032 CrossRefPubMed
29.
go back to reference Dawes C (1972) Circadian rhythms in human salivary flow rate and composition. J Physiol 220:529–545CrossRef Dawes C (1972) Circadian rhythms in human salivary flow rate and composition. J Physiol 220:529–545CrossRef
30.
go back to reference Navazesh M, Kumar SKS (2008) Measuring salivary flow: challenges and opportunities. J Am Dent Assoc 139(Suppl):35S–40SCrossRef Navazesh M, Kumar SKS (2008) Measuring salivary flow: challenges and opportunities. J Am Dent Assoc 139(Suppl):35S–40SCrossRef
31.
go back to reference Vitali C, Bombardieri S, Jonsson R, Moutsopoulos HM, Alexander EL, Carsons SE, Daniels TE, Fox PC, Fox RI, Kassan SS, Pillemer SR, Talal N, Weisman MH, European Study Group on Classification Criteria for Sjögren’s Syndrome (2002) Classification criteria for Sjögren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 61:554–558 Vitali C, Bombardieri S, Jonsson R, Moutsopoulos HM, Alexander EL, Carsons SE, Daniels TE, Fox PC, Fox RI, Kassan SS, Pillemer SR, Talal N, Weisman MH, European Study Group on Classification Criteria for Sjögren’s Syndrome (2002) Classification criteria for Sjögren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 61:554–558
38.
go back to reference Borgeat F, Chagon G, Legault Y (1984) Comparison of the salivary changes associated with a relaxing and with a stressful procedure. Psychophysiology 21:690–698CrossRef Borgeat F, Chagon G, Legault Y (1984) Comparison of the salivary changes associated with a relaxing and with a stressful procedure. Psychophysiology 21:690–698CrossRef
Metadata
Title
Relationship among perceived stress, xerostomia, and salivary flow rate in patients visiting a saliva clinic
Authors
Marjolein S. Bulthuis
Derk H. Jan Jager
Henk S. Brand
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 9/2018
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-018-2393-2

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