Anticholinergic Medications and Caries Status in Middle Aged Xerostomia Patients

Objectives: Over 500 medications have anticholinergic effects blocking the salivary muscarinic receptors and causing xerostomia, which is the most frequent side effect of anticholinergic medications. Little is known about the anticholinergic medication burden in younger than older adults and the effects on their oral health. The primary aim of this study was to determine the impact of the anticholinergic drugs associated with xerostomia on oral health measured by the number of decayed, missing, and filled teeth in the permanent teeth among middle-aged adults.
Methods: An epidemiological retrospective study was performed on adults between 45 and 54 years old who received a dental examination at Eastman Institute for Oral Health. 176 adults were recruited based on the inclusion criteria of reported xerostomia. Patients with dry mouth of known salivary gland damage from radiation or cancer treatment, Sjogren’s syndrome, and autoimmune diseases were excluded. Anticholinergic burden from medications was calculated for each patient by the anticholinergic drug score (ADS). Caries history as the primary outcome was evaluated using the decayed, missing, and filled teeth (DMFT) index. Regression analysis was performed to identify factors associated to predict DMFT based on the comorbidities, smoking, gender, age, total number of medications, total number of anticholinergic medications. Inferential analyses were performed using Chi-square and ANOVA tests.
Results: The number of anticholinergic medications (5.4±3.5), age, and smoking status were found significant predictors (p=0.001), while comorbidities or gender did not explain a significant amount of variance in the DMFT (15.4±7.8). The multiple linear regression model showed that the higher ADS scores were significantly associated with higher DMFT.
Conclusions: Our study concluded that the number of anticholinergic drugs associated with xerostomia has a significant impact on the higher DMFT score. Further studies with the control group and bigger sample size are required to investigate this correlation in more depth.