Saliva has several important functions that assist in preventing oral diseases, including lubricating soft tissues, regulating pH levels, clearing food particles, antimicrobial function, and facilitating tooth mineralization. The lack of saliva can be determined through both subjective sensations (xerostomia) and objective evidence (hyposalivation). Medications and systemic diseases can contribute to xerostomia. Xerostomia greatly increases the risk of developing dental caries as well as periodontal disease.1
A clinician’s awareness of xerostomia is essential to help patients manage the cause as well as the symptoms patients experience. A questionnaire-based study aimed to compare awareness and clinical management among dentists and dental hygienists and determine if the length of professional experience influenced the clinician’s awareness and understanding of xerostomia.1
The Study
The study was designed as a cross-sectional survey that included dental hygienists and dentists employed within the Public Dental Service in Sweden. The survey was distributed to 2,668 dental professionals.1
The questionnaire included four sections: 1) demographics, 2) content of undergraduate education, 3) approaches used in clinical practice for the management of individuals with xerostomia, and 4) awareness of saliva functions, causes, and complications associated with xerostomia.1
The assessment among respondents for levels of agreement regarding their awareness of saliva functions, factors that may cause oral dryness, and complications associated with oral dryness, the questionnaire utilized a five-point scale ranging from one (strongly agree) to five (strongly disagree) with an additional option for “don’t know.”1
The Results
This study revealed a gap in dental care: despite widespread awareness of xerostomia risks, the condition is often overlooked in patients under 65. An estimated 88.6% of dental professionals only inquire about xerostomia in older adults, even though the condition is prevalent and problematic in younger age groups due to factors like medication use and chronic conditions.1
Dental hygienists were more proactive than dentists, frequently asking about xerostomia across all age groups. Hygienists with over a decade of experience were more likely to provide preventive care and educate patients about xerostomia risks.1
In contrast, dentists with more experience focused on providing written information compared to those with less experience. The study also determined that only a third of professionals provide patients with written guidance on managing xerostomia despite over half frequently recommending products. Previous studies found that patients struggle to remember verbal instructions from appointments, highlighting the importance of clear, written information to support ongoing care.1
The proactive approach of experienced dental hygienists may stem from treating individuals with xerostomia and witnessing the devastating impacts of oral health. Conversely, studies show a general lack of interest in prevention among dentists, as prevention has a lower priority than the treatment they provide in their daily practice. It has also been shown that some dentists expect preventive care to be managed by dental hygienists alone.1
Conclusion
Compared to dentists, dental hygienists inquired more often about patients’ experience with xerostomia. Hygienists were more likely to recommend preventive steps across all age groups, demonstrating a comprehensive understanding of xerostomia risks. Experience improved their approach, suggesting that time in the profession can enhance xerostomia management skills. This was especially true for hygienists, who seemed to leverage their experience into better patient outcomes.1
It’s crucial that all dental professionals prioritize xerostomia screening and prevention for patients of all ages. The risks are too great to ignore, and the consequences of inaction can be severe. By making prevention a core part of daily practice, dental professionals can safeguard oral health across the lifespan of the patient’s dentition.1
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Reference
1. Fisic, A., Aras, H.C., Almhöjd, U., Almståhl, A. Dental Care Professionals’ Awareness of Oral Dryness and Its Clinical Management: A Questionnaire-Based Study. BMC Oral Health. 2024; 24(1): 45. https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-023-03813-2
