The interrelationship between xerogenic medication use, subjective oral dryness and tooth wear.

OBJECTIVE: To investigate the association between xerogenic medication use and tooth wear among American adults and whether this association can be explained by subjective oral dryness. METHODS: We used data from 3578 adults who participated in the National Health and Nutritional Examination Survey (NHANES). Tooth wear was clinically determined using the modified Tooth Wear Index. Information on xerogenic medication use, subjective oral dryness (amount of saliva in mouth and feeling the mouth dry when eating) and potential confounders (sociodemographic factors, dental insurance coverage, gastroesophageal reflux disease medication use and soft drinks intake) were self-reported. The associations among xerogenic medication use, subjective oral dryness and tooth wear were assessed in regression models adjusting for confounders. RESULTS: Adults taking xerogenic medication had greater odds of reporting too little amount of saliva and feeling the mouth dry when eating. In addition, participants taking one and multiple (two or more) xerogenic medications had, respectively, 1.53 (95 % CI: 1.01-2.32) and 1.44 (95 % CI: 0.62-3.33) greater odds of having tooth wear than those taking no xerogenic medications. In a regression model including all explanatory variables, the association of xerogenic medication use with tooth wear was fully attenuated whereas subjective oral dryness (amount of saliva in mouth but not feeling the mouth dry when eating) remained positively associated with prevalence of tooth wear. Similar findings were obtained with long-term use of xerogenic medication (in the past month and for three or more years). CONCLUSION: Current (last month) use of xerogenic medication was associated with the presence of tooth wear. This association was accounted for by subjective indicators of oral dryness. CLINICAL SIGNIFICANCE: Dentists should be familiar with the possible connection between patient's medical prescription and tooth wear. Changing prescriptions to non-xerogenic alternatives, whenever possible, could improve patients' oral condition. The findings also suggest that patients may recognise, through the perception of dry mouth, when medication is placing them at risk.