일부 전신질환자에서 구강건조증의 관련요인 분석

김선주 ( Sun Ju Kim ),최준선 ( Jun Seon Choi ) 한국치위생과학회 2013 치위생과학회지 Vol.13 No.4

The purpose of this study was to evaluate the factors related to xerostomia in patients with systemic diseases, and the results were analyzed through t-test, ANOVA, and multiple linear regression analysis. There were 62 respondents (56.9%) who reported dry mouth and the season of the most severe dry mouth was reported to be the highest during winter. According to the analysis made in the relationship of xerostomia with the awareness of general health and health behavior, the group that understood their own health poorly, had more than two kinds of diseases, and had been administered more than two kinds of daily medication showed higher xerostomia. Also, those who experienced desperation, had high dryness in other parts of the body, and heavy snoring were more aware of xerostomia (p<0.05). According to the analysis made in the relationship between xerostomia and awareness of oral health state, the group that understood their oral health poorly and had pain in the oral mucous membrane and halitosis was more aware of xerostomia (p<0.05). According to the analysis made in the relationship between quality of life and xerostomia, the group that showed high level of problem in daily living and stress and were self-conscious and felt tense due to halitosis reported more xerostomia (p<0.05). Finally, xerostomia was most correlated with consciousness of the eyes of others due to halitosis followed by the number of transferred systemic diseases and stress level. Based on such results, xerostomia was understood to be an obstacle in maintaining favorable social life and health. Since xerostomia was shown to be related to the number of transferred systemic diseases, the dental professions are asked to further improve their understanding not only on oral health but also systemic diseases. Therefore, these efforts are expected to prevent xerostomia and reduce various complications caused by xerostomia.

세기조절방사선치료를 시행받은 두경부암 환자군에서 구강건조증지표 분석

이석호(Seok Ho Lee),김태현(Tae Hyun Kim),지의규(Eui Kyu Chie),임현선(Hyun Shil Im),임은실(En Shil Im),류준선(Jun Sun Ryu),정유석(Yoo Seok Jung),박성용(Sung Yong Park),김주영(Joo Young Kim),표흥렬(Hong Ryull Pyo),신경환(Kyung Hwan Shi 대한방사선종양학회 2004 Radiation Oncology Journal Vol.22 No.2

목 적: 세기조절방사선치료 (IMRT) 를 시행받은 두경부암 환자군에서 구강건조증 지표들을 측정시점별로 비교분석 하고 이 지표들과 이하선에 ￡사된 방사선량과의 연관성을 분석하고자 하였다. 대상 및 방법 : 2003년 2월부터 10월까지 두경부암으로 IMRT를 시행받은 13명을 대상으로 하였다.IMRT군의 연령은 43-77세(중앙값 57서1) 01 었고, 구강건조증을 평가하는 주관적 지표로서 4항목으로 구성된 구강지표점수 (xerostomia questionnaire score: XQS) 와 객 관적 지 표로서 자극유무에 따른 saliva 의 분비 량(unstimulated & stimulated salivary flow rate: USFR & SSFR) 를 측정하였고, 주관적 그리고 객관적 통합지표로서 LENT SOMA scale(LSC) 을 측정하였다 측정시점은 치료 전, 치료 후 1 개월, 3개월이었다 IMRT 군 내에서 전체 환자군과 전체이하선에 조사된 평균방사선량을 기준으로 나눈 두 군에서의 측정시점에 따른 지표들 간 변화유무를 보았고 나아가 구강건조증지표들과 타액분비량 간의 상관관계를 분석하였다. 결 과 IMRT 군 전체 13 명 내에서 치료 전과 치료 후 1 개월, 3개월에 측정된 XQS, LSC, USFR &SSFR은 유의한 번 화가 없어 구강건조증의 발현이 관찰되지 않았다. 전체이하선에 조사된 평균선량 3,밍o cGy를 기준으로 환자군을 나누어 보았을 때, 3, 500 cGy 미만 조사받은 8명의 환자군에서는 유의한 변화가 없었으나 3,500 cGy 이상 조사받 은 5명의 환자군에서는 XQS, LSC, SSFR 그리고 USFRol 유의하게 증가되어 구강건조증의 발련이 관찰되었다- 또 한 각 지표들과 타액분비량 간의 상관관계를 보았을 때 치료 후 1 개월째에서 유의한 상관관계를 보이지 않았으 나, 치료 후 3개월째에서 XQS, LSC:가 커질수록 USFR, SSFROI 감소하는 유의한 상관관계를 보였다. 결 론 본 연구결과 IMRT는 구강건조증을 상당한 정도로 감소시킬 수 있는 것으로 나타났고, XQS와 LScol 유용한 임상지표로서의 가능성을 보였음을 알 수 있었다 삶의 질을 저하할 정도의 심한 구강건조증을 피하기 위해서는 양측 이하선 전체에 조사되는 평균선량을 가능한 한 3,500 cGy 미만으로 조사되도록 하여야 할 것으로 생각한다- 향후, 충분한 환자를 대상으로 하여 전체이하선의 평균선량에 대한 신뢰할 수 있는 결과와 나아가 타액의 분비량을 대신할 수 있는 임상적지표를 선정하는 연구가 진행되어야 할 것이다. Purpose: This study was done to evaluate xerostomia following intensity modulated radiotherapy for patients with head and neck cancer, and to analyze the correlation between the dosimetric parameters and xerostomia parameters. .Materials and Methods: From February till October 2003, t3 patients with 3 months of follow-up were evaluated for xerostomia after being treated for head and neck cancer with IMRT. Their median age was 57 years (range: 43 - 771. Xerostomia were assessed with a 4-question xerostomia questionnaire score (XQS) and a test for salivary flow rates (unstimulated and stimulated), The patients were also given a validated LENT SOMA scale (LSC) questionnaire. The evaluations were completed before radiation therapy (pre-RT) and at f and, 3 months after radiation therapy (RTI. We evaluated xerostomia at pre-RT, 1 and, 3 months after RT. The association between the xerostomia parameters (XQS and LSC) and salivary flow rates (unstimulated and stimulated: USFR and SSFR) was assessed at 1 and 3 months after RT. Results: All t3 patients showed no significant changes in XQS, LSe and Salivary How rates. As a result, we couldn't find out about xerostomia development. Based on the total mean parotid dose, 3,500 cGy, we divided these patients into two groups. The 8 patients « 3,500 cGy) showed no significant changes in XQS, LSC and Salivary Flow rates. However, in 5 patients (23,500 cGy), there was a significant increase in USFR and, SSFR at 3 months after RT, and for the XQS and, LSC at t and 3 months after RT. The correlation between XQS and, LSC, and USFR and, SSFR in all patients (t 3) was significant at 3 months after RT. The correlation had a tendency to the decrease for USFR and, SSFR In proportion to the Increase of XQS and, LSC. ,Conclusion: Based on the results of this study, IMRT seem to be an effective treatment to significantly decrease the xerostomia. XQS and, LSC seem to be a effective tool for predicting the xerostomia. A total parotid gland mean dose of <3,500 cGy should be a planning goal if substantial sparing of the gland function is desired. Furthermore, patients should be enrolled in a study to define a more accurate threshold dose for the parotid gland.

New Approaches to Xerostomia with Salivary Flow Rate Based on Machine Learning Algorithm

이연희,이연희,어규식,박희경 대한치의학회 2023 Journal of korean dental science Vol.16 No.1

Purpose: We aimed to investigate the objective cutoff values of unstimulated flow rates (UFR) and stimulated salivary flow rates (SFR) in patients with xerostomia and to present an optimal machine learning model with a classification and regression tree (CART) for all ages. Materials and Methods: A total of 829 patients with oral diseases were enrolled (591 females; mean age, 59.29±16.40 years; 8~95 years old), 199 patients with xerostomia and 630 patients without xerostomia. Salivary and clinical characteristics were collected and analyzed. Result: Patients with xerostomia had significantly lower levels of UFR (0.29±0.22 vs. 0.41±0.24 ml/min) and SFR (1.12±0.55 vs. 1.39±0.94 ml/min) (P<0.001), respectively, compared to those with non-xerostomia. The presence of xerostomia had a significantly negative correlation with UFR (r=–0.603, P=0.002) and SFR (r=–0.301, P=0.017). In the diagnosis of xerostomia based on the CART algorithm, the presence of stomatitis, candidiasis, halitosis, psychiatric disorder, and hyperlipidemia were significant predictors for xerostomia, and the cutoff ranges for xerostomia for UFR and SFR were 0.03~0.18 ml/min and 0.85~1.6 ml/min, respectively. Conclusion: Xerostomia was correlated with decreases in UFR and SFR, and their cutoff values varied depending on the patient’s underlying oral and systemic conditions.

노인 구강건조증 환자들의 설태 양상에 관한 고찰

한가진 ( Gajin Han ),박재우 ( Jae-woo Park ),고석재 ( Seok-jae Ko ),김주연 ( Juyeon Kim ),손지영 ( Jiyoung Son ),장승원 ( Seungwon Jang ),김슬기 ( Seul-ki Kim ),김민지 ( Minji Kim ),김진성 ( Jinsung Kim ) 대한한의진단학회 2013 大韓韓醫診斷學會誌 Vol.17 No.3

Objectives The aim of this study is to analyze the characteristics of the tongue coating pattern in the elderly patients with xerostomia. Methods Ninety-six elderly patients with xerostomia were recruited by advertisement and they visited the oral diseases clinics at Kyung Hee University Korean Medicine Hospital and Kyung Hee University Hospital at Gangdong from November, 2011 to August, 2013. After signifying the assent, the subjects who passed screening were enrolled this study. The subjects were evaluated on their clinical characteristics of xerostomia using visual analogue scale for xerostomia, dry mouth questionnaire, unstimulated salivary flow rate. In addition, Yin-deficiency questionnaire was used to evaluate the Yin-deficiency state and Winkel tongue coating index and Digital Tongue imagin system were used to measure the tongue coating of patients. Results The proportion of women was higher than that of men, and there were few smokers in this study population. This population had chronic and relatively severe xerostomia symptoms. Also, thin coating pattern was showed in this elderly patients with xerostomia and this result was regarded to the influence of Yin-deficiency. The thin coating patten was observed in the group with higher Yin-deficiency score. There was no difference in tongue coating between the hyposalivation and normosalivation group. Conclusion In the elderly patients with xerostomia, Yin-deficiency is might be considered as one of the main cause of xerostomia. Hence, it is thought that this patients showed the thin coating pattern. This results could be used in diagnosis and treatment for the elderly patients with xerostomia in traditional Korean medicine.

직장인의 직무스트레스가 구강건조감에 미치는 영향

김명은 ( Myung Eun Kim ) 한국치위생학회 2012 한국치위생학회지 Vol.12 No.1

Objectives : The purpose of this study was to examine the effect between job stress in jobholders and xerostomia. Methods : 250 jobholders living in Jecheon city were the subjects of this questionnaire. The questionnaire was made up of three contents and 37 items: general characteristic(13), job stress(14), degree & behavior of xerostomia( 10). The data were analyzed by two-sample t-test, one-way ANOVA to examine the subjects general characteristics, job stress and degree of xerostomia and were analyzed by Chi-square test to examine the subjects general characteristics, job stress and behavior of xerostomia. Results : Only 215 jobholders were evaluated due to inadequate responses. The results were as follow. 1. As general characteristic of jobholder, male(83.7%) were more than women(16.3%), 30~39 year-old(47%) in age variable, university graduation(63.7%) in the last educational background variable, 2~3 million won(31.2%) in the month average income variable, 1~5 year(33.5%) in tour of duty variable, non-smoker(47.9%) in smoking variable were most. Married(58.6%) were more than unmarried(39.5%). Alcoholic(69.8%) were more than nonalcoholic( 30.2%). 2. As classification of job stress, high strain group was 28.4%, active group was 26%, low strain group was 24.2%, passive group was 21.4%. 3. Analysis of effect between general characteristic and degree & behavior of xerostomia showed smoker were statistical significantly higher than non-smoker on ``dry eat``, ``Am-sal``, ``Night awake``, ``Slip-liq``and ``Gumcandy``( p<0.05) and showed alcoholic were statistical significantly higher than non-alcoholic on ``Dry PM``, ``Night awake``, ``H2O-bed``(p<0.05). 4. Analysis of effect between job stress and degree & behavior of xerostomia showed hight strain group were statistical significantly higher than low strain group on ``Dry PM``, ``Dry-day``, ``Am-sal``, ``Eff-life``and ``Night awake``(p<0.05). Conclusions : As high strain group were higher than other groups on degree & behavior of xerostomia, stress would be factor that have an effect on xerostomia. Thus consider and management of stress is necessary for diagnosis and treatment of xerostomia.(J Korean Soc Dent Hygiene 2012;12(1):1-15)

일부 만 30세 이상 성인에서 구강건조증 관련요인 분석

한해성 ( Hae Seong Han ),권다애 ( Da Ae Kwon ),김리나 ( Ri Na Kim ),김유나 ( Yu Na Kim ),이결희 ( Gyeol Hui Lee ),이나람 ( Na Ram Lee ),이다정 ( Da Jeong Lee ),이승희 ( Seung Hui Lee ),최준선 ( Jun Seon Choi ) 한국치위생과학회 2013 치위생과학회지 Vol.13 No.1

The aim of this study was to analyze factors related to xerostomia in adults aged 30 years and over. The data were analyzed using the t-test, one-way ANOVA and multiple linear regression analysis in the SPSS version 12.0 program. The results were as follow. 1. The respondents who were older than 51 years old, unemployed and had less than 3 million won of average monthly income were more aware of xerostomia (p<0.05). 2. The respondents who answered poor and moderate for their general and oral health and the group with duplicate medication and comorbidity were more aware of xerostomia (p<0.05). 3. The respondents that had problems in chewing, communication, ordinary activities and complained of pain? discomfort and suffered from anxiety depression were more aware of xerostomia (p<0.001). 4. The respondents that answered frequent dryness on their skin, eyes, lips, and nasal mucosa were more aware of xerostomia (p<0.001). 5. Xerostomia showed highest correlation with quality of life (b=0.436) followed by the number of medications (b=0.239), sense of entire body dryness (b=0.200), feeling of hopelessness (b=0.160) and number of oral mucosa disease symptoms (b=0.099) (p<0.05). According to the results of the study, xerostomia may cause deterioration in quality of life. Thus, it is advised to improve the patient management system among dental professions to prevent various complications caused by xerostomia and conduct regular health education on the cause and management method of xerostomia.

구강건조증의 진단과 치료

최정석,임재열 대한이비인후과학회 2016 대한이비인후과학회지 두경부외과학 Vol.59 No.6

Xerostomia is a subjective sensation of a dry mouth which is frequently encountered in otorhinolaryngologic practice. There are a variety of salivary and nonsalivary causes of xerostomia such as side effects of medication, systemic disorders, radiation and Sjögren’s syndrome. The patients with xerostomia have difficulties in chewing, swallowing, speaking, tasting and mataining oral hygiene. Because of the ageing population, and the concomitant increase in medicated individuals, otorhinolaryngologists can expect to be presented with xerostomia in an increasing number of patients in the coming years and therefore should be familiar with its diagnosis and treatment. A systematic approach should be needed to determine the etiology of xerostomia and the management of xerostomia should be multidisciplinary and multimodal. This review summarizes the current literature on the diagnosis, and complications of xerostomia, and on the management of patients with xerostomia. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(6):424-9

구강건조증과 구취

이연희(Yeon-Hee Lee) 대한치과의사협회 2017 대한치과의사협회지 Vol.55 No.9

Xerostomia is usually caused by a reduced salivary flow or by changes in the biochemical composition of saliva. Halitosis or oral malodor is an offensive odor usually originating from the oral cavity. Halitosis can lead to anxiety and psychosocial embarrassment. The occurrence of halitosis closely related with intraoral conditions including the presence of xerostomia. Especially, the relationship between xerostomia and halitosis is prominent in elderly patients receiving polypharmacy with at least two systemic diseases. This study is a review of the update literature of xerostomia and halitosis. A large number of papers have been searched and identified using the words <dry mouth>, <xerostomia>, <halitosis>, <elderly>, <causes>, <symptoms>, <treatment> and <dentistry>. Papers not relevant to the issue were removed reducing the entries to 79 only. Most of identified papers were systematic reviews, non-systematic reviews, and observational studies. With a proper diagnosis, identification of the etiology and timely referrals certain steps are taken to create a successful individualized therapeutic approach. It is significant to highlight the necessity of an interdisciplinary method for the treatment of xerostomia and halitosis to prevent misdiagnosis or unnecessary treatment. This article concisely focuses on the development of a systemic flow of events to come to the proper treatment of the xerostomia and halitosis.

Clinical Guidelines to Diagnose and Manage Dental Patients with Hyposalivation and Xerostomia

구정귀,황경균,윤필영,정상일,정원 대한치의학회 2023 Journal of korean dental science Vol.16 No.1

Xerostomia is defined as the subjective complaint of dry mouth with or without hyposalivation, which is insufficient salivary secretion from salivary gland. Xerostomia can lead to multiple oral symptoms such as dental caries, halitosis, burning mouth syndrome, and oral candidiasis, which can significantly impact the well-being of patients, especially in geriatric patients who may already have compromised health. Clinical findings of xerostomia include decreased salivary flow and alterations in salivary composition. These changes can lead to various oral health problems such as dental caries, periodontitis, swallowing and speaking difficulties, taste disturbances, halitosis, mucosal diseases, and burning mouth syndrome. Recognizing these clinical manifestations is essential for early diagnosis and appropriate management. Although several reasons and risk factors have been suggested for xerostomia such as aging, chemo-radiation therapy, systemic disease, and Sjögren’s syndrome, the polypharmacy is recently highlighted especially in elderly patients. Understanding the etiology and risk factors associated with xerostomia is crucial for effective management. To manage xerostomia patients, a multidisciplinary guideline should be established beyond dental care. Through this literature review, we summarized consideration for diagnostic, therapeutic, nursing essentials for the clinical guideline. By addressing the underlying causes and implementing appropriate treatment strategies, healthcare professionals can improve the quality of life for individuals suffering from xerostomia.

구취환자의 구강건조감과 스트레스, 기울의 상관성 분석

한가진,김진성,선종기,손지희,오승환,박영선,정용재,정의민,박재우,류봉하,Han, Ga-Jin,Kim, Jin-Sung,Seon, Jong-Ki,Son, Ji-Hee,Oh, Seung-Wha,Park, Young-Sun,Jung, Yong-Jae,Jerng, Ui-Min,Park, Jae-Woo,Ryu, Bong-Ha 대한한방내과학회 2010 大韓韓方內科學會誌 Vol.31 No.3

Objective : This study was designed to investigate the correlation between Qi movement stagnation condition, stress level and xerostomia in halitosis patients. Methods : Ninety-nine halitosis patients visiting the Halitosis Clinic in the hospital of Oriental medicine, Kyung Hee University from January, 2010 to May, 2010 were recruited. The subjects were assessed on their stress levels(based on the Stress Response Inventory), xerostomia symptoms(based on the 8-item Visual Analogue Scale xerostomia questionnaire), and Qi movement stagnation(氣鬱) condition(one of the subcategories in the Qi, blood and water pattern identification(氣血水辨證)). Salivary functions were evaluated using the unstimulated whole salivary flow rate measurements. Results : Compared to the non-Qi movement stagnation group(Qi movement stagnation pattern identification score < 30), the confirmed Qi movement stagnation group(Qi movement stagnation pattern identification score $\geqq$ 30) showed higher levels of xerostomia and stress. In the regression analysis, the Qi movement stagnation condition and stress levels showed a significant correlation. Furthermore, the Qi movement stagnation condition and stress levels each displayed significant correlations with xerostomia. Conclusions : The results of this study suggest that stress and Qi movement stagnation condition contribute to xerostomia symptoms in halitosis patients. Considering the correlation found between the Qi movement stagnation and stress, this study suggests a novel methodology in treating xerostomia, halitosis, and other stress-related disorders through the Qi movement stagnation-related approach.