Association between medication-induced xerostomia and orofacial pain: a systematic review

• Published in: Quintessence international (Berlin, Germany : 1985)
• Main Authors: Kohli, Divya, Madhu, Nikkita, Korczeniewska, Olga A, Eliav, Tal, Arany, Szilvia
• Format: Journal Article
• Language: English
• Published: Germany 19.09.2023
• Subjects: dry mouth; orofacial pain; oral pain; xerostomia; medications
• ISSN: 1936-7163
• DOI: 10.3290/j.qi.b4154345

Xerostomia, (or oral dryness), is most commonly caused by medications that affect saliva secretion and is often accompanied by symptoms of orofacial pain. Medication-induced xerostomia may or may not be associated with objectively demonstrable hyposalivation. In this study, we attempt to systematically identify an association between medication-induced xerostomia and orofacial pain. A systematic search was conducted using the following databases: WoS, PubMed, SCOPUS, and MEDLINE. The search terms used were: xerostomia OR "dry mouth" AND medication AND ("oral pain" OR "orofacial pain" OR "craniofacial pain" OR "burning mouth" OR "glossodynia") NOT Sjögren's NOT cancer. Inclusion criteria were medication-induced xerostomia and reported symptoms of orofacial pain. Four researchers performed the selection process and quality assessment and two researchers conducted data extraction. Seven studies with a total of 1,029 patients were included. These studies were conducted between 2009 - 2022 and consisted of cross-sectional studies, case-control studies, and one randomized crossover trial. The studies consisted of a total of 1029 participants. All studies included male and female participants whose mean ages ranged from 43 to 100 years. A positive association was found between medication-induced xerostomia and orofacial pain. We found no associations between salivary flow measurements (hyposalivation) and medication use. Future research should focus on saliva flow measurements, standardized assessment of medication-induced xerostomia as well as the inclusion of accompanying orofacial pain diagnosis in the medical history to allow for higher level of evidence in establishing reliable predictors of medication-induced oral health damage to facilitate clinical prevention and management.