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Xerogenic medications as a predictor for dental health intervention in people with dementia
Author(s) -
Tan Edwin CK,
Lexomboon Duangjai,
Häbel Henrike,
Fastbom Johan,
Eriksdotter Maria,
Johnell Kristina,
SandborghEnglund Gunilla
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.039181
Subject(s) - dementia , medicine , poisson regression , comorbidity , confidence interval , population , rate ratio , psychological intervention , tooth loss , incidence (geometry) , polypharmacy , dentistry , psychiatry , oral health , environmental health , disease , physics , optics
Background Older people with dementia often have poor oral health. Chronic use of xerogenic medications may contribute to adverse dental outcomes. The aim of our study was to investigate the impact of xerogenic medication classes on the predicted risk for dental health interventions in people with dementia. Method This was a population‐based register study involving the Swedish Dementia Registry (SveDem), the Swedish Prescribed Drug Register, the Swedish National Patient Register, and the Dental Health Register. Participants were persons with dementia who were registered in the SveDem at the time of their dementia diagnosis. The exposure was xerogenic medication classes used over the 3‐year period immediately preceding the date of dementia diagnosis (baseline). The primary outcome was the composite of number of tooth extractions and dental restorations during the 3‐year period after baseline. Secondary outcomes included the number of tooth extractions and number of dental restorations. Poisson regression models were used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for the association between the exposure and outcomes. Analyses were adjusted for age, gender, Mini‐Mental State Examination, living arrangement, dementia disorder, average number of medications, Charlson’s comorbidity index, number of dental visits and number of teeth. Result A total of 30955 people were included in the analysis. After adjusting for potential covariates, the use of urological drugs (IRR 1.16, 95% CI 1.04 – 1.28), proton pump inhibitors (IRR 1.13, 95% CI 1.04 – 1.23) and opioids (IRR 1.19, 95% CI 1.06 – 1.34) were significantly associated with the primary composite outcome. Conclusion The use of specific classes of xerogenic medications was associated with an increased risk for tooth extractions and restorations in people with dementia. The risks and benefits of xerogenic medications, in the context of oral health, should be carefully assessed in this vulnerable population.