The associations between dry mouth and oral health-related quality of life in diabetic patients in Songkhla, Thailand

Objective: To examine the associations between dry mouth and oral health-related quality of life (OHRQoL) in diabetic patients in Songkhla, Thailand utilising the Wilson and Cleary model as the guiding framework.
Background: Dry mouth is a condition in which the individual experiences a dryness sensation (xerostomia) and/or salivary gland hypofunction. Dry mouth is a common oral health problem for patients with diabetes, which can lead to a range of impacts in daily life which, in turn, may lead to a lower quality of life (QoL). To date, there have been few studies that have examined the associations between dry mouth and OHRQoL in diabetic patients.
Methods: Two hundred and ten diabetic patients were included in the study. Data collection was by self-reported questionnaires collected via telephone interview including symptom and functional status, general health perceptions, psychological distress (depression and anxiety), sense of coherence, health locus of control and self-esteem. Clinical data retrieved from medical records included underlying diseases, medications, blood sugar levels and duration of diabetes, alongside demographic characteristics (age, sex, income, education level). Structural equation modelling ( SEM) was used to analyse the direct and indirect pathways between the variables according to the Wilson and Cleary model.
Results: The main results were that worse dry mouth symptoms status were associated with worse OHRQoL. This association was mediated by functioning and health perceptions. However, an association was not found between clinical status and symptoms. The psychological variables (sense of coherence and self-esteem) played a key role at each stage of the model. Furthermore, polypharmacy and multimorbidity impacted on clinical status, health perceptions, and OHRQoL.
Conclusions: The findings support Wilson and Cleary model, indicating that dry mouth impacted on daily lives of diabetic patients in a range of ways including eating, drinking, and socialising. Interventions targeted at reducing multi-morbidity, managing polypharmacy, and improving psychological adaptation were also found to be important suggesting potential avenues to minimise impact of dry mouth and improve QoL.