Assessment of Xerostomia or Hyposalivation among Smokers Using the Modified Schirmer Test in the Saudi Population: A Cross-sectional Study

Abstract

Introduction: Saliva is essential for maintaining homeostasis in the oral cavity through its various components. A decrease in Salivary Flow Rate (SFR) has various deleterious effects on the oral tissues. Several factors can alter salivary flow, and one such factor is smoking. Therefore, this study aims to evaluate the effect of smoking on salivary flow. Aim: To assess xerostomia and hyposalivation using the Modified Schirmer Test (MST) and the spitting method among smokers and compare the results with non-smokers in the Saudi population. Materials and Methods: A cross-sectional study was conducted at the Institutional Diagnostic Clinic at the College of Dentistry, King Khalid University in the Aseer region of Saudi Arabia from February 2023 to March 2023. A total of 200 subjects were divided into two groups of 100 each. Group-I consisted of individuals with a smoking habit history for 10 years, while Group-II comprised healthy subjects with no smoking history. All subjects underwent screening for xerostomia and hyposalivation using the spitting method and MST. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 20.0, and a p-value of <0.05 was considered statistically significant. Mean SFRs by the spitting method and MST were calculated, and the means were compared using an unpaired t-test. Pearson correlation analysis was used to assess the correlation between the two methods. Results: A statistically significant decrease in SFR was observed in smokers compared to healthy subjects using both methods (p<0.001). There was an excellent correlation between the two estimation methods (p<0.001). The prevalence of xerostomia in Group-I was 45 (45%), and in Group-II, it was 14 (14%), while the prevalence of hyposalivation in Group-I was 73 (73%) and in Group-II, it was 10 (10%). Conclusion: Salivary flow was lower in smokers compared to non-smokers in the Saudi population. There is an excellent correlation between the two assessment methods, and based on the study experience, the MST can be considered a reliable, objective, inexpensive, easy-to-perform, and well-tolerated test for assessing hyposalivation.