Dentists’ Knowledge, Clinical Recognition, and Management of Xerostomia: An International Cross-Sectional Questionnaire-Based Study

Abstract

Xerostomia is the subjective sensation of oral dryness and may occur with or without objectively reduced salivary flow. It is associated with medications, systemic disease, salivary-gland dysfunction, dehydration, and head-and-neck radiotherapy, and may increase the risk of dental caries, candidiasis, mucosal discomfort, and functional difficulties. Dentists have an important role in recognition and initial management. This study was conducted to assess dentists’ knowledge of xerostomia, clinical recognition and management practices, diagnostic confidence, and perceived need for additional education, and to explore associations between professional characteristics and knowledge. An international cross-sectional questionnaire framework was applied to 378 dentist responses from nine reported country categories. The questionnaire included professional characteristics, five knowledge items, clinical recognition and management questions, diagnostic confidence, and perceived educational need. Knowledge was scored from 0–5. Categorical variables were assessed with chi-square/Fisher’s exact tests; mean scores with t-tests/ANOVA as appropriate; ordinal relationships with Spearman correlation; and exploratory logistic regression assessed predictors of high knowledge (≥3/5). A total of 378 dentists participated. The mean knowledge score was 3.82 ± 0.98/5 (95% CI, 3.72–3.92), and 341 (90.2%) achieved a score of ≥3/5. Recognition was highest for oral complications (82.8%), followed by the definition of xerostomia (79.6%). Overall, 59.8% reported always or often asking about dry-mouth symptoms, while 54.0% reported always or often investigating medication-related causes. Only 40.5% were confident or very confident in diagnosing and managing xerostomia, whereas 89.4% expressed a definite or possible need for additional education. Participants with formal Oral Medicine training had higher mean knowledge scores than those without training (4.15 ± 0.86 vs 3.67 ± 0.99; p < 0.001). However, in exploratory multivariable analysis, formal Oral Medicine training was not significantly associated with a knowledge score of ≥3/5 (adjusted OR, 2.06; 95% CI, 0.88–4.85; p = 0.098). Dentists demonstrated generally favorable knowledge of fundamental xerostomia concepts, but gaps were observed in clinical recognition, medication-focused assessment, and diagnostic confidence. The substantial perceived need for further education supports structured, clinically oriented education in xerostomia recognition and management. The association between formal Oral Medicine training and knowledge should be interpreted cautiously because it was not statistically significant after adjustment.