Abstract
BackgroundThe most advocated clinical method for diagnosing salivary dysfunction is to quantitate unstimulated and stimulated whole saliva (sialometry). Since there is an expected and wide variation in salivary flow rates among individuals, the assessment of dysfunction can be difficult. The aim of this systematic review is to evaluate the quality of the evidence for the efficacy of diagnostic methods used to identify oral dryness.MethodsA literature search, with specific indexing terms and a hand search, was conducted for publications that described a method to diagnose oral dryness. The electronic databases of PubMed, Cochrane Library, and Web of Science were used as data sources. Four reviewers selected publications on the basis of predetermined inclusion and exclusion criteria. Data were extracted from the selected publications using a protocol. Original studies were interpreted with the aid of Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool.ResultsThe database searches resulted in 224 titles and abstracts. Of these abstracts, 80 publications were judged to meet the inclusion criteria and read in full. A total of 18 original studies were judged relevant and interpreted for this review. In all studies, the results of the test method were compared to those of a reference method.Based on the interpretation (with the aid of the QUADAS tool) it can be reported that the patient selection criteria were not clearly described and the test or reference methods were not described in sufficient detail for it to be reproduced. None of the included studies reported information on uninterpretable/intermediate results nor data on observer or instrument variation. Seven of the studies presented their results as a percentage of correct diagnoses.ConclusionsThe evidence for the efficacy of clinical methods to assess oral dryness is sparse and it can be stated that improved standards for the reporting of diagnostic accuracy are needed in order to assure the methodological quality of studies. There is need for effective diagnostic criteria and functional tests in order to detect those individuals with oral dryness who may require oral treatment, such as alleviation of discomfort and/or prevention of diseases.
Highlights
The most advocated clinical method for diagnosing salivary dysfunction is to quantitate unstimulated and stimulated whole saliva
Since this review focused on diagnostic methods and an initial search resulted in a number of publications on intervention with pilocarpine, the decision was made to confine the search by excluding those studies
Seven of the studies interpreted in this review evaluated different tests for determining decreased salivary flow and used sialometry as a reference method
Summary
The most advocated clinical method for diagnosing salivary dysfunction is to quantitate unstimulated and stimulated whole saliva (sialometry). Oral dryness is a complex condition, expressed as a physiological deficiency with or without perceived dysfunction. Salivary dysfunction has mainly been related to a decrease in salivary flow rate, but the molecular composition of saliva has gained more attention in understanding the complexity of the condition. Saliva has been shown to have multi- functional characteristics as expressed by several families of salivary molecules, each comprising multiple members that are multifunctional and overlapping [1]. This explains the presence of a compensatory mechanism in saliva and that the expression of salivary dysfunction is most likely to be multi-facetted. The prevalence of oral dryness reported in the literature varies from 10% to 80% [2,3,4,5,6,7,8,9,10,11,12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
