Abstract
The purpose of this study was to explore the association of the clinical oral dryness score (CODS) with salivary flow rates, xerostomia inventory (XI), and bother index (BI). 147 patients were screened using CODS, which determined 10 features of oral dryness. Each feature contributed 1 point, and the total score varied from 0 to 10. Unstimulated (UWS), chewing-stimulated (CH-SWS) and acid-stimulated (A-SWS) whole salivary flows and the XI and BI were measured. Associations were explored with a bootstrapped Spearman rank correlation test (1000 × bootstrapping). Based on unstimulated salivary flow, 55 patients were classified as hyposalivators, 31 as low salivators, 48 as normosalivators and 13 as high salivators. Median CODS in the hyposalivation group was 5 (IQR 3–6) compared with 3 (IQR 2–5) in the low salivation group, 2 (IQR 1–4) in the normal salivation group and 2 (IQR 1–2.5) in the high salivation group. Significant associations between CODS and the other parameters were only found in the hyposalivation group between CODS and UWS (ρ(53) = − 0.513; p < 0.01), between CODS and CH-SWS (ρ(53) = − 0.453; p < 0.01), between CODS and A-SWS (ρ(53) = − 0.500; p < 0.01), CODS and XI (ρ(53) = 0.343; p < 0.001) and between CODS and BI (ρ(53) = 0.375; p = 0.01). In patients with hyposalivation, CODS is associated with unstimulated and stimulated salivary flow and XI and BI. CODS alone or a combination of CODS with a subjective measure, such as the XI or BI, could be recommended during routine clinical assessment to detect hyposalivation.
Highlights
Whole saliva is a complex oral fluid comprising a mixture of secretions from major and minor salivary glands, with additional contributions by crevicular fluid [1]
We investigated whether there is a relationship between the clinical oral dryness score (CODS) and xerostomia measured by two subjective measures (XI and Bother Index (BI))
Analysis of patients according to reason for referral revealed that the lowest median unstimulated whole mouth salivary (UWS) values were found in the Sjögren’s syndrome group (Mdn = 0.02 mL/min, interquartile range (IQR) 0.0–0.6) and the highest median UWS values were found in the control group (Mdn = 0.22 mL/min, IQR 0.09–0.35) and in the erosion, wear, bruxism, caries (EWBC) group (Mdn = 0.26 mL/min, IQR 0.18–0.36)
Summary
Whole saliva is a complex oral fluid comprising a mixture of secretions from major and minor salivary glands, with additional contributions by crevicular fluid [1]. In addition to objective quantification of the saliva secretion, several subjective measures are available to assess the symptoms and burden for patients experiencing dry mouth. Odontology (2018) 106:439–444 used questionnaire, that explores how the patient experiences dry mouth (xerostomia) [6]. This questionnaire consists of 11 items, each on a 5-point Likert scale. In the BI, the patient is asked to rate the severity of dry mouth on a scale from 0 to 10 [7] Both the XI and the BI are based on selfreport, and are subjective. A new instrument was designed to objectively quantify clinical signs of reduced salivary secretion: the clinical oral dryness score (CODS). In the study by Osailan, it was suggested that the CODS is a reliable routine assessment of the severity of hyposalivation
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