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 disease (Lofgen et al., 2012).
Examples:
- Xerostomia Inventory schort form (SXI-D)
- Index for symptoms of xerostomia (bother index)
- Clinical oral dryness score for clinical signs (CODS)
- Sialometry, the measurement of whole salivary flow rates
Clinical oral dryness score for clinical signs (CODS) would be a good screening test.
http://www.oooojournal.net/article/S2212-4403%2812%2900391-4/abstract
the diagnostic instruments such as mouth mirror while doing a routine check up or carrying out procedure could be used to detect mild to severe xerostomia; if the instrument sticks to the mucosa and offers resistance while withdrawing a diagnostic or confirmatory test could be carried out for further evaluation
Dear Barbara, Great quastion, my best regards! First of all we have to separate the terms "Xerostomia" (wich is mostly a symptom) from hyposalivation (wich is mostly a signal) And so, we will have different aproaches. We have no test for xerostomia but for qualitative and quantitative saliva. I use a simple method, sialometry of salivaliry flow, stimulated or non stimulated, (lower than 1 ml of saliva in 5 minutes in non stimulated test or less than 5 ml in 5 minutes for stimulated flow - I use a piece of glove rubber or phosphoric acid 10% for stimulated test). So I think the most important is to make salivary flow tests achievable for any clinic, making diagnosis of hyposalivation easier... Thanks for the question, hope I could be hellpfull, greetings from hot and Sunny Rio de Janeiro!
Dear Alexandre,
Thank you for your response.
"So I think the most important is to make salivary flow tests achievable for any clinic, making diagnosis of hyposalivation easier..."
Yes, that is precisely what I'm trying to do. I'm trying to write down when dentists (GP) should decide to use a salivary flow test.
comparable evaluation of C-reactive protien in saliva and serum in patient with periodontitis ? Any idea
salivary flow rate is most objectively measured when patient sits in the chair and spits out saliva during five minutes in calibrated test tubes (0,1 ml). if salivary flow rate is lower than 2,0 ml in five minutes i.e. 0,4 ml in one minute this can be consider as xerostomia better hyposalivation. xerostomia is a subjective feeling of dry mouth unlike hyposalivation which is objective one. However, published literature is full of mistakes regarding subjective and objective dry mouth feeling.
I totally agree with Vajia! Sialomtery of flow (stimulated and non-stimulated) is the simpliest, cheaper and easie test we can do in order to help our patients, anywhere in the world to test sallivary function, for me the KEY for oral health!
The chair side investigations include tongue blade sign and lipstick test for decreased salivation
Abhijeet could you please explain the tongue blade sign and the lipstick test?
In "tongue blade" sign examiner will hold a tongue blade against the buccal mucosa; in a dry mouth, the tissue will adhere to tongue blade as the tongue blade is lifted away.
Lipstick test is the presence of lipstick or shed epithelial cells on the labial surfaces of the anterior maxillary teeth is indicative of reduced saliva secretion
Abhijeet,
Do you think the "tongue blade sign" is equivalent to:
- Mirror sticks to buccal mucosa
- Mirror sticks to tongue
As stated in the Clinical oral dryness score for clinical signs (CODS).
Probably should not discount the importance of a thorough medical history. There are currently over 100 medications that can cause hyposalivation, as well as a number of medical conditions. A simple test is the retraction of the lower lip for 30 seconds and tamping with small piece of blotting paper. You are looking for evidence of wet dots to indicate function of the minor salivary glands
Chris thanks for your input.
So, basically dentist need to know how to make a diagnosis
a - take a medical history,
b - ask for the symptoms and
c - look for the clinical signs
Chis,
"A simple test is the retraction of the lower lip for 30 seconds and tamping with small piece of blotting paper. You are looking for evidence of wet dots to indicate function of the minor salivary glands."
Has this test been described in the literature?
No . I guess it is a modified Schirmer technique, but faster. Current Schirmer saliva function test can be found at this link:
http://www.ncbi.nlm.nih.gov/pubmed/16519773
it is known that saliva collection is method for determining xerostomia
as xerostomia expected when:
amount of collected non stimulated saliva less than 0.1ml/min or
amount of collected stimulated saliva less than 0.7mllseconds
but the important notice how long pt is suffering did he toke any new medication in this period as anti hypertensive drugs anti histamine, anti convalescent , anti collengeric drugs ,sedative and tranquillizers can cause xerostomia
also is the affection oral only or involve eye (with xero-opthalmia) as in several auto-immune diseases as sjogren,s disease , Mikulicz,s disease
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