A Clinical Score of Oral Dryness:relation to salivary flow rates

Objective: To develop a clinical score of oral dryness for routine use in assessment of patients with dry mouth symptoms and to correlate it with salivary flow rates and patient diagnosis.

Method: A Clinical Score of Oral Dryness (CSOD) was determined from 10 features of oral dryness, each feature scored as 1 point on a score of 0-10. One hundred dry mouth patients and 50 healthy control subjects were included in the study. CSOD, Unstimulated Whole Mouth (UWM), and Stimulated Parotid (SP) salivary flow rates were measured in all patients and controls. Patients were divided into sub-diagnostic groups: Primary (SS1) or Secondary (SS2) Sjögren's Syndrome; SNOX Syndrome; Drug-induced Hyposalivation (DIH) or Xerostomia for other reasons (NOS). In order to determine the reliability and reproducibility of this scoring system, 20 patients with oral dryness were scored individually by three examiners. Results: The interaction effect of CSOD using interclass correlation was significant between examiners 1, 2, and 3 giving effects of 0.89, 0.93, and 0.93 respectively. CSOD was inversely correlated with UWM (r = -0.59 p = 0.01) and SP (r = -0.36, p = 0.01) flow rates. SS1 patients had the highest CSOD with a mean of 6.5 (range 6-9) while the mean for the NOS group was 3 (range 2-4) and in controls was 0.5 (range 0-2). Conclusion: The clinical scoring of oral dryness can be reliably used for monitoring the severity of dry mouth and was inversely correlated with UWM and SP flow rates.