AbstractsMedical & Health Science

Dry mouth, or oral dryness, is a complex and quite common condition, reported with a varying prevalence of 10-80 %, expressed as a physiological deficiency with or without perceived dysfunction. This condition can severely affect oral health, oral function and quality of life.This t hesis is based on f our s tudies: Study I is a systematic review of the scientific literature and an evaluation of the quality of the evidence for diagnostic methods used to identify oral dryness. The literature included publications during the time period January 1966 to February 2011. Results and conclusions : The database searches resulted in 224 titles and abstracts. A total of 18 original studies were judged relevant and interpreted for this review . When evaluating the included studies with a quality assessment tool for diagnostic accuracy , many of the studies exhibited shortcomings. The most common shortcomings were that the patient selection criteria were not clearly described and the test or reference methods were not described in sufficient detail. Seven of the included studies presented their results as a percentage of correct diagnoses. The evidence for the efficacy of clinical methods to assess oral dryness is sparse and improved standards for the reporting of diagnostic accuracy are needed in or der to assure the methodological quality of studies. Furthermore, a global consensus regarding the terminology of oral dryness is needed in order to facilitate diagnostic procedures, choice of treatment and research design. Salivary dysfunction has mainly been described as being related to low salivary flow rate but the correlation between salivary flow rate and symptoms has shown to be weak. This suggests that not only quantity as a parameter , but also qualitative parameters of saliva, are needed to be included as factors of importance in evaluating the perception of oral dryness. The protective functions of saliva are performed both through and within the bulk liquid phase of saliva, but maybe more implicit through saliva components being dynamically associated as a thin intermediary film on all surfaces exposed in the oral cavity . For instance, examples of qualitative protective functions of surface associated saliva would be the film- forming capacity and rheological characteristics of saliva. T oday there is a lack of clinical diagnostic methods that systematically combine individual’ s perception of saliva and tests of protective functions of s a li v a , w h i ch i n c om b i na t i on m a y id e n t if y i n di v id u a ls a t r is k a n d need of directed preventive regimens. The overall aim of this thesis was to evaluate scientifically reported diagnostic methods in use to identify oral dryness and to explore methods for clinical monitoring of protective functional characteristics of…