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A systematic review of methods to diagnose oral dryness and salivary gland function
Malmö högskola, Faculty of Odontology (OD).
Malmö högskola, Faculty of Odontology (OD).ORCID iD: 0000-0002-8183-8846
Malmö högskola, Faculty of Odontology (OD).ORCID iD: 0009-0001-8816-4952
Malmö högskola, Library and IT Services (BIT).ORCID iD: 0000-0003-1671-7244
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2012 (English)In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 12, no 29Article in journal (Refereed) Published
Abstract [en]

Background The 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. Methods A 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. Results The 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. Conclusions The 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.

Place, publisher, year, edition, pages
BioMed Central, 2012. Vol. 12, no 29
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-15627DOI: 10.1186/1472-6831-12-29ISI: 000315591200001PubMedID: 22870895Scopus ID: 2-s2.0-84873702513Local ID: 14096OAI: oai:DiVA.org:mau-15627DiVA, id: diva2:1419149
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-03-18Bibliographically approved
In thesis
1. Oral dryness in relation to film-forming properties of saliva
Open this publication in new window or tab >>Oral dryness in relation to film-forming properties of saliva
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Dry mouth, or oral dryness, is a complex and quite commoncondition, 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 andquality of life.This thesis is based on four studies:Study I is a systematic review of the scientific literature and anevaluation 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 witha quality assessment tool for diagnostic accuracy, many of the studiesexhibited 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 ofdiagnostic accuracy are needed in order to assure the methodological quality of studies. Furthermore, a global consensus regarding theterminology 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 onlyquantity as a parameter, but also qualitative parameters of saliva,are needed to be included as factors of importance in evaluatingthe perception of oral dryness. The protective functions of salivaare performed both through and within the bulk liquid phase ofsaliva, but maybe more implicit through saliva components beingdynamically associated as a thin intermediary film on all surfacesexposed in the oral cavity. For instance, examples of qualitativeprotective functions of surface associated saliva would be the film- forming capacity and rheological characteristics of saliva. Today thereis a lack of clinical diagnostic methods that systematically combine individual’s perception of saliva and tests of protective functions of saliva, which in combination may identify individuals at risk andneed 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 exploremethods for clinical monitoring of protective functional characteristicsof salivary films Study II surveyed the occurrence of subjective and objective oraldryness in two populations, one randomly selected group and onedental care-seeking group. The relationship between subjectiveand objective oral dryness to clinical parameters was analyzed and individuals were designated into one of four groups depending onthe occurrence of subjectively described and /or clinically measured oral dryness.Results and conclusions: No association between subjective oraldryness and flow rates of unstimulated and stimulated saliva wasfound in either of the two populations studied. Individuals identified with subjective oral dryness or objective oral dryness presented to a greater extent a history of oral rehabilitation compared to individualswho showed no indications of oral dryness. Results and conclusions: Individuals with subjective oral drynessexhibited lower values for saliva viscosity and elasticity, whencompared to the other groups. Additionally, the amount of salivaassociated to a germanium prism was the lowest measured in thisgroup, even if the total protein concentration was not extremely low. These test results in combination with a moderate decrease in surfacetension after 600 s may be indicative of a lower film forming capacityof saliva from individuals expressing subjective oral dryness.

Place, publisher, year, edition, pages
Malmö University, Faculty of Odontology, 2016. p. 119
Series
Doctoral Dissertation in Odontology
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-7689 (URN)19636 (Local ID)978-91-7104-658-1 (ISBN)978-91-7104-659-8 (ISBN)19636 (Archive number)19636 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-16Bibliographically approved

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Diogo Löfgren, ChristinaWickström, ClaesSonesson, MikaelTapia Lagunas, PabloChristersson, Cecilia

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