There are numerous questionnaires used to assess dry mouth symptoms, including various quality of life scales and some specific instruments such as the Xerostomia Questionnaire (XQ)  and the Xerostomia Inventory (XI) , . An extensive discussion of the different instruments (objective and subjective) to measure Xerostomia is available in the article by Sasportas et al. .
The Xerostomia Inventory (XI), is reliable, reflects many manifestations of the xerostomic experience, has appropriate wording, is grounded in the experiences of xerostomic sufferers and is easy to administer. For example, it could be mailed to the patients for them to fill out and bring to their next appointment; it does not need the presence of the dentist or a trained staff member to collect the information.
The XI consists of an 11-item summated rating scale with each response assigned a score between 1 and 5 and the combined total score calculated into a sum ranging from 11 to 55, that represents the severity of the underlying Xerostomia. A score of 11 is characterized as very mild Xerostomia and 55 represents severe Xerostomia .
The XI has been validated to provide a both a discriminative measure of the severity of dry mouth symptoms as well as serve as a responsive measure to determine the success of interventions for dry mouth. A change in XI score of 6 or more points is likely to be clinically meaningful , .
Further Reading: Geriatric Dental Care: Older Adults and Oral Conditions
Xerostomia Inventory Questions
These are the 11 questions from the XI that individuals are asked to choose a response for, from never 1, hardly ever 2, occasionally 3, fairly often 4, very often 5.
- My mouth feels dry
- I have difficulty in eating dry foods
- I get up at night to drink
- My mouth feels dry when eating a meal
- I sip liquids to aid in swallowing food
- I suck sweets or cough lollies to relieve dry mouth
- I have difficulties swallowing certain foods
- The skin of my face feels dry
- My eyes feels dry
- My lips feel dry
- The inside of my nose feels dry
Diagnosing Salivary Hypofunction (SGH)
There are many ways to measure salivary flow from individual glands, combined oral surfaces (whole mouth measurement), during rest (drooling) or when stimulated (chewing a neutral substances or gustatory stimulants) . Some of the methods are more relevant for research based collections ,  and others are more practical for the clinicians to perform in their practice. Navazesh et al. provides an extensive review on saliva collection methods , , , .
Smith recommended a whole simulated saliva collection consisting of having each subject chew on two pieces of gauze for 1 min, the weights of the gauzes having been measured before and after the exercise. This method is simple and inexpensive, and requires minimal equipment. It has been demonstrated to be a reliable method of assessment of the function of the salivary glands in patients with dry mouth .
Another method of interest is an adaptation of the Schirmer Test used to measure eye dryness . Chen et al. recommended the Modified Schirmer Test (MST) to provide a quick screening for salivary gland hypofunction in any office setting; as it is performed in less than 5 min, is inexpensive, does not need sophisticated equipment and has acceptance from the patients .
Further Reading: Geriatric Dentistry: Understanding the Role of Saliva
Postgraduate Degrees in Geriatric Dentistry
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About the Authors
The article, “Dry mouth: A critical topic for older adult patients,” was authored by Phuu Han, Piedad Suarez-Durall, and Roseann Mulligan, Director Geriatric Dentistry Master and Certificate programs at the Herman Ostrow School of Dentistry of USC, and was originally published by Elsevier in the Journal of Prosthodontic Research.
14. A. Chen, Y. Wai, L. Lee, S. Lake, S.B. Woo
Using the modified Schirmer test to measure mouth dryness: a preliminary study
J Am Dent Assoc, 136 (2005), pp. 164-170
20. S. Furness, G. Bryan, R. McMillan, S. Birchenough, H.V. Worthington
Interventions for the management of dry mouth: non-pharmacological interventions
Cochrane Database Syst Rev, 9 (2013), CD009603s
22. H. Mese, R. Matsuo
Salivary secretion, taste and hyposalivation
J Oral Rehabil, 34 (2007), pp. 711-723
47. W.M. Thomson
Issues in the epidemiological investigation of dry mouth
Gerodontology, 22 (2005), pp. 65-76
48. W.M. Thomson
Measuring change in dry-mouth symptoms over time using the Xerostomia Inventory
Gerodontology, 24 (2007), pp. 30-35
49. L.S. Sasportas, D.N. Hosford, M.A. Sodini, D.J. Waters, E.A. Zambricki, J.K. Barral, et al.
Cost-effectiveness landscape analysis of treatments addressing xerostomia in patients receiving head and neck radiation therapy
Oral Surg Oral Med Oral Pathol Oral Radiol, 116 (2013), pp. e37-e51
50. W.M. Thomson, J.M. Chalmers, A.J. Spencer, S.M. Williams
The Xerostomia Inventory: a multi-item approach to measuring dry mouth
Community Dent Health, 16 (1) (1999), pp. 12-17
51. M. Navazesh, S.K. Kumar, University of Southern California School of Dentistry
Measuring salivary flow: challenges and opportunities
J Am Dent Assoc, 139 (2008), pp. 35S-40S
52. A. Wolff, A. Begleiter, D. Moskona
A novel system of human submandibular/sublingual saliva collection
J Dent Res, 76 (1997), pp. 1782-1786
53. P.C. Fox, P.F. van der Ven, B.C. Sonies, J.M. Weiffenbach, B.J. Baum
Xerostomia: evaluation of a symptom with increasing significance
J Am Dent Assoc, 110 (1985), pp. 519-525
54. K. Ogami, K. Sakurai, T. Ando
A method of measuring salivary flow rate in the lower labial mucosal region
J Oral Rehabil, 31 (2004), pp. 861-865
55. R.G. Smith, A.P. Burtner
Oral side-effects of the most frequently prescribed drugs
Spec Care Dentist, 14 (1994), pp. 96-102
56. H.-J. Haga, B. Hulthen, Al. Bolstad, E. Ulvestad, R. Jonsson
Reliability and sensitivity of diagnostic tests for primary Sjogren’s syndrome
J Rheumatol, 26 (1999), pp. 604-608