Development of Diagnosis Chart for Xerostomia

Abstract

The causes of xerostomia are diverse and include Sjӧgren’s syndrome, psychological stress, and side effects of medications. In some patients, the cause may be multifactorial (e.g., psychological stress and side effects of medications, or irradiation and mouth breathing). No unified diagnostic criteria for xerostomia have been established; therefore, the criteria used in clinical practice differ among dentists. Furthermore, it is difficult to diagnose multiple causes using a flow chart-type diagnostic sheet. Therefore, we created a new diagnostic sheet that is useful for multiple causes of xerostomia. In the present study, we used this sheet to diagnose new patients in our xerostomia clinic.　 The cause of xerostomia was an autonomic nerve disturbance (61.4%); other causes included the side effects of medications (57.3%), mouth breathing (36.8%), Sjӧgren’s syndrome (15.9%), dental psychosomatic disorder (14.5%). The degree of coincidence of diagnosis was very high (κ: 0.99, p＜ 0.001). A total of 164 patients (74.5%) had plural diagnosis.　 The results of this study indicate that multiple factors are likely related to xerostomia. Therefore, the use of a diagnostic sheet that can facilitate multiple diagnoses in patients with xerostomia seems necessary.