The clinical assessment of oral dryness is a significant predictor of salivary gland hypofunction

OBJECTIVES: To compare subjective complaints of xerostomia and salivary gland dysfunction and a clinical assessment of oral dryness with an objective measurement of salivary gland dysfunction, in a group of UK patients attending a Dry Mouth Clinic. The aim of the study was to identify signs and symptoms that may be of predictive value for salivary gland hypofunction (SGH) in clinical practice. METHODS: This prospective study investigated 214 patients who attended a Dry Mouth Clinic, held at Liverpool University Dental Hospital. Patients gave a history of xerostomia for a minimum of 6 months and were asked standardised questions to subjectively assess oral dysfunction. The oral mucosa was then clinically assessed for dryness and sialometry was performed. Unstimulated whole saliva flow rates (UFR) of < 0.2 ml min-1 were considered to be indicative of SGH. RESULTS: One or more symptoms of oral dysfunction were reported in 178 (83%) patients, in addition to xerostomia. The clinician diagnosed oral dryness in 105 patients. Objective evidence of SGH was found in 125 (58%) of patients. The clinicians' subjective assessment of oral dryness was indicative of a reduced UFR (P < 0.0001) and a significant predictor of an UFR < 0.2 ml min-1 using logistic regression analysis (odds ratio 9.6; 95% CI 4.8 and 19.3). The mean UFR of patients who reported symptoms of oral dysfunction was significantly lower than the mean UFR of patients who reported no oral dysfunction. Using logistic and multiple regression analyses, symptoms of oral dysfunction were not found to be significant predictors of either an UFR < 0.2 ml min-1 or a reduced UFR. CONCLUSIONS: The clinical assessment of oral dryness was a significant predictor of SGH, in this selected group of patients. Patients who complain of xerostomia may have additional symptoms of oral dysfunction indicative of a reduced UFR.     

Hyposalivation and Xerostomia in Dentate Older Adults

BackgroundOlder adults are susceptible to reduced saliva production related to certain medications, radiation and chronic conditions. Many of these people have many physical and oral health problems and limited access to dental care. The use of effective screening tools for xerostomia and hyposalivation would be helpful in identifying those at risk. The authors conducted a study to investigate the association between three measures of oral dryness: hyposalivation (low unstimulated salivary flow), self-reported xerostomia and clinically assessed dry mouth.MethodsThe authors included a convenience sample of 252 nondemented and dentate West Virginia participants 70 years and older who were part of a larger study on oral health and cognition among older adults. Participants completed a self-reported xerostomia index, provided an unstipulated salivary sample and underwent an oral assessment for the study.ResultsTwenty-eight participants (11.1 percent) had hyposalivation, eight of whom reported having xerostomia (sensitivity = 28.6 percent). Of the 43 participants who reported having xerostomia, only eight had hyposalivation (positive predictive value = 18.6 percent). Hyposalivation and self-reported xerostomia were not significantly related. Clinically assessed dry mouth correlated modestly, but significantly, with hyposalivation and self-reported xerostomia.ConclusionsObtaining routine unstimulated salivary flow rates in addition to self-reported information and oral evaluations may increase early detection of oral dryness, which would assist in implementing early interventions to improve patients' quality of life.Clinical ImplicationsVisually inspecting oral tissues for dryness and asking a patient if his or her mouth is dry are insufficient measures for clinicians to use to determine if the patient has hyposalivation. The authors recommend that clinicians determine the patient's unstimulated salivary flow rate.     

Unstimulated whole saliva flow rate in relation to sicca symptoms in Hungary

Objective: To assess the prevalence of xerostomia and the related oral and extraoral dryness symptoms in Hungary, to evaluate the association of those symptoms with the unstimulated whole saliva (UWS) flow rate, and to find correlation between the level of UWS flow rate and the oral health status of the questioned patients. Subjects And Methods: A total of 600 patients between the age of 18 and 92 years, 265 male, 335 female, were selected in accordance with the current regional age and residence distribution scheme of the Hungarian Statistical Office. A questionnaire was designed to determine the subjective presence or absence of the sicca symptoms. UWS flow rate and the dental and periodontal status were determined. Results: The percentages of subjective symptoms in the questioned subjects were oral dryness, 34%; reduced salivation, 11%; mucous saliva, 15%; dysphagia, 13%; glossopyrosis, 7%; dysphonia, 31%; dysgeusia, 9%; nasal dryness, 32%; ocular dryness, 21%; itching, 40% and xeroderma, 60%. Vaginal dryness was 14%, vaginal itching was 16% in the interviewed women. The grade of xerostomia, dysphagia, tiredness, and additionally the gingival bleeding index showed a negative correlation with the UWS flow rate. After all decayed, missing and filled teeth (DMF‐T) mean values, gingival bleeding index and plaque index were significantly higher in hyposalivators, compared with those who had normal flow rates Conclusion: This cross sectional study, representative of the Hungarian population, clearly shows that one‐third of the adult population suffers from xerostomia. The clinical severity of the xerostomia demonstrated a strong relationship with the lower levels of UWS flow rate. Reduced levels of UWS flow rate in this study were also shown to be associated with dysphagia, fatigue, and increased DMF‐T numbers. The data show that oral dryness, its associated desiccation symptoms and its clinical manifestations are significant health problems in Hungary.     

灼口综合征患者静态唾液流速和口干症状的相关研究

目的：探讨不同亚型灼口综合征（BMS）患者静态唾液流速有无差异以及静态唾液流速速与BMS患者口干症状之间有无相关性,方法：采用舌下置纱团浸唾称重法测定52例BMS患者和37例正常对照组的静态唾液流速,结果：BMS组的平均静态唾液流速较对照组低,但统计学上无显著差异。BMS的3个亚型间平均静态唾液流速无统计学上显著差异,具口干症状的BMS患者静态唾液流速与不具口干症状者差异亦不显著,结论：BMS患者口干症状与静态唾液流速之间的相关性不显著。     

生津活血中药在头颈部放疗中对涎腺功能影响的研究

目的探讨生津活血中药在头颈部肿瘤患者放疗过程中对涎腺功能的影响。方法将38例首程放疗的患者随机分为实验组(中药加放疗)18例和对照组(单纯放疗)20例。对放疗前及放疗不同剂量时的口干程度、pH值、唾液流率及淀粉酶浓度进行比较。结果随放疗剂量的增加,2组患者口干程度增加,唾液流率与淀粉酶浓度均降低。在放疗至20、40 Gy时实验组的唾液流率和淀粉酶浓度均较对照组高。但在达到60 Gy时,2组数据则趋于接近。另外,患者的主观口干程度与客观的唾液流率下降程度之间并不直接对应。结论①头颈部肿瘤患者在放疗过程中辅以生津活血中药,可在一定程度上改善口干症状,但并不足以预防放射性口干症的发生。②患者的口干严重程度和唾液流率下降程度之间并不严格对应,患者主观的口干程度并不能作为反映唾液腺功能受损程度的可靠指标。     

A salivary sensor for the management of xerostomia in edentulous patients

This article describes a method for managing xerostomia in edentulous patients with a newly developed salivary sensor. A micropressure sensor unit with a capsule to hold artificial salivary substitute was built into the dental prosthesis. This sensor prosthesis can help patients overcome mouth dryness, improves patient comfort, and aids in retention of the prosthesis.     

Effect of Saliinent® on parotid salivary glandsecretion and on xerostomia caused by Sjogren's syndrome

Abstract – The stimulatory effect of a recently introduced saliva substitute (Saliment®) on the parotid salivary secretion was experimentally investigated in 10 healthy individuals without signs or symptoms of xerostomia and in 11 patients with xerostomia due to Sjogren's syndrome. Further, in 15 patients with Sjogren's syndrome, the effect of Salimem on the sensation of xerostomia was examined in a double-blind clinical study with cross-over. The use of Saliment was followed by a significant stimulation in the parotid salivary secretion ( P <0.01) and die subjective sensation of xerostomia was significantly reduced ( P <0.01).     

World Workshop on Oral Medicine VI: a systematic review of medication‐induced salivary gland dysfunction

The aim of this paper was to perform a systematic review of the pathogenesis of medication‐induced salivary gland dysfunction (MISGD). Review of the identified papers was based on the standards regarding the methodology for systematic reviews set forth by the World Workshop on Oral Medicine IV and the PRISMA statement. Eligible papers were assessed for both the degree and strength of relevance to the pathogenesis of MISGD as well as on the appropriateness of the study design and sample size. A total of 99 papers were retained for the final analysis. MISGD in human studies was generally reported as xerostomia (the sensation of oral dryness) without measurements of salivary secretion rate. Medications may act on the central nervous system (CNS) and/or at the neuroglandular junction on muscarinic, α‐and β‐adrenergic receptors and certain peptidergic receptors. The types of medications that were most commonly implicated for inducing salivary gland dysfunction were those acting on the nervous, cardiovascular, genitourinary, musculoskeletal, respiratory, and alimentary systems. Although many medications may affect the salivary flow rate and composition, most of the studies considered only xerostomia. Thus, further human studies are necessary to improve our understanding of the association between MISGD and the underlying pathophysiology.     

Using the modified Schirmer test to measure mouth dryness: a preliminary study

BACKGROUND: Current methods of measuring saliva volume often are difficult to perform in a general dental or medical office setting. This study seeks to determine whether the Schirmer test for measuring eye dryness can be modified to measure mouth dryness. METHODS: The authors performed a modified Schirmer test (MST) on a control group composed of 41 healthy adult volunteers and a study group composed of 10 patients who had received head and neck radiation and 10 patients who had oral chronic graft-versus-host disease (CGVHD). The authors placed the strip on the floor of each subject's mouth and took readings at one minute, two minutes and three minutes. Fourteen control subjects also spat into a container over a five-minute interval, and the authors weighed the collected saliva. RESULTS: The mean reading for the control subjects at three minutes was 29.5 millimeters, while the mean reading for the test subjects was 6.9 mm (P < .00005). CONCLUSIONS: The results of the MST were able to distinguish between healthy adult volunteers and subjects who experienced profound xerostomia and hyposalivation. CLINICAL IMPLICATIONS: The MST as used in this preliminary study is an objective, inexpensive, easy-to-perform and well-tolerated test for measuring mouth dryness. It readily distinguishes between patients who are healthy and asymptomatic and those who experienced profound xerostomia and hyposalivation.     

Dental status, xerostomia and the oral health-related quality of life of an elderly institutionalized population

The author examined the relative effects of tooth loss and xerostomia on the oral health-related quality of life of an elderly, medically compromised population, living in a long-term care setting. Data were collected from 225 subjects (mean age: 83 years) via a questionnaire and review of dental charts. Oral health-related quality of life was assessed using self-ratings, satisfaction ratings, an index of chewing capacity, the GOHAI, and OH1P-14. Almost all participants had one or more chronic medical conditions and were taking prescribed medications. Two-thirds of the study group was dentulous with a mean number of 16 remaining teeth. One-third of the participants had scores on a xerostomia index indicating marked oral dryness. In bivariate and multivariate analyses, xerostomia index scores were significantly associated with all oral health-related quality of life outcomes. Dental status was associated with chewing capacity only. The results suggest that xerostomia has an important influence on the well-being and quality of life of this population.     

Influence of tendencies toward depression, neurosis and psychosomatic disorders on oral symptoms

This study revealed that the tendencies towards depression, neurosis, and psychosomatic disorders have effects on oral symptoms. The total number of subjects was 102. The subjects were divided into two groups using the SDS (Self-rating Depression Scale): a control group of 66 subjects with an SDS value of less than 40, and a group of 36 subjects having depression tendencies with an SDS value of over 50. Most of the subjects in the depression tendency group showed symptoms of neurosis and psychosomatic disorders as well. The two groups were compared on the basis of their psychological characteristics, dosages of medicine taken, esthesis of mouth dryness, glossalgia, salivary flow rate, oral wettability, existence of dental cavities, and condition of the oral mucosa. No xerostomia at the mucobuccal fold was observed in the depression tendency group. However, there was an evident decrease of the resting salivary flow rate and the wettability of proglossis. It is considered that such a decrease resulted in an increase in the symptoms derived from xerostomia or esthesis of mouth dryness. The number of conservable but untreated dental cavities in the depression tendency group was larger than that in the control group with a significant difference, suggesting that both oral self-care and dental care management tended to be inadequate in the depression tendency group.     

Xerostomia and associated factors in a community-dwelling adult population

Abstract Xerostomia is the subjective sensation of dry mouth. Estimates on the occurrence of xerostomia in community-dwelling adults have ranged from 10% among persons over age 50 to 40% for persons over age 65. Virtually no data are available for persons under age 50. To begin to establish a database on the occurrence of xerostomia and factors associated with it, a cross-sectional assessment of self-reported symptoms and salivary function was conducted across a broad age-range of generally healthy community-dwelling adults. A convenience sample of 710 adults who ranged from 19 to 88 years of age was drawn from various sources in the greater-Rochester, New York area. Study volunteers were administered a standardized questionnaire on general and oral health, which included questions on the symptoms of xerostomia, and were provided an oral screening examination, which included measurement of unstimulated and stimulated whole saliva flow rates. Overall, the observed prevalence of xerostomia was 24% among females and 18% among males. While xerostomia was more commonly observed in women than men, this association was only clear after age 50. Xerostomia was associated with: use of medications with hyposalivatory side-effects; difficulty with dry foods; cracked lips; dry eyes; difficulty swallowing; and, among males, current cigarette smoking. Results indicated a tendency for salivary flow rates to be lower for older persons, particularly the stimulated flow rate. There was a tendency in the younger cohorts for flow rates to be lower among individuals who reported sensation of dry mouth than among those who did not. This tendency was not apparent among older persons, suggesting that younger persons may be more likely to experience symptoms of oral dryness when salivary flow was low while older persons may relate symptoms of dry mouth to a more complex constellation of factors where salivary flow is only one component. These findings need to be examined further.     

Impact of wearing an intra-oral lubricating device on oral health in dry mouth patients

OBJECTIVE: To establish whether an intra-oral lubricating device for dry mouth alters the oral environment. DESIGN: A single-blind randomized cross-over study. METHOD: Twenty-nine dentate subjects from the Sjogren's syndrome clinic attended on five occasions at 4-week intervals. They were randomized, having the device fitted on either the second or the fourth visit for the experimental period, whilst using their preferred method of lubrication throughout the rest of the study. The preferred methods of lubrication were either water (group 1, n = 10) or saliva substitute (group 2, n = 9) or sugar-free chewing gum (group 3, n = 10). At each visit microbiological, unstimulated and stimulated saliva samples were collected. Dry mouth score, speech test and periodontal indices were recorded. RESULTS: The water lubrication group (1) had a resting salivary flow greater than lubrication groups (2 and 3) by post-ANOVA contrasts (P < 0.001). The postdevice data also demonstrated a salivary flow greater than lubrication group (3) by post-ANOVA contrasts (P < 0.05). The epithelial cell count using the Spearman correlation was high, possibly reflecting increased viscosity of the saliva (P = 0.044). The speech test indicated that the experimental subjects had difficulty in speaking (P = 0.001). This was slightly easier postdevice wear. Streptococcus mutans (P = 0.009) and Lactobacillus (P = 0.058) increased in the saliva after wearing the device. Salivary flow rate, Candida albicans, oral dryness, speaking and periodontal indices were unchanged. CONCLUSIONS: The oral environment was altered by wearing a lubricating device with an increase in the numbers of Strep. mutans and Lactobacillus. Clinical dryness and speech test correlated with the mean whole salivary flow suggesting a screening method for xerostomia.     

Salivary interleukin-6 and tumor necrosis factor alpha in patients with drug-induced xerostomia

It is well known that cytokines are involved in the homeostasis of oral cavity and that altered levels of either serum and/or salivary cytokines have been found in certain oral/systemic diseases. So far, cytokines in connection with xerostomia have been investigated in patients with Sjögren's syndrome. We wanted to find out whether drugs themselves influence salivary glands, which would result in altered cytokine level or whether xerostomia itself of different causes leads to the changes in salivary cytokine levels. Therefore, the aim of this study was to evaluate levels of salivary interleukin‐6 (IL‐6) and tumor necrosis factor (TNF)‐α in 30 patients with drug‐induced xerostomia, age range 29–84 and mean 63.9 years. Control group consisted of 30 healthy participants, age range 30–82 years and mean age 65.2 years. Enzyme‐linked immunoassay was performed on commercially available kits. Statistical analysis was performed by use of Student's test. No significant differences in salivary IL‐6 and TNF‐α between patients with drug‐induced xerostomia when compared with the healthy controls were found (P < 0.05). We might conclude that drugs do not induce damage to the salivary glands which could be seen in altered salivary IL‐6 and TNF‐α levels and that xerostomia itself, induced by drugs does not alter levels of the investigated salivary cytokines.     

Effect of 0.1% pilocarpine mouthwash on xerostomia: double‐blind,randomised controlled trial

The objective of this study was to evaluate the effect of 0.1% pilocarpine mouthwash in xerostomic patients. Sixty volunteers were randomly allocated to two groups. The experimental group used 0.1% pilocarpine solution, and the control group used 0.9% saline. The short‐ and long‐term effects of pilocarpine were investigated by measuring the severity of oral dryness, minor salivary flow rates and unstimulated whole salivary flow rate at predetermined times. The severity of oral dryness was decreased in both groups at 0, 30 and 60 min after mouthwashing, with no significant difference between the groups. Buccal and labial secretions were increased in both groups, but only the experimental group exhibited increased palatal secretion. Labial and palatal secretions, but not buccal secretion, differed between the groups. The unstimulated whole salivary flow rate was increased in the experimental group and differed from that in the control group. After 4 weeks, the severity of oral dryness was decreased in both groups and did not differ between them. The oral dryness at night or on awakening significantly decreased in both groups, with no significant difference between them, but the oral dryness at other times of the day and the difficulty in swallowing foods were not significantly changed in both groups. Minor salivary and unstimulated whole salivary flow rates did not increase in both groups. Until 1 h after mouthwashing, 0.1% pilocarpine mouthwash increased minor salivary and unstimulated whole salivary secretions, but was not superior compared with 0.9% saline at relieving subjective oral dryness.     

Efficacy of pilocarpine lozenge for post-radiation xerostomia in patients with head and neck cancer

BACKGROUND: Patients with radiation-induced xerostomia produce little or no saliva. Several studies have demonstrated the efficacy of systemic administration of pilocarpine hydrochloride in individuals with post-radiation xerostomia. However, analysis of pilocarpine lozenges for treatment of post-radiation xerostomia in patients with head and neck cancer has not been reported. METHODS: The aim of this study was to quantify improvement in clinical symptoms and salivary function after treatment of post-radiation xerostomia with pilocarpine lozenges. In a double-blinded, placebo-controlled trial, 33 head and neck cancer patients were assigned randomly to receive Salagen tablet, pilocarpine hydrochloride lozenge (3 or 5 mg) or placebo lozenge every 10 days. At each visit, a subjective evaluation was undertaken through the use of visual analog scales before and at 180 minutes after treatment. Whole resting saliva was collected before and at 0, 30, 60, 90, 120, 150 and 180 minutes after treatment. RESULTS: The percentage of patients with decreased feeling of oral dryness, sore mouth or speaking difficulties after taking 5-mg pilocarpine lozenge was greater than Salagen or placebo. There were statistically significant increases in salivary production in pilocarpine treatment groups vs. placebo (P < 0.05). CONCLUSION: The 5-mg pilocarpine lozenge produced the best clinical results, but further investigation with a larger group of patients is required.     

A pilot study to test the efficacy of oral administration of interferon-alpha lozenges to patients with Sjögren's syndrome

BACKGROUND: Complications from Sj?gren's syndrome-induced xerostomia may cause a significant disruption in daily routines such as speech and eating habits. In addition, the reduction in salivary output may lead to increased incidence of caries, oral ulcers, sialadenitis, periodontal problems, and Candida infections. Interferon-alpha has been suggested as an effective drug therapy to increase salivary output. OBJECTIVE: The objective was to test the efficacy of interferon-alpha lozenges in relieving the symptoms of dry mouth and dry eyes when administered orally to patients with Sj?gren's syndrome in double-blind placebo-controlled and open-label trials. STUDY DESIGN: Twelve patients with a diagnosis of primary Sj?gren's syndrome were provided an Institutional Review Board-approved, written informed-consent form. During the double-blind placebo-controlled study they were randomized to receive 150 IU of interferon-alpha (8 patients) or placebo (4 patients) for 24 weeks with 6-week reevaluations. Five patients who received interferon-alpha in the double-blind placebo-controlled trial were treated in an open-label study for another 24 weeks. Whole saliva was measured during each visit, and symptoms were assessed by questionnaires and visual analog scales. The Wilcoxon signed rank test was used to detect significant changes for each variable. RESULTS: The results indicated that, by the end of 24 weeks, patients who received interferon-alpha had a statistically significant improvement in unstimulated salivary flow rate (P < .05), and statistically significant changes were observed in the median ocular dryness visual analog scale (P < .05) and oral dryness visual analog scale (P < .05). No significant changes were observed among the placebo patients. By the end of 48 weeks, medicated patients had better results than they had at the end of the double-blind placebo-controlled study and showed improvements in whole stimulated salivary flow rate, conditions of throat, and swallowing dry food. CONCLUSION: Oral administration of 150 IU interferon-alpha 3 times a day for the patients with primary Sj?gren's syndrome improved saliva production, relieved symptoms of xerostomia and xerophthalmia, and was well tolerated by the patients.     

Hyposalivation, xerostomia and oral health status of HIV-infected subjects in Thailand before HAART era

J Oral Pathol Med (2010) 39 : 28–34
Background:  The aims of this study were to determine hyposalivation, xerostomia, and oral health status of HIV-subjects in Thailand before highly active antiretroviral therapy era.
Methods:  Oral examination and measurement of saliva flow rate of both unstimulated and wax-stimulated whole saliva were performed in 135 subjects (56 HIV-subjects, mean age: 34.5 years, and 79 non-HIV controls, mean age: 29.5 years). Presence of oral candidiasis, cervical root caries, and number of existing teeth were recorded. Microbiological investigation of oral Candida was conducted using oral rinse technique. Risk factors associated with hyposalivation and xerostomia were analysed.
Results:  The unstimulated flow rates in HIV-subjects and non-HIV controls were 0.19 and 0.33 ml/min ( P  = 0.0024). For stimulated flow rates, the corresponding figures were 1.45 and 1.62 ml/min ( P  = 0.31). The unstimulated flow rate was significantly higher in the asymptomatic HIV-subjects: 0.17 ml/min, when compared with the symptomatic/AIDS group 0.11 ml/min ( P  = 0.003). No significant difference between the groups could be found with respect to stimulated flow rate. Hyposalivation was significantly associated with the colony forming unit of Candida . Smoking and alcohol consumption were significantly associated with hyposalivation, but not xerostomia. The following factors were significantly associated with both hyposalivation and xerostomia; sex, stage of HIV infection, risk group of HIV infection, systemic disease, and medication use.
Conclusions:  Salivary flow rate of HIV-subjects in Thailand was affected by HIV infection. The rate was significantly decreased with advanced stage of the disease. Various factors including medication use were associated with hyposalivation and xerostomia among the subjects.     

Translation, validation, and construct reliability of a Portuguese version of the Xerostomia Inventory

Oral Diseases (2012) 18 , 293–298 Objectives: To generate and validate at pretest level a cross‐culturally adapted Portuguese version of Xerostomia Inventory (XI), a 11‐item questionnaire designed to measure specific xerostomia rating of patients complaints. Methods: The original English version of the XI was translated into Portuguese following the guidelines for cross‐cultural adaptation of health‐related quality of life measures. Thirty patients with primary Sjögren syndrome were recruited for this study. The questionnaires were administered by trained and calibrated dental doctors to each patient. XI properties were examined including reliability, internal consistency, and test‐retest reliability, using Cronbach’s alpha, total and inter‐item correlation, and intra‐class correlation coefficients (ICC), respectively. Construct validity supported by objective measurements of xerostomia intra‐oral signs and salivary secretion was investigated. Alpha was set at 0.05. Informed consents and local ethical committee clearance were obtained. Results: Internal consistency and test‐retest reliability were excellent (Cronbach’s α = 0.9; ICC range = 0.79–0.94). Scatterplot interpolation and Pearson correlation coefficient suggested the presence of a strong, negative, and significant correlation between salivation and the XI scores indicating construct validity. Conclusion: The Portuguese version of the XI can be considered a reliable and valid instrument to measure patients’ xerostomia symptoms.     

Salivary evaluation in radioactive I131 treated patients with thyroid carcinoma

Background and objective: radioiodine treatment (I¹³¹) used to treat thyroid carcinomas produces side effects (sialadenitis, xerostomia, dysphagia and caries susceptibility) reflecting in a poor patient quality of life. This study aimed to evaluate the effect of I¹³¹ on salivary function and possible oral impairment.

Material and methods: Thirty-seven patients undergoing I¹³¹ were submitted to oral examination, answer questions regarding xerostomia/hyposalivation and collect saliva at three moments (M1: 30–45 days before I¹³¹, M2: 1–2 days after I¹³¹ and M3: 7–10 days after treatment). Saliva was assayed for flow rate and calcium/phosphate concentrations.

Results and conclusions: significant difference in calcium/phosphate concentration was shown between M1 and M2, with evident decrease at M2. Flow rate reduced right after treatment with 41% of patients returning to previous rate at M3 (no statistical difference). A higher number of patients related xerostomia and difficulty in swallowing food at M2. The results showed that xerostomia/hyposalivation, dysphagia and calcium/phosphate concentration decrease may be considered early radioiodine side effects.