177 Oral dryness and use of dry-mouth interventions the floor of the mouth and the inside cheeks were experienced as least dry [8]. This supports the suggestion that use of the RODI might add in screening or diagnosis of Sjögren syndrome. The current study found that the use of dry-mouth interventions is influenced by intra-oral dryness (RODI questionnaire) in Sjögren’s patients. For almost all dry-mouth interventions, there was a significant association with the RODI scores except for “eating fruit’’ (Table 7). Only “eating fruit’’ was significantly associated with the overall mouth dryness (total XI score); however, the odds ratio was only slightly above 1 (1.09). While for all other associations between dry-mouth interventions and RODI scores, the odds ratios were around 2 or above (Table 7). On the other hand, patients’ discomfort was not significantly associated with any dry-mouth interventions. These results show that the intraoral dryness, measured by the RODI questionnaire, can be a helpful tool in advising dry-mouth interventions for Sjögren’s syndrome patients. An interesting significant association could be seen for the dry-mouth interventions “drinking water’’, “rinsing of the mouth”, and “drinking small volumes’’ with some intra-oral regions. However, it is expected that these generic dry interventions would be significantly associated with the overall mouth dryness (XI score) and not with the intra-oral dryness. In a previous study, it was found that the XI scores of Sjögren’s patients had the highest correlations with the RODI scores of the posterior palate, anterior and posterior tongue, and floor of the mouth [8]. When looking to the other dry-mouth patients, it was found that the RODI scores of the anterior and posterior tongue and the floor of the mouth had the highest correlations with total XI scores [8]. This finding indicates that the tongue and possibly also the posterior palate play an important role in dry-mouth perception. A different study that used the Clinical Oral Dryness Score (CODS), a clinical tool to semi-quantitatively assess oral dryness, found that the items “fissured or depapillated tongue’’ and “lack of saliva pooling in the floor of the mouth’’ are signs of hyposalivation [28]. Other clinical features of their study, such as a mirror sticking to the tongue, a lack of saliva pooling in the floor of the mouth and a tongue showing loss of papillae, can be associated with a moderate but significant reduction in mucosal wetness [28]. Taken together, this suggests that the tongue might play an important role in dry-mouth perception. This may explain why Sjögren’s patients have a significant association between “rinsing of the mouth”, “drinking small volumes” and the RODI scores of the anterior and posterior tongue, respectively. The significant association between “drinking water’’ and the RODI scores of the posterior palate is explained by the high RODI scores of this region. Of all intra-oral regions, the posterior palate was considered the 8
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