19 General introduction, aim and outline of the thesis 1) perceived intra-oral dryness (Chapters 2, and 3); 2) intra-oral surface area and salivary distribution (Chapters 4, 5 and 6); and 3) interventions to relieve oral dryness (Chapters 7, 8 and 9). In Chapter 2, a novel questionnaire, the Regional Oral Dryness Inventory (RODI) was developed to quantify the severity of dryness at various locations in the mouth. Next, this questionnaire was validated in various groups of dry-mouth patients aiming to differentiate between causes of oral dryness (Chapter 3). As the size of the surface area of the intra-oral regions, the palate, can possibly influence the distribution and average thickness of the salivary film, in Chapter 4 intra-oral surface areas were quantified using cone-beam computed tomography (CBCT). Besides, potential correlations between intraoral surface areas and facial anthropomorphic measurements were analyzed which would enable easy and safe chair-side approximation of intra-oral surface areas. In Chapter 5 the relation between the palate surface area, measured using an intra-oral scanner, and anthropometric measurements of the head and face was validated in living subjects. In Chapter 6, palatal surface area measurements were explored in healthy volunteers in combination with measurements of the salivary film and the salivary consistency, especially the concentration of a salivary mucin, at various intra-oral locations. The aim of Chapter 7 was to investigate the use of dry-mouth interventions by subgroups of patients with different causes of oral dryness and explored the possible relation of the applied interventions with intra-oral dryness and salivary flow rate. In accordance with this study, Chapter 8 has a similar aim, but focuses on Sjögren’s syndrome patients specifically. The purpose of Chapter 9 was to explore the preferences of Sjögren’s syndrome patients regarding various product characteristics of potential new saliva substitutes, important functions of possible substitutes, objections against certain ingredients, desired flavors for the substitutes, objections against potential side-effects of saliva substitutes, and the preferred method of administration. 1
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