210 Chapter 10 In the event of broad use of such a tool for dry-mouth screening and/or diagnosis, an important prerequisite is that relevant dental education should be provided to dental students about saliva and dry-mouth-related topics. In general, the current European dental schools have included the anatomy of the salivary glands, the functions of saliva and causes of dry mouth in their dental curriculum [2], but the importance of dry-mouth diagnosis and interventions are less frequently covered. Almost half of the dental schools spend only 10 hours or less on saliva-related topics during their entire curriculum [2]. This indicates that it is important to extend the saliva-related education in the curricula of dental schools and emphasize its importance, for the benefit of current and future dry-mouth patients. The prevalence of xerostomia is currently estimated to be approximately 20%, with higher prevalence in females (up to 30%) and in older adults (up to 50%) [3-5]. However, the number of people suffering from xerostomia will probably increase in the upcoming years due to ageing of the worldwide population (Figure 2, prognosis of the number of individuals ≥65 years in upcoming years) [6]. Therefore, the need for improved diagnostics in regular dental clinics, and better dry mouth education, is emerging. Salivary filmand MUC5B In this thesis, the volume of the salivary film was determined at various intraoral locations. At first, for each region of the oral mucosa a standardized filter paper (SialoPaper strips) was placed to sample the saliva fluid on the surface of interest. After a given period of time, when the saliva was immersed in the filter, the volume was be determined using the change in conductance in a Periotron [7]. However, more recently, it was shown that Schirmer test strips, traditionally used in the diagnosis of xerophthalmia, can be a helpful instrument in intra-oral dryness assessment as well [8, 9]. The Schirmer test strip consists of a 35-mm long prefabricated absorbent filter paper strip with millimeter scaling. While the test strip is collecting fluid, the advancing fluid front is visualized by the blue coloration of the indicator due to the pH of saliva, and can be read from the millimeter scale [9]. This will enable easy measurement of saliva volumes at various intra-oral locations without the need of a Periotron device. Schirmer test strips can also easily be used in saliva clinics, because no specialized equipment is needed. In this thesis, the levels of MUC5B weremeasured at various intra-oral regions in healthy volunteers (Chapter 6). The salivary glycoprotein MUC5B plays a versatile role in maintaining oral health. It contributes to lubrication, pellicle formation, antimicrobial defense, and water retention, and its glycans are an
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