38 Chapter 2 The RODI scores at the nine intra-oral regions showed weak to nonsignificant negative correlations with the UWS, CH-SWS, and A-SWS with Spearman’s rho correlation coefficient ranging between − 0.27 and − 0.13. Xerostomia Inventory Table 4 shows that the median of the 11 items of the XI ranged between 2.0 and 4.0. There was a significant difference in perceived oral dryness and mouth feel between the 11 items of the XI (Friedman test p < 0.05, followed by Wilcoxon signed-rank tests p < 0.05). The XI item 4 (my mouth feels dry) had the highest scores and items XI 1 (sip liquids to swallow food) and XI 7 (I have difficulty swallowing food) had the lowest scores. The scores on the nine areas of the RODI correlate significantly with all items of the XI (data not shown) (presented in Appendix 1, for review purposes only). The highest correlation coefficient was observed between XI item 4 (mouth feel dry) and the dryness of the anterior tongue (r = 0.70). XI items related to extra-oral regions have poor correlations with RODI scores (correlation coefficient varying between 0.21 and 0.49) according to the standards described by Mukaka and co-workers and Akoglu and co-workers, for example, items 8 (skin of face), 9 (eyes), and 11 (nose) [31, 32]. In contrast, scores on XI items related to intra-oral locations show a stronger correlation with and the associated region of the RODI. Mainly XI item 7 (difficulty swallowing certain food) and XI item 10 (lips feel dry) have the highest correlation with the local dryness of respectively the pharynx (r = 0.56) and both upper and lower lip (r = 0.63 and 0.62). Clinical Oral Dryness Score The median CODS of 319 persons is 4.0 with IQR of 2.0–5.0 (mean = 3.57, SD = 1.82). Table 5 presents how frequently each item of the CODS was scored. In the overall sample, item 1 (the mirror sticks to the cheek; 78.9%) was most frequently scored, and item 8 (debris on the palate; 2.5%) the least. The presence of CODS item 1 (mirror sticks to buccal mucosa) was associated with a significant difference in dry-mouth feeling inside the cheeks (Mann-Whitney U = 4897, p = 0.009, r = − 0.16). CODS item 2 (mirror sticks to tongue) and CODS item 4 (tongue lobulated/fissured) were associated with higher dryness of the regions anterior and posterior tongue (CODS 2 respectively for anterior and posterior tongue; U = 6960, p = 0.000, r = − 0.26 and U = 7520, p = 0.000, r = − 0.21) (CODS 4 respectively anterior and posterior tongue; U = 5424, p = 0.000, r = − 0.22 and U = 6208, p = 0.023, r = − 0.14). CODS item 6 (no saliva pooling in floor of mouth) corresponds with a higher dry-mouth feeling of the floor of the
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