title: Detection of mild hyposalivation in elderly people based on the chewing time of specifically designed disc tests: diagnostic accuracy.
abstract: OBJECTIVE
  To compare sialometry with chewing time (including swallowing) of specifically designed disc tests.
  
  
  METHODS
  Index test versus reference standard (sialometry; 60 patients); reliability study (10 patients).
  
  
  METHODS
  Outpatient dental clinic and geriatric ward, Nice University Hospital, France.
  
  
  METHODS
  Thirty adults and 30 older patients (mean ages 47 and 84).
  
  
  METHODS
  Index test assessment in patients with and without hyposalivation.
  
  
  METHODS
  Data from medical files, interviews and oral examination were collected. Sialometry (stimulated salivary flow rate (SSFR) mL/min) and disc chewing times (seconds) were measured.
  
  
  RESULTS
  Sialometry was too long and was inappropriate for five of the 30 older persons. Chewing times were negatively correlated to sialometry results (Spearman correlation coefficient (R)=0.77, P<.001). The threshold to diagnose hyposalivation (SSFR <1 mL/min) was 40 seconds (area under the receiver operating characteristic curve (AUC)=0.921, 100% sensitivity, 72% specificity). Twenty-seven subjects with a SSFR less than 1.5 mL/min had a chewing time longer than 40 seconds, suggesting that mild hyposalivation and eating difficulties were related (AUC=0.941, 93% sensitivity, 88% specificity). Mean chewing time was greater with xerostomia (51.9 vs 30.7 seconds, P<.001) but not with dental pain (39.5 vs 39.9, P=.96). Masticatory percentage (e.g., pairs of antagonistic teeth) had no effect on chewing time (SSFR <1 mL/min, AUC=0.921; SSFR <1.5 mL/min, AUC=0.950). Reliability was better for the disc test than for sialometry (intraclass correlation 0.85 vs 0.70).
  
  
  CONCLUSIONS
  This disc test was conceived to detect mild hyposalivation in geriatric patients with impaired dental health. Early detection of hyposalivation could help to suppress or avoid xerostomia-inducing drugs and to prevent oral infections and dental caries.
authors.affiliation: Laboratory of Oral Microbiology URE 01 UNS, Faculty of Dentistry, University of Nice Sophia Antipolis, Nice, France. Isabelle.MADINIER@unice.fr
authors.forename: Isabelle
authors.initials: I
authors.lastname: Madinier
authors.forename: Mireille
authors.initials: M
authors.lastname: Starita-Geribaldi
authors.forename: Frederic
authors.initials: F
authors.lastname: Berthier
authors.forename: Catherine
authors.initials: C
authors.lastname: Pesci-Bardon
authors.forename: Patrice
authors.initials: P
authors.lastname: Brocker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008409:Mastication / Q000502:physiology; D008875:Middle Aged; D012372:ROC Curve; D012016:Reference Values; D012472:Salivation / Q000502:physiology; D014987:Xerostomia / Q000175:diagnosis* / Q000503:physiopathology