The wafer test: A semi-quantitative test to screen for xerostomia

J. Sánchez-Guerrero, E. Aguirre-García, M. R. Pérez-Dosal, A. Kraus, M. H. Cardiel, A. E. Soto-Rojas

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Objective. To develop a screening test for xerostomia. Methods. A cross-sectional study was conducted among 152 healthy subjects aged <20-60 yr, 30 patients with primary Sjögren's syndrome and 60 patients with other connective tissue diseases, sampled randomly. A validated screening questionnaire for sicca syndrome and the Schirmer-1 and wafer tests were carried out in all subjects. In addition, non-stimulated whole salivary flow was measured in a random sample of 113 participants. The main outcome was the time of dissolution of the wafer. Results. Time of dissolution of the wafer was 2.8 ± 2.1 min in the healthy group, 3.3 ± 1.5 min in the connective tissue diseases group, and 9.2 ± 3.9 min in the primary Sjögren's syndrome group (P < 0.001). The correlation coefficient between the wafer test and non-stimulated whole salivary flow was -0.60 [95% confidence interval (CI) -0.47, -0.71]. A cut-off value of 4 min ('wafer 4') showed sensitivity of 92.9%, specificity of 71.7%, a positive predictive value of 31.7%, a negative predictive value of 98.6%, accuracy of 74.3%, an ROC (receiver operating curve) value of 82.3 and a likelihood ratio of 3.3 (95%, CI 2.3, 4.6) for xerostomia. The proportion of patients with wafer 4 was 8% in the healthy group, 23% in the connective tissue diseases group and 93% in the primary Sjögren's syndrome group (P < 0.001). Wafer 4 was a significant predictor of xerostomia after controlling for age, gender, temperature and relative humidity. Conclusion. The wafer test is valid and reliable for identifying subjects with xerostomia.

Original languageEnglish (US)
Pages (from-to)381-389
Number of pages9
JournalRheumatology
Volume41
Issue number4
StatePublished - Jun 1 2002
Externally publishedYes

Keywords

  • Screening
  • Sicca syndrome
  • Sjögren's syndrome
  • Xerostomia

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

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