The Challacombe scale is a widely used diagnostic

medical Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practi ...

tool designed to produce a clinical oral dryness score (CODS) which quantifies the extent of dryness of the mouth, with the aim of making a decision of whether to treat or not, and to monitor its progression or regression. It can be used to assess salivary flow and therefore calculate a risk of

dental caries Tooth decay, also known as cavities or caries, is the breakdown of teeth due to acids produced by bacteria. The cavities may be a number of different colors from yellow to black. Symptoms may include pain and difficulty with eating. Complicatio ...

. In addition, it has a particular use in the assessment of dry mouth in

Sjögren syndrome Sjögren syndrome or Sjögren's syndrome (SjS, SS) is a long-term autoimmune disease that affects the body's moisture-producing (lacrimal and salivary) glands, and often seriously affects other organ systems, such as the lungs, kidneys, and nerv ...

. Based on a 10-point scale of clinical physical findings, a score of one is least severe and ten most severe.

Medical use

Dry mouth (xerostomia) is frequently caused by medication and to a lesser extent, by anxiety or Sjögren's syndrome. It can be useful to have the extent of dryness recorded. That is, if a person has a complaint of a dry mouth, the clinician can apply the Challacombe scale to determine its severity and whether treatment is required. The scale also provides a common reference point, allowing progress or deterioration to be monitored. The Challacombe score can be used to assess dry mouth in

and to assess salivary flow and therefore calculate a risk of

, which are more likely in drier mouths. The score correlates with the rate of salivary flow and with the wetness of the mouth, indicated by the thickness of the mucosal film on the inside of the cheeks, on the

palate The palate () is the roof of the mouth in humans and other mammals. It separates the oral cavity from the nasal cavity. A similar structure is found in crocodilians, but in most other tetrapods, the oral and nasal cavities are not truly s ...

and on the

tongue The tongue is a muscular organ in the mouth of a typical tetrapod. It manipulates food for mastication and swallowing as part of the digestive process, and is the primary organ of taste. The tongue's upper surface (dorsum) is covered by taste bu ...

. While a high score indicates the need for treatment and investigation, a low score may indicate the need not to intervene, a decision frequently more difficult to make.

Procedure and interpretation of results

The following factors are used to evaluate the dryness of the mouth. The presence of each accrues one point and further referral and assessment is required for scores of 7 or more. As the mouth becomes drier, each feature is often seen in sequence with the score progressively increasing. Scores may change, for better or worse, allowing monitoring. Example images accompany the features. # Dental mirror sticks to

buccal mucosa The oral mucosa is the mucous membrane lining the inside of the mouth. It comprises stratified squamous epithelium, termed "oral epithelium", and an underlying connective tissue termed '' lamina propria''. The oral cavity has sometimes been descri ...

# Mirror sticks to tongue # Saliva frothy # No saliva pooling in floor of mouth # Tongue shows generalised shortened papillae (mild depapillation) # Altered gingival architecture (i.e. smooth) # Glassy appearance of oral mucosa, especially palate # Tongue lobulated/fissured # Cervical caries (more than two teeth) # Debris on palate or sticking to teeth

History

The Challacombe scale was launched on 2 September 2011 and based on research conducted at King's College London Dental Institute under the supervision of professor Stephen Challacombe.

References

{{reflist, 30em Medical assessment and evaluation instruments Medical scales Medical scoring system

Medical use

Procedure and interpretation of results

History

See also

References