This thesis comprises a number of studies aiming to provide insight in the acute and long term effects of dialysis on oral dryness (salivary flow rate and xerostomia), thirst and oral health in ESRD patients. Furthermore, the aim was to assess the relationship between oral dryness (defined as reduced salivary flow rates and xerostomia), thirst and IWG in patients on hemodialysis, and to investigate potential therapies to reduce oral dryness and consequently IWG. First, the acute effects of HD on the salivary flow rate and composition were studied before, during and after a dialysis session (Chapter 2). To unravel the association between oral dryness and fluid-intake in HD patients, we investigated in HD patients the relation between IWG, thirst and oral dryness (Chapter 3). The oral health of dentate ESRD patients on dialysis treatment was assessed and compared to a healthy reference group (Chapter 4). In a two-year follow up study, the oral health, salivary flow rates, thirst and xerostomia were compared of those patients that received a renal transplant with those remaining on dialysis (Chapter 5). Since it appeared that chewing could stimulate the salivary flow rate in healthy subjects Appendix) and HD patients, we investigated the effect of chewing gum and artificial saliva on IWG, salivary flow rate, xerostomia and thirst in a crossover study (Chapter 6). The more subjective reports and preferences of the HD patients between chewing gum and artificial saliva were explored in Chapter 7. Finally, in Chapter 8, we discuss the results of our studies.Nieuw Amerongen, A. van [Promotor]Wee, P.M. ter [Promotor
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