Dry Mouth Questionnaire
What a dry mouth questionnaire asks, why each part matters, and how dental practices collect it.
A dry mouth questionnaire records how dry the mouth feels, how it affects eating and swallowing, and medicines or conditions that may play a part. The questions on this page are a typical set built from a published research protocol and an oral medicine health history.
Dry mouth questionnaire, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on a dry mouth questionnaire in the patient's own language, strictly following the practice's instructions.
- Intake before the visit. Patients answer online before they arrive, or at a kiosk when they check in.
- Answers ready for the clinician. Clinicians see what the patient said before the visit starts.
- Less workload at the front desk. Staff spend less time handing out forms and entering answers by hand.
- Key details at a glance. The care team sees what matters up front and decides who needs attention first.
The form becomes a natural conversation: patients answer by talking, in their own words. AI Doctor is an information and patient-assistance interface. It collects answers for the care team to review. It doesn't diagnose, triage, or give treatment advice.
Sample dry mouth questionnaire questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- Does your mouth frequently feel dry?Dryness
- Does the amount of saliva seem too little?Dryness
- Does your mouth feel dry when eating?Eating
- Do you sip liquids to help you swallow?Eating
- Which medicines do you take daily?Medicines
- Have you started any new medicine recently?Medicines
- Have you had radiation or chemotherapy?Medical history
- Do you have diabetes or a thyroid condition?Medical history
- Do you have mouth ulcers or sores?Mouth problems
- Do you have Sjögren's syndrome?Mouth problems
- Do you smoke or use tobacco?Habits
- How much alcohol do you drink per week?Habits
These are examples to read, not a form to fill in.
Dry mouth questionnaire: FAQ
What does a dry mouth questionnaire ask?
The sample questions on this page cover six areas: dryness, eating and swallowing, medicines, medical history, other mouth problems, and habits.
Who fills in a dry mouth questionnaire, and when?
The patient, before a visit where dry mouth is the concern. Dry mouth questions also appear inside oral medicine health histories.
Why does the questionnaire ask about medicines and conditions?
Oral medicine health histories place dry mouth next to the medicine list and conditions such as diabetes or past radiation. The dentist reads them together.
What does xerostomia mean?
Xerostomia is the medical word for a dry mouth. The questions on this page ask about how it feels and what it affects.
Is there a standard dry mouth questionnaire?
The PhenX Toolkit lists a five-question dry mouth protocol from the National Institute on Aging that is free to use. The sample questions on this page show a typical set.
What happens after the questionnaire?
The dentist reviews the answers, examines the mouth, and discusses the next steps with the patient.
Does AI Doctor give medical advice?
No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.
Can patient answers stay on our own servers?
Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.
Set up your AI Doctor in Genesis AI Avatar Studio
Genesis AI Avatar Studio is where you set up, test, and publish AI avatars for your website, mobile app, or Holobox. No coding or technical skills needed.
- 01Choose the AI Doctor avatar.
- 02Add your practice's FAQs and visit information.
- 03Talk to it, then publish it.
