Effect of 0.1% pilocarpine mouthwash on xerostomia: double‐blind, randomised controlled trial

Abstract

The objective of this study was to evaluate the effect of 0.1% pilocarpine mouthwash in xerostomic patients. Sixty volunteers were randomly allocated to two groups. The experimental group used 0.1% pilocarpine solution, and the control group used 0.9% saline. The short- and long-term effects of pilocarpine were investigated by measuring the severity of oral dryness, minor salivary flow rates and unstimulated whole salivary flow rate at predetermined times. The severity of oral dryness was decreased in both groups at 0, 30 and 60 min after mouthwashing, with no significant difference between the groups. Buccal and labial secretions were increased in both groups, but only the experimental group exhibited increased palatal secretion. Labial and palatal secretions, but not buccal secretion, differed between the groups. The unstimulated whole salivary flow rate was increased in the experimental group and differed from that in the control group. After 4 weeks, the severity of oral dryness was decreased in both groups and did not differ between them. The oral dryness at night or on awakening significantly decreased in both groups, with no significant difference between them, but the oral dryness at other times of the day and the difficulty in swallowing foods were not significantly changed in both groups. Minor salivary and unstimulated whole salivary flow rates did not increase in both groups. Until 1 h after mouthwashing, 0.1% pilocarpine mouthwash increased minor salivary and unstimulated whole salivary secretions, but was not superior compared with 0.9% saline at relieving subjective oral dryness.

Efficacy and safety of pilocarpine mouthwash in elderly patients with xerostomia

“…Topical pilocarpine application had nearly a 50% success rate in patients with RT‐induced xerostomia, and these results are in agreement with our xerostomia patients. On the other hand, Kim reported that pilocarpine mouthwash for 4 weeks was not superior to 0.9% saline at relieving the oral dryness of patients with xerostomia . Although the reason for this discrepancy is unknown, a possible explanation is that the amount of pilocarpine usage in our trial was more frequent than that in Kim’s trial (at any time vs. 3 times per day).…”

“…In healthy subjects, a randomized, double‐blinded, placebo‐controlled study showed that a single rinse with 1% to 2% pilocarpine mouthwash significantly increased salivation without cardiovascular, visual, gastrointestinal, or behavioral side effects . In middle‐aged (mean: 53.6 years) xerostomia patients, a double‐blinded, randomized, controlled, long‐term trial showed that 0.1% pilocarpine mouthwash was not more effective than 0.9% saline after 4 weeks of treatment. Moreover, two studies reported that pilocarpine mouthwash was effective in relieving RT‐induced xerostomia .…”

Treatment of late sequelae after radiotherapy for head and neck cancer

“…a topical administration of pilocarpine suspended in candy-like pastilles [35], a lozenge [36], or a mouthwash [37,38]. As these studies were small, further investigations are warranted to confirm some of the promising results observed.…”

The Change of Salivary Flow Rate according to Olfactory Stimulation

“…39) Similarly, in the present study, pre-and post-stimulation comparisons were made to test the effect of stimulation. However, in contrast, we continuously administered stimulation and measured the changes throughout the 4-week period in order to address a reliability issue stemming from contrast reduction due to the olfactory system's immediate reaction and adaptation.…”

“…38) According to a study conducted to investigate the change in the salivation rate from minor salivary glands following pilocarpine mouthwash, 39) Among the 5 sensory organs, the olfactory organ is the most sensitive and fast-reacting. 40) Indeed, salivation markedly increased following the first olfactory stimulation.…”