Efficacy of gel-based artificial saliva on Candida colonization and saliva properties in xerostomic post-radiotherapy head and neck cancer patients: a randomized controlled trial

Abstract

Objective To evaluate the efficacy of an edible artificial saliva gel, oral moisturizing jelly (OMJ), and a topical commercial gel (GC dry mouth gel) on Candida colonization and saliva properties. Materials and methods This study was a secondary analysis of a single-blinded randomized controlled trial conducted in xerostomic post-radiotherapy head and neck cancer patients. Candida colonization, stimulated salivary flow rate (SSFR), saliva pH, and buffering capacity (BC) were measured at 0, 1, and 2 months after each intervention. Candida colonization was quantified by colony counts and species identified by Candida Chromagar, polymerase chain reaction, and API 20C AUX system. Statistical significance level was 0.05. Results A total of 56 participants in OMJ (N = 30) and GC (N = 26) groups completed the study. OMJ significantly increased saliva pH (p = 0.042) and BC (p = 0.013) after 1-month use, while GC only improved saliva pH (p = 0.027). Both interventions tended to increase SSFR but only GC had a significant increase at 2 months (p = 0.015). GC and OMJ significantly decreased the number of Candida species at 1 and 2 months, respectively. Both groups tended to reduce Candida counts but not significant. Conclusions Both OMJ and GC saliva gels could improve saliva pH and decrease the number of Candida species. OMJ is superior to GC in its buffering capacity, while GC may better improve salivary flow rate. Long-term and large-scale study is warranted to test the efficacy of artificial saliva in oral health improvement. Clinical relevance OMJ and GC gel could decrease the number of Candida species and improve saliva properties in post-radiation xerostomic patients. Trial registration number Clinicaltrials.gov NCT03035825. Date of registration: 25th January 2017.

Exploration of the Efficacy and Safety of Oral Moisturizing Agents for Dry Mouth and Xerostomia: A Systematic Review

“…Based on the 5 included articles [16][17][18][19][20], the most related conditions to dry mouth were not only in patients with systemic diseases such as Sjogren's syndrome [16], post-radiotherapy in head and neck cancer patients [18,20], diabetes mellitus [19], and patients using endotracheal tubes [19] but can also be found in non-Sjogren's syndrome patients. This article review completes the previously published review articles, which already stated that dry mouth or xerostomia could be related to aging [1,2,7,8,21], burning mouth syndrome [1], and medication-induced.…”

A Review on Xerostomia and Its Various Management Strategies: The Role of Advanced Polymeric Materials in the Treatment Approaches

“…The symptomatic relief or control of oral dryness includes hydration (frequent sipping of water), discontinuation or reduction in xerogenic medications, and elimination of common dry mouth offenders, such as tobacco and alcohol [ 76 ]. Moreover, artificial salivary substitutes (i.e., commercial products containing specific ingredients, whose properties resemble those of the natural saliva) are frequently used as symptomatic treatments for patients with decreased salivary flow rate [ 77 , 78 ]. In fact, they act as oral lubricants that maintain the lubrication of the mucosa and, hence, relieve the sensation of dryness, without stimulating the salivary flow.…”

Identification of Candida Species Isolated from Oral Candidiasis in Cancer Patients using PCR-RFLP in Sulaimani, Iraq

“…After the accumulation of saliva, it's tested with an Electrolytes Analyzer, YACOi (Yarsan-India). Then the acidity was tested to start comparing the PH intervals of patients with oral candidiasis and control cases (Lam-ubol et al, 2021).…”