Interventions for the treatment of xerostomia: A randomized controlled clinical trial

Abstract

Background Xerostomia or dry mouth sensation corresponds to a common clinical problem that can significantly impair the oral health related quality of life (OHRQoL). Currently, there is a large variety of local agents available for the treatment of xerostomia, but there is a lack robust evidence supporting the use of one treatment over another. We aimed to compare the effectiveness of a 1% malic acid salivary stimulant spray with a 1.33% betaine-based saliva substitute mouthwash in the improvement of xerostomia. Material and Methods Fifty-one participants with drug induced or idiopathic xerostomia were randomly allocated into three groups, two intervention and one control group (placebo). OHRQoL and severity of xerostomia were assessed with the OHIP-14sp questionnaire and a visual analogue scale (VAS) respectively. Stimulated and non-stimulated salivary flow rates before and after treatments were also measured. Results All three groups reported a significantly improvement in the dry mouth sensation and non-stimulated salivary flow rates, but only the malic acid spray and the betaine-based mouthwash significantly improved the OHRQoL. There were no significant differences between both intervention groups. Conclusions This study provides evidence that both tested agents are comparable in improving the dry mouth sensation and OHRQoL of patients with drug induced and idiopathic xerostomia. Key words: Xerostomia, dry mouth, malic acid, betaine, oral-health related quality of life.

Efficacy and safety of two artificial saliva-based polymers containing 0.1% pilocarpine for treatment of xerostomia: A randomized clinical pilot trial

“…First, artificial saliva may act like salivary lubrication, moistening, and buffering. The lubricant effect of artificial saliva may increase oral physiological movement that can promote local mechanical stimuli, along with spearmint oil and xylitol used as flavoring agents which function as salivary stimulants ( 27 ). The second, pilocarpine can promote saliva secretion by stimulating muscarinic M3 receptors ( 15 ).…”

Oral Care Recommendation for Cystic Fibrosis Patients–Recommendation for Dentists

“…In this age group, apart from the procedures described above, a strong recommendation is to evaluate the level of mouth hydration, basing it on their medical history and physical examination. If CF patients complain of dry mouth, or when examination indicates lower hydration of the oral mucosa (or the symptoms suggestive of it such as crusting of the mouth corners or dry lips) [ 31 ], stimulated saliva secretion should be measured using a paraffin block. Among additional investigations, the evaluation of saliva pH or its microbial analysis may be conditionally recommended.…”

“…Relief is also brought about by a proper diet, with no spicy or salty foods. Moreover, salivation may be activated by physical stimulation, for instance by chewing sugar-free gum [ 31 ]. In cases of considerable dryness, moisturizing agents might be useful (they contain carboxycellulose or mucin) presented as tablets, sprays, gels or mouthwashes.…”

“…The feeling of dryness is also effectively relieved by the so-called “artificial saliva”, which covers the oral mucosa with a moist, protective layer. The formula of preparations containing mucin, carboxymethylcellulose, glycoproteins, glycerin and some enzymes [ 31 , 32 ] show similarity to natural saliva composition.…”

“…The biofilm will stay not only on the surfaces of the teeth but also on the mucous membranes. Xerostomia may also promote aphthae, mucosal ulceration, bacterial or fungal infections and halitosis [ 31 , 32 ]. In these patients, who are at high risk of oral diseases, there is a strong recommendation that control dental visits will be made more frequent, not only to control oral health and to monitor the success of the bacterial biofilm removal procedures from the teeth, tongue and cheeks, but also to encourage patients to actively participate in treatment, both through the use of appropriate measures and suitable symptom-reducing habits.…”