Efficacy of saliva substitutes and stimulants in the treatment of dry mouth

2019 ◽  
Vol 39 (3) ◽  
pp. 287-297 ◽  
Author(s):  
Lydia See ◽  
Mehdi Mohammadi ◽  
Phuu P. Han ◽  
Roseann Mulligan ◽  
Reyes Enciso
Keyword(s):  
Dry Mouth ◽  
Saliva Substitutes

Multifunctional artificial saliva preparation – challenges and needs

2021 ◽  
Vol 8 ◽  
pp. 37-46
Author(s):  
Katarzyna Niemirowicz-Laskowska ◽  
Joanna Mystkowska ◽  
Dawid Łysik ◽  
Sylwia Chmielewska ◽  
Łukasz Suprewicz ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Artificial Saliva ◽  
Salivary Secretion ◽  
Biological Properties ◽  
Pharmacological Therapy ◽  
Oral Microbiome ◽  
Dry Mouth ◽  
Rheological Parameters ◽  
Saliva Substitutes

Saliva plays a crucial role in maintaining homeostasis not only within the oral cavity but also in further sections of the gastrointestinal tract. Pleiotropic properties of saliva include participation in the digestion of carbohydrates, cleansing and moisturizing the oral cavity, and maintaining the composition of the oral microbiome. The result of impaired function of the salivary gland is reduced salivation – hyposalivation, leading to dry mouth – xerostomia. It is established that numerous physiological factors (age, sex, weight change) and pathological factors (polytherapy, head and neck cancer, coexisting diseases such as diabetes, depression, cardiovascular diseases) lead to the reduction in saliva secretion, and in effect, causing a dry mouth. Treatment of salivary secretion disorders involves pharmacological therapy (including hormone therapy) or replacement therapy which based on the use of saliva substitutes. In the case of disturbances in the secretion of natural saliva, the application of the artificial saliva preparations should support the chewing processes, moisturize the oral cavity, and fulfill the biological functions of saliva. However, to date, on the pharmaceutical market, there are no saliva substitutes that meet the biological criteria and maintaining favorable physicochemical properties and rheological parameters. Taking into account the problems of the patients which are burden by impaired salivary secretion, the aim of our research was to attempt to develop an artificial saliva preparation that reflecting as much as possible the properties of natural saliva, both in terms of mechanical and biological properties. As part of the research, the chemical composition was developed and a detailed study of the physicochemical and rheological parameters of artificial saliva preparations containing mucins as well as their microbiological and biocompatibility assessment, at in vitro level were carried out.

scholarly journals Correction to: Dry mouth: saliva substitutes which adsorb and modify existing salivary condition films improve oral lubrication

2020 ◽  
Vol 24 (11) ◽  
pp. 4031-4031 ◽  
Author(s):  
Jeroen Vinke ◽  
Hans J. Kaper ◽  
Arjan Vissink ◽  
Prashant K. Sharma
Keyword(s):  
Dry Mouth ◽  
Saliva Substitutes

scholarly journals Alleviation of dry mouth by saliva substitutes improved swallowing ability and clinical nutritional status of post-radiotherapy head and neck cancer patients: a randomized controlled trial

2019 ◽  
Vol 28 (6) ◽  
pp. 2817-2828 ◽  
Author(s):  
Sumalee Nuchit ◽  
Aroonwan Lam-ubol ◽  
Wannaporn Paemuang ◽  
Sineepat Talungchit ◽  
Orapin Chokchaitam ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Head And Neck Cancer ◽  
Nutritional Status ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Controlled Trial ◽  
Dry Mouth ◽  
Randomized Controlled ◽  
Saliva Substitutes

Abstract Purpose The aim of this study is to investigate the effect of an edible saliva substitute, oral moisturizing jelly (OMJ), and a topical saliva gel (GC) on dry mouth, swallowing ability, and nutritional status in post-radiotherapy head and neck cancer patients. Methods Sixty-two post-radiation head and neck cancer patients with xerostomia completed a blinded randomized controlled trial. They were advised to swallow OMJ (n = 31) or apply GC orally (n = 31) for 2 months. Outcome measures were assessed at baseline, 1, and 2 months, including subjective and objective dry mouth (Challcombe) scores, subjective swallowing problem scores (EAT-10), water swallowing time, clinical nutritional status (PG-SGA), body weight, and dietary intake. Results After 1 and 2 months of interventions, subjective and objective dry mouth scores, subjective swallowing problem scores, swallowing times, and clinical nutritional status in both groups were significantly improved (p < 0.0001). Compared to GC, OMJ group had higher percent improvement in all outcome measures (p < 0.001) except swallowing time and clinical nutritional status. Interestingly, subjective dry mouth scores were significantly correlated with subjective swallowing problem scores (r = 0.5321, p < 0.0001). Conclusions Continuous uses of saliva substitutes (OMJ or GC) for at least a month improved signs and symptoms of dry mouth and enhanced swallowing ability. An edible saliva substitute was superior to a topical saliva gel for alleviating dry mouth and swallow problems. These lead to improved clinical nutritional status. Thus, palliation of dry mouth may be critical to support nutrition of post-radiotherapy head and neck cancer patients. Clinical trial registry Clinicaltrials.gov NCT03035825

The use of drugs for the treatment of xerostomia – brief review

2016 ◽  
Vol 5 (4) ◽  
pp. 238
Author(s):  
Marcelo Cesar ◽  
Rayssa Justo ◽  
João Vidal ◽  
Maurício Bonel ◽  
Edimilson Migowski ◽  
...  
Keyword(s):  
Sodium Citrate ◽  
Oral Care ◽  
Dry Mouth ◽  
Secretory Vesicles ◽  
Saliva Substitutes ◽  
Monopotassium Phosphate ◽  
Dipotassium Phosphate ◽  
Salivary Substitutes ◽  
Saliva Composition

Inadequate production of saliva causes an oral imbalance that has a great impact on the individual's quality of life. Diseases of various types are responsible for impaired production of saliva and dry mouth, as happens in xerostomia. It is usually associated with hypofunction of the salivary glands, which shows signs of dryness on oral mucosa, and other morphological features in the oral cavity. Saliva is composed of water and 1% of electrolytes and immunoglobulins, enzymes and other proteins. Its fluid component, which contains ions, is mainly produced by parasympathetic stimulation, while the protein component, produced in the acinar secretory vesicles, is released by sympathetic stimulation. The use of certain drugs is a major cause of xerostomia. Among these we found analgesics, anticonvulsants, antihistamines, antihypertensives, diuretics and antidepressants. The treatment is mainly done by saliva substitutes such as sodium chloride, potassium chloride, monopotassium phosphate and dipotassium phosphate. However, in some cases, stimulants, such as citric acid and sodium citrate, or even topical salivary substitutes can be effective. Furthermore, the use of specific oral care products is well accepted by the patients. The treatment is selected according to the ability of the glands to produce saliva. It is still not fully known what mechanism of action drugs that cause hyposalivation, dry mouth or changes in saliva composition use. Yet, it is important to know the side effects of prescribed drugs.

scholarly journals Dry mouth diagnosis and saliva substitutes—A review from a textural perspective

2020 ◽  
Author(s):  
Jing Hu ◽  
Efren Andablo‐Reyes ◽  
Alan Mighell ◽  
Sue Pavitt ◽  
Anwesha Sarkar
Keyword(s):  
Dry Mouth ◽  
Saliva Substitutes

scholarly journals Artificial Saliva: Challenges and Future Perspectives for the Treatment of Xerostomia

2019 ◽  
Vol 20 (13) ◽  
pp. 3199 ◽  
Author(s):  
Dawid Łysik ◽  
Katarzyna Niemirowicz-Laskowska ◽  
Robert Bucki ◽  
Grażyna Tokajuk ◽  
Joanna Mystkowska
Keyword(s):  
Salivary Gland ◽  
Artificial Saliva ◽  
Antimicrobial Properties ◽  
Antimicrobial Effect ◽  
Biological Properties ◽  
Dry Mouth ◽  
Disease Condition ◽  
Saliva Substitutes ◽  
Salivary Substitutes ◽  
Qualitative Changes

The chronic sensation of a dry mouth is a disease condition called xerostomia and affects a large part of the population. Xerostomia is associated with decreased secretion, or more often, qualitative changes in saliva proteins and immunoglobulin concentrations that develop as a result of salivary gland dysfunction. Several reasons causing dry mouth were described, and usually, they include taking medications, diseases or radiotherapy. In some situations, when it is difficult to use salivary stimulants or salivary gland damage is irreversible, the only option might seem to be saliva substitutes. The paper presents the most important aspects considering saliva preparations. The rheological and lubricating properties and the reconstruction of the complex saliva structure has been the main purpose of research. The biological properties of saliva preparations were also widely discussed. As part of the work, the antimicrobial effect of three commercial saliva preparations was tested. Finally, inadequate antimicrobial properties against the strains isolated from the oral cavity were demonstrated. The development of salivary substitutes, in particular, the improvement of antimicrobial properties, can be achieved using nanotechnology, including drug delivery systems containing nanocarriers.

Influence of intraoperative administration of glycopyrronium on early post-operative thirst, dry mouth and wellbeing. A post hoc analysis of an interventional study

2021 ◽  
pp. 103078
Author(s):  
Gregor Schittek ◽  
Gerold Schwantzer ◽  
Vasileios Papamargaritis ◽  
David Gebauer ◽  
Helmar Bornemann-Cimenti
Keyword(s):  
Dry Mouth ◽  
Interventional Study ◽  
Post Hoc Analysis ◽  
Post Hoc

scholarly journals Comparison of Safety and Tolerability of Deutetrabenazine During Titration and Maintenance in Patients with Tardive Dyskinesia

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 164-180
Author(s):  
Amanda Wilhelm ◽  
Karen E. Anderson ◽  
Hubert H. Fernandez ◽  
Hadas Barkay ◽  
Nayla Chaijale ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Adverse Events ◽  
Tardive Dyskinesia ◽  
Dry Mouth ◽  
Fixed Dose ◽  
Open Label ◽  
Serious Adverse Events ◽  
Open Label Extension ◽  
Pharmaceutical Industries ◽  
Flexible Dose

AbstractBackgroundDeutetrabenazine is approved to treat tardive dyskinesia (TD) in adults and is titrated weekly by 6 mg/day, from 12 to 48 mg/day, based on dyskinesia control and tolerability. This analysis compared the safety of deutetrabenazine during titration versus maintenance.MethodsSafety was assessed during titration versus maintenance using integrated data from two 12-week placebo-controlled studies (ARM-TD and AIM-TD) and the open-label extension study. Rates were compared for overall and serious adverse events (AEs), AEs leading to discontinuation, treatment-related AEs, common AEs (≥4%), and specific AEs (parkinsonism, suicidal ideation, akathisia, restlessness).ResultsIn titration versus maintenance, AE rates with placebo (n=130) were: overall, 43.1% vs 25.4%; serious, 4.6% vs 2.3%; leading to discontinuation, 3.1% vs 0; treatment-related, 26.9% vs 10.0%. For placebo, common AEs during titration were somnolence, headache, nausea, fatigue, and dry mouth; none occurred during maintenance. In titration versus maintenance, AE rates in fixed-dose deutetrabenazine 12–36 mg (n=216) were: overall, 33.3–38.9% vs 22.2–29.2%; serious, 2.8–6.9% vs 0–1.4%; leading to discontinuation, 2.8–5.6% vs 0; treatment-related, 8.3–16.7% vs 8.3–13.9%. For fixed-dose deutetrabenazine, common AEs during titration were headache, diarrhea, nasopharyngitis, depression, hypertension, and dry mouth; headache was the only common AE during maintenance. In titration versus maintenance, AE rates with flexible-dose deutetrabenazine (n=168) were: overall, 49.4% vs 32.7%; serious, 3.6% vs 2.4%; leading to discontinuation, 2.4% vs 0.6%. For flexible-dose deutetrabenazine, the only common AE during titration was somnolence; none occurred during maintenance. Rates of parkinsonism, suicidal ideation, akathisia, and restlessness were low and comparable in titration and maintenance.ConclusionsDeutetrabenazine was well-tolerated, with AE rates similar to placebo during both phases; AE rates were higher during titration and decreased during maintenance.FundingTeva Pharmaceutical Industries Ltd., Petach Tikva, Israel

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