Objectives
The objective of this study was to identify systemic diseases associated with hyposalivation
and xerostomia and develop evidence-based management recommendations for hyposalivation/xerostomia.
Study design
Literature searches covered the English language medical literature from 1966 to 2005.
An evidence-based review process was applied to management studies published from
2002 to 2005.
Results
Several systemic diseases were identified. From studies published 2002 to 2005, 15
were identified as high-quality studies and were used to support management recommendations:
pilocarpine and cevimeline are recommended for treating hyposalivation and xerostomia
in primary and secondary Sjögren’s syndrome (SS). IFN-α lozenges may enhance saliva
flow in primary SS patients. Anti-TNF-α agents, such as infliximab or etanercept,
are not recommended to treat hyposalivation in SS. Dehydroepiandrosterone is not recommended to relieve hyposalivation or xerostomia in primary SS. There was not
enough evidence to support any recommendations for the use of local stimulants, lubricants,
and protectants for hyposalivation/xerostomia. However, professional judgment and
patient preferences may support the use of a specific product for an individual patient.
Conclusions
These evidence-based management recommendations should guide the clinician’s management
decisions for patients with salivary dysfunction related to systemic disease. Future
treatment strategies may include new formulations of existing drugs, e.g., local application
of pilocarpine. Recent discoveries on gene expression and a better understanding of
the etiopathogenesis of SS may open new treatment options in the future.
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Article info
Publication history
Accepted:
November 8,
2006
Received:
November 8,
2006
Identification
Copyright
© 2007 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
