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Patient satisfaction and impact of salivary flow rate on effectiveness of xerostomia products

Published:September 07, 2022DOI:https://doi.org/10.1016/j.oooo.2022.08.017

      Objectives

      To determine the types of products used to treat dry mouth and their perceived effectiveness, the relationship between salivary function and xerostomia symptoms, and whether salivary function predicts response to management strategies.

      Study Design

      Cross-sectional study of 87 patients with dry mouth and documented unstimulated whole salivary (UWS) and stimulated whole salivary (SWS) flow rates. Participants completed a questionnaire assessing dry mouth complaints and symptoms and effectiveness of specific dry mouth products.

      Results

      Mean (SD) age was 61.7 (12.9) years including 78 (90%) females. 47 (54%) participants had Sjögren's disease. Oral dryness symptoms (0-10 scale) rated highest with a mean (SD) of 7.2 (2.17); other symptoms scored from 3.4 to 5.1. Lower levels of UWS and SWS were associated with worse dry mouth and difficulty speaking, while lower levels of SWS flow alone were associated with greater difficulty swallowing and a decline in taste. More than half of the participants (55%, n = 48) reported using ≥4 dry mouth products. Participants with normal SWS flow had significantly better responses to lozenges and prescription products.

      Conclusions

      Patients with dry mouth and normal stimulated flow rates (i.e., residual salivary capacity) respond better to stimulatory products (parasympathomimetic and lozenges). Salivary flow rate assessments may help with recommendations of dry mouth products.
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      References

        • Narhi TO.
        Prevalence of subjective feelings of dry mouth in the elderly.
        J Dent Res. 1994; 73: 20-25
        • Diep MT
        • Jensen JL
        • Skudutyte-Rysstad R
        • et al.
        Xerostomia and hyposalivation among a 65-yr-old population living in Oslo, Norway.
        Eur J Oral Sci. 2021; 129: e12757
        • Thomson WM
        • Chalmers JM
        • Spencer AJ
        • Ketabi M.
        The occurrence of xerostomia and salivary gland hypofunction in a population-based sample of older South Australians.
        Spec Care Dentist. 1999; 19: 20-23
        • Johansson AK
        • Johansson A
        • Unell L
        • Ekback G
        • Ordell S
        • Carlsson GE.
        A 15-yr longitudinal study of xerostomia in a Swedish population of 50-yr-old subjects.
        Eur J Oral Sci. 2009; 117: 13-19
        • Ekback G
        • Astrom AN
        • Klock K
        • Ordell S
        • Unell L.
        Variation in subjective oral health indicators of 65-year-olds in Norway and Sweden.
        Acta Odontol Scand. 2009; 67: 222-232
        • Fox PC
        • Bowman SJ
        • Segal B
        • et al.
        Oral involvement in primary Sjogren syndrome.
        J Am Dent Assoc. 2008; 139: 1592-1601
        • von Bultzingslowen I
        • Sollecito TP
        • Fox PC
        • et al.
        Salivary dysfunction associated with systemic diseases: systematic review and clinical management recommendations.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 103 (e1-S57.e15): S57
        • Suh KI
        • Lee JY
        • Chung JW
        • Kim YK
        • Kho HS.
        Relationship between salivary flow rate and clinical symptoms and behaviours in patients with dry mouth.
        J Oral Rehabil. 2007; 34: 739-744
        • Chaushu G
        • Bercovici M
        • Dori S
        • et al.
        Salivary flow and its relation with oral symptoms in terminally ill patients.
        Cancer. 2000; 88: 984-987
        • Ikebe K
        • Matsuda K
        • Morii K
        • et al.
        Impact of dry mouth and hyposalivation on oral health-related quality of life of elderly Japanese.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 103: 216-222
        • Cho MA
        • Ko JY
        • Kim YK
        • Kho HS.
        Salivary flow rate and clinical characteristics of patients with xerostomia according to its aetiology.
        J Oral Rehabil. 2010; 37: 185-193
      1. Sreebny LM, Valdini A. Xerostomia. Part I: relationship to other oral symptoms and salivary gland hypofunction. Oral Surg Oral Med Oral Pathol. 1988;66:451-458.

        • Marton K
        • Madlena M
        • Banoczy J
        • et al.
        Unstimulated whole saliva flow rate in relation to sicca symptoms in Hungary.
        Oral Dis. 2008; 14: 472-477
        • Donaldson M
        • Epstein J
        • Villines D.
        Managing the care of patients with Sjogren syndrome and dry mouth: comorbidities, medication use and dental care considerations.
        J Am Dent Assoc. 2014; 145: 1240-1247
        • Fox PC
        • Atkinson JC
        • Macynski AA
        • et al.
        Pilocarpine treatment of salivary gland hypofunction and dry mouth (xerostomia).
        Arch Intern Med. 1991; 151: 1149-1152
        • Stewart CM
        • Jones AC
        • Bates RE
        • Sandow P
        • Pink F
        • Stillwell J.
        Comparison between saliva stimulants and a saliva substitute in patients with xerostomia and hyposalivation.
        Spec Care Dentist. 1998; 18: 142-148
        • Regelink G
        • Vissink A
        • Reintsema H
        • Nauta JM.
        Efficacy of a synthetic polymer saliva substitute in reducing oral complaints of patients suffering from irradiation-induced xerostomia.
        Quintessence Int. 1998; 29: 383-388
        • van der Bijl P
        • de Waal J.
        Preparation and clinical evaluation of a high viscosity saliva substitute.
        J Dent Assoc S Afr. 1994; 49: 299-303
        • Lopez-Jornet P
        • Camacho-Alonso F
        • Rodriguez-Aguado C.
        Evaluation of the clinical efficacy of a betaine-containing mouthwash and an intraoral device for the treatment of dry mouth.
        J Oral Pathol Med. 2012; 41: 201-206
        • Leung KC
        • McMillan AS
        • Wong MC
        • Leung WK
        • Mok MY
        • Lau CS.
        The efficacy of cevimeline hydrochloride in the treatment of xerostomia in Sjogren's syndrome in southern Chinese patients: a randomised double-blind, placebo-controlled crossover study.
        Clin Rheumatol. 2008; 27: 429-436
        • Jensen SB
        • Vissink A.
        Salivary gland dysfunction and xerostomia in Sjogren's syndrome.
        Oral Maxillofac Surg Clin North Am. 2014; 26: 35-53
        • Farag AM
        • Holliday C
        • Cimmino J
        • Roomian T
        • Papas A.
        Comparing the effectiveness and adverse effects of pilocarpine and cevimeline in patients with hyposalivation.
        Oral Dis. 2019; 25: 1937-1944