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

Abstract

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.

Antimicrobial and Physicochemical Properties of Artificial Saliva Formulations Supplemented with Core-Shell Magnetic Nanoparticles

“…Thus, in this work, the ability of preparation B containing gold-or aminosilane coated magnetic nanoparticles was assessed in vitro, for inhibition of the adhesion and biofilm formation of tested microorganisms co-culturable with oral bacteria (Figure 4). As published previously [14], the evaluation of the ability of artificial saliva preparations to restrict the adhesion process indicated that, in most cases, only substitute B possesses the ability to significantly decrease the attachment of tested microorganisms to the surface. The addition of nanoparticles does not decrease or slightly decrease the adhesion efficacy.…”

“…Saliva controls the pH around neutrality, in effect creating an environment that is adequate for the growth of many oral microorganisms, and provides a relationship developing between the host and the resident microbiota. However, any perturbation in the flow of saliva, including xerostomia, might cause dysbiosis to occur rapidly [14]. Oral cavity bacteria, specifically those involved in biofilm formation and dental disorders, are major health concerns.…”

“…In light of the above-listed problem, the development of artificial saliva preparations to reduce symptoms of dry mouth and to improve the quality of patients' life have been proposed by several investigators [14][15][16][17]. To date, the use of different substitutes, which are based on carboxymethylcellulose, glycerol, and mucin, has been reported [18,19].…”

“…Those include lubricating, antimicrobial and immunomodulatory properties that are crucial in the protection of mucosal membrane, tissues, teeth, adequate functioning of the speech apparatus and food intake. However, to achieve ideal composition, which will fit all listed criteria of artificial saliva substitutes, more studies and novel solutions should be provided [14,22].…”

Evaluation of the toxic effect of silver nanoparticles and the possible protective effect of ascorbic acid on the parotid glands of albino rats: An in vivo study

“…The parotid gland (PG) is the largest of the three major salivary glands, and its function and structure may be affected by different factors resulting in toxicity and dysfunction (Esfahani et al, 2015). PG dysfunction results in xerostomia that affects other oral tissues causing mucous membrane infections, altered taste, burning tongue, and difficulty in talking and chewing (Lysik et al, 2019).…”