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

See, Lydia; Mohammadi, Mehdi; Han, Phuu Pwint; Mulligan, Roseann; Enciso, Reyes

doi:10.1111/scd.12370

Cited by 13 publications

(13 citation statements)

References 30 publications

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“…Formulations with active stimulants or medicines are beyond the scope of this review. Complementary reviews that focus on therapeutic trials of salivary substitutes are available (Assery, 2019; Brennan, Shariff, Lockhart, & Fox, 2002; Furness, Worthington, Bryan, Birchenough, & Mcmillan, 2011; Salum et al, 2018; See, Mohammadi, Han, Mulligan, & Enciso, 2019). Abbreviations used throughout this review article are shown in Table 1.…”

Section: Introductionmentioning

confidence: 99%

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

Andablo‐Reyes

Mighell

et al. 2020

Journal of Texture Studies

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The aim of this review is to assess the objective and subjective diagnosis, as well as symptomatic topical treatment of dry mouth conditions with a clear focus on textural perspective. We critically examine both the current practices as well as outline emerging possibilities in dry mouth diagnosis and treatment, including a patent scan for saliva substitutes. For diagnosis, salivary flow rates and patient‐completed questionnaires have proven to be useful tools in clinical practice. To date, objective measurements of changes in mechanical properties of saliva via rheological, adsorption, and tribological measurements and biochemical properties of saliva such as assessing protein, mucins (MUC5B) are seldom incorporated into clinical diagnostics; these robust diagnostic tools have been largely restricted to application in non‐clinical settings. As for symptomatic treatments of dry mouth, four key agents including lubricating, thickening, adhesive, and moisturizing agents have been identified covering the overall landscape of commercial saliva substitutes. Although thickening agents such as modified celluloses, polysaccharide gum, polyethylene glycol, and so forth are most commonly employed saliva substitutes, they offer short‐lived relief from dry mouth and generally do not provide boundary lubrication properties of real human saliva. Innovative technologies such as self‐assembly, emulsion, liposomes, and microgels are emerging as novel saliva substitutes hold promise for alternative approaches for efficient moistening and lubrication of the oral mucosa. Their adoption into clinical practice will depend on their efficacies, duration of relief, and ease of application by the practitioners and patient compliance.

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Section: Introductionmentioning

confidence: 99%

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

Andablo‐Reyes

Mighell

et al. 2020

Journal of Texture Studies

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“…With the introduction of radiation to treat malignant pathologies of the upper aerodigestive tract, the patient will suffer loss of 50-70% of saliva function if 10-15 Gy of radiation is applied or even worse it is undetectable when higher doses of radiation (40-42 Gy) is given to the patient [37]. There have been numerous published studies on the efficacy of saliva substitute in treating xerostomia [14,[38][39][40][41][42][43][44]. Studies that looked into the efficacy of Oral7® mouthwash in treating xerostomia in post radiotherapy patients is, however scarce [21].…”

Section: Discussionmentioning

confidence: 99%

Saliva substitute mouthwash in nasopharyngeal cancer survivors with xerostomia: a randomized controlled trial

et al. 2020

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Objectives Xerostomia is a prevalent sequelae among nasopharyngeal cancer (NPC) survivors; yet, effective treatment protocols have been elusive. This study was a prospective randomized clinical trial to compare the effects of saliva substitute mouthwash in nasopharyngeal cancer survivors with xerostomia, between two treatment arms, conducted in a tertiary center. Materials and methods This study measured the effects within 4 weeks in relation to summated xerostomia inventory (SXI) and unstimulated whole saliva (UWS). Patients randomized into the interventional arm were prescribed an immunologically active saliva substitute (IASS), while patients in the control arm were prescribed a non-immunologically active mouthwash as placebo. Results The study population consisted of 94 patients. There was a significant difference in SXI difference (p < 0.0001) and UWS difference (p < 0.0001) between control and interventional arms. No harmful side effects associated with the use of either mouthwash encountered throughout the study duration. Conclusion IASS mouthwash significantly reduces subjective xerostomia scores measured using SXI and improves objective measurement of salivary flow using UWS among nasopharyngeal cancer survivors with xerostomia. Clinical relevance IASS is significantly more effective in improving subjective and objective xerostomia measurements compared to non-immunologically active mouthwash. Additionally, this treatment is very safe, with superior side effect profiles. Trial registration ClinicalTrials.gov Identifier: NCT04491435

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“…Xerostomia greatly impact the patient's quality of life ( Porcheri and Mitsiadis, 2019 ). The available treatments for SG atrophy are temporary and limited to systemic parasympathomimetic drugs such as pilocarpine, sialogogues, and artificial saliva substitutes and SG is not regenerate functionally ( See et al., 2019 ). New therapeutic options have shifted to regenerating SG cells by stem cell transplantation ( Lombaert et al., 2017 ; Kim et al., 2019 ).…”

Section: Discussionmentioning

confidence: 99%

“…Despite multiple treatment options for SG hypofunction such as systemic parasympathomimetic, sialogogues, and artificial saliva substitutes their effect are challenging. Common treatment strategies for SG hypofunction are temporary and the SGs are not restored functionally ( See et al., 2019 ). Stem cell-based therapy has been recently introduced for treatment of SGs hypofunction ( Sui et al., 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of necrotic submandibular salivary gland using mesenchymal stem cells

Najafi

Hassan

Faraji

et al. 2020

Heliyon

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Background The efficacy of mesnchymal stem cells (MSCs) to treat the necrotic tissue of salivary glands (SGs) has yet investigated. Objective This study was conducted to investigate the potential capacity of MSCs to restore the function and regenerate the necrotic submandiular gland in the rat animal model. Methods Twenty-one Sprague–Dawley rats were provided from a breeding colony and randomly divided into three groups including the positive control or induced SG atrophy without treatment, the treatment group or induced SG atrophy with MSCs isolated transplantation and the negative control group consists of healthy rats. The atrophic and necrotic submandiular gland was induced using intraoral duct ligation of the main duct of submandiular gland for one month. The isolated stem cells were confirmed using flow cytometry for CD90 and CD 105. The isolated MSCs were cultured and injected to submandiular gland and the potential efficacy of MSCs to treat the atrophic submandibular glands was evaluated using histopathology on two weeks post-transplantation. To detect the acinar cell protein secretory granules, Alcian Blue and periodic acid shift (PAS) staining were done. For the demonstration of mitotic index or proliferation rate of the SG epithelia tissue, Ki-67 and Smbg proteins expression were evaluated using immunohistochemistry. Results The locally injected MSCs could regenerate the overall histological structure of the necrotic submandibular gland tissue within 2 weeks of post-transplantation. Alcian Blue and PAS staining indicated that the mean amount of serous and mucin secretions in the treatment group was significantly increased compared to the positive control groups. We have also found that the treatment group significantly express higher Ki-67 protein, as a diagnostic marker for cell mitosis and proliferation rate, and lower Smbg protein, as a diagnostic marker, for damage to the submandibular gland than that of control group. Conclusion This study demonstrates the therapeutic benefits of MSCs isolated from the SG in treating atrophic and necrotic SGs in a rat model. MSCs may be potential candidates for cell-based therapies targeting hypofunction of SG induced by a range of diseases or because of surgery and radiotherapy of head and neck cancers.

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

Cited by 13 publications

References 30 publications

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

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

Saliva substitute mouthwash in nasopharyngeal cancer survivors with xerostomia: a randomized controlled trial

Reconstruction of necrotic submandibular salivary gland using mesenchymal stem cells

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