Evaluation of photobiomodulation in salivary production of patients with xerostomy induced by anti-hypertensive drugs

Abstract

Introduction: Hypertension (systemic arterial hypertension [SAH]) is a systemic condition that affects about 30% of the world population, according to data from the World Health Organization (WHO). Drugs used to control this disease have the potential to induce xerostomia, an oral condition in which the decrease of the salivary flow is observed and whose presence leads to the increase of the index of caries, periodontal disease, loss of the teeth, dysgeusia, difficulty of mastication, dysphagia, bad breath and oral burning and impairment of prothesis installed in the buccal cavity, including retention of removable and total dentures.Methods: This is a randomized, placebo-controlled, blind clinical protocol that aims to analyze the impact of phobiomodulation (PBM) on salivary glands of patients with antihypertensive drug induced xerostomia. Patients will be divided into 2 groups: G1: older adults with xerostomia induced by antihypertensive drugs and treatment with PBM (n = 30); G2: placebo PBM (n = 30). The irradiation will be made using a diode laser emitting at 808 nm with 100 mW and 40 seconds of exposure per site at the salivary glands. Twenty sites will be irradiated weekly for 4 weeks. Non-stimulated and stimulated salivary flow will be analyzed before and after the treatment.Results: This protocol will determine the effectiveness of photodynamic therapy regarding the reduction of xerostomia in older adults using antihypertensive drugs.Conclusion: This protocol will determine the effectiveness of photodynamic therapy regarding the reduction of xerostomia in older adults using antihypertensive drugs.

Efficacy of Photobiomodulation in Reducing Symptomatology and Improving the Quality of Life in Patients with Xerostomia and Hyposalivation: A Randomized Controlled Trial

“…In this respect, extraoral irradiation over the gland itself is considered to be more effective than exclusively intraoral administration [ 14 ]. In previous biostimulation studies of the sublingual glands, a wavelength of 660 nm was the most widely used setting, though a number of authors used longer wavelengths, particularly for the biostimulation of glands at the extraoral level (780–904 nm) [ 14 , 29 , 30 ]. We used the same wavelength as Campos-Louzeiro et al in their study published in 2020 (810 nm) [ 19 ].…”

“…It would be very useful to stratify xerostomia according to its underlying cause when assessing the efficacy of PBM. Relatedly, in elderly patients with xerostomia due to the use of antihypertensive drugs, Zarvos-Varellis et al [ 30 ] found photodynamic therapy to be effective in reducing xerostomia. In turn, Vidovic-Juras et al, in their study in 2010 [ 37 ], found the Xerostomia VAS score to improve as a result of laser treatment.…”

A prediction model for xerostomia in locoregionally advanced nasopharyngeal carcinoma patients receiving radical radiotherapy

“…The salivary flow rate and its pH were influenced by hypertension and the salivary flow rate was lower in borderline hypertension people than in normotensives [ 32 , 33 ]. According to previous study, drugs utilized for controlling hypertension also have a potential to induce xerostomia [ 34 , 35 ]. Drugs controlling hypertension act on central alpha 2 adrenergic receptors, and the activation of alpha 2 adrenoceptor is in the lateral hypothalamus which is an important central area for the control of salivary secretion and resulting in xerostomia [ 36 ].…”

Acute and cumulative benefits of Photobiomodulation for xerostomia: A systematic review and meta‐analysis

“…Our search strategy did not identify papers on the impact of PBM in patients with medication-induced hyposalivation, despite its higher prevalence (Millsop et al, 2017;Ship et al, 2002). A study protocol has been published recently to evaluate the effect of PBM in patients with antihypertensive drug-induced xerostomia (Varellis et al, 2020) so that may endorse the need for further studies that deal with this population. Our review also did not retrieve studies on patients who had undergone radiotherapy, despite the recognized glandular changes associated with the irradiation (Avila et al, 2009) that involved xerostomia/hyposalivation, both dose-dependent.…”