Treatment of xerostomia and hyposalivation in the elderly: A systematic review

Abstract

BackgroundTherapeutic strategies for xerostomia, regardless of etiology, have so far not had definitive or clearly effective results. Objectives. To systematically revise the latest scientific evidence available regarding the treatment of dry mouth, regardless of the cause of the problem.Material and MethodsThe literature search was conducted in March 2015, using the Medline and Embase databases. The “Clinical Trial”, from 2006 to March 2015, was carried out in English and only on human cases. The draft of the systematic review and assessment of the methodological quality of the trials was carried out following the criteria of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and the “Oxford Quality Scale”.ResultsFinally, a total of 26 trials were identified that met the previously defined selection and quality criteria; 14 related to drug treatments for dry mouth, 10 with non-pharmacological treatment and 2 with alternative treatments.ConclusionsPilocarpine continues to be the best performing sialogogue drug for subjects with xerostomia due to radiation on head and neck cancer or diseases such as Sjogren’s Syndrome. For patients with dry mouth caused solely by medication, there are some positive indications from the use of malic acid, along with other elements that counteract the harmful effect on dental enamel. In general, lubrication of oral mucous membrane reduces the symptoms, although the effects are short-lived. Key words:Systematic review, xerostomia, clinical trial, hyposalivation.

Practical Guidelines for Physicians in Promoting Oral Health in Frail Older Adults

“…As hyposalivation is a significant risk factor for dental caries and periodontal into consideration potential adverse-effects). 28,46…”

“…Counseling for patients suffering from hyposalivation and xerostomia includes meticulous daily oral hygiene, use of high fluoride or other products advised by the dentist, regular dental visits, smoking cessation and dietary counseling (avoid acidic and sugary food and drinks). 28,46,52 As salivary flow can be triggered by masticating, non-mixed food should be preferred whenever it can be chewed. Daily measures to alleviate symptoms include moistening the mouth with frequent water intake, using lip lubricants to protect lips from dryness, using saliva substitutes to moisten oral tissues and improve denture fit, and using saliva stimulants such as sugarless chewing gums with xylitol.…”

Epidemiology of Sjögren’s Syndrome—from an Oral Perspective

“…Pilocarpine was associated with improvements in dry mouth of 61–70 vs. 24–31 % in placebo, whereas civemeline was associated with improvement in dry mouth of 66–76 vs. 35–37 % in placebo [88]. Some regard pilocarpine as the best-performing sialagogues drug for SS [93]. …”

Saúde bucal de idosos com 80 anos ou mais: condição, autopercepção e utilização de serviços odontológicos

“…A boca seca tem sido relatada como manifestação relacionada ao efeito colateral de medicamentos 18 , condição ocasionada por outras comorbidades relacionadas à idade 3,19 . Idosos com baixos níveis de secreção salivar podem apresentar prejuízos funcionais: paladar, fala e dificuldades para mastigar e deglutir os alimentos 20 . O uso de medicamentos está associado tanto à sensação de boca seca quanto à hipofunção da glândula salivar 21 .…”