Abstract
Objective
The aim of the present study was to compare the efficiency of oral spray based on thermal spring water (Buccotherm®) versus commercial saliva substitute (Xeros®) and marshmallow root on the quality of life in patients with hyposalivation.
Materials and methods
A total of 60 patients with unstimulated salivary flow rate <0.2 ml/min were randomized into three groups. In the first group, 30 patients were using Buccotherm®; in the second group, 15 patients were using Xeros®; and in the third group, 15 patients were using marshmallow root. Therapy lasted for 2 weeks; everyday, patients used one of the products four times a day. Quality of life was measured by the Croatian version of Oral Health Impact Profile 14 questionnaire, and visual analog scale was used to determine the intensity of dry mouth before and after therapy. Statistical analysis was performed by Wilcoxon signed-rank test and Kruskal-Wallis test. Standardized effect size was calculated for OHIP following treatment.
Results
Buccotherm® has shown the biggest effect on quality of life in patients with hyposalivation. Intensity of dry mouth was lower after the applied therapy whatever substitute patients used.
Conclusions
We recommend the use of all three saliva substitutes for decreasing the intensity of dry mouth symptoms as well as improvement in the quality of life.
Clinical relevance
Although all tested agents showed beneficial effect in alleviating hyposalivation symptoms, it seems that Buccotherm® was superior to Xeros® and marshmallow root.
References
Tschoppe P, Wolgin M, Pischon N, Kielbassa AM (2010) Etiologic factors of hyposalivation and consequences for oral health. Quintessence Int 41:321–333
Fedele S, Wolff A, Strietzel FP, Martín-Granizo López R, Porter S, Konttinen YT (2010) Electrostimulation for the treatment of dry mouth. Harefuah 149(99–103):123
Levine MJ, Aguirre A, Hatton MN, Tabak LA (1987) Artificial salivas: present and future. J Dent Res 66 Spec No:693-698
Kielbassa AM, Shohadai SP, Schulte-Mönting J (2001) Effect of saliva substitutes on mineral content of demineralized and sound dental enamel. Support Care Cancer 9:40–47
Furness S, Worthington HV, Bryan G, Birchenough S, McMillan R (2011) Interventions for the management of dry mouth: topical therapies. Cochrane Database Syst Rev. doi:10.1002/14651858.CD008934.pub2
Wu-Wang CY, Patel M, Feng J, Milles M, Wang SL (1995) Decreased levels of salivary prostaglandin E2 and epidermal growth factor in recurrent aphthous stomatitis. Arch Oral Biol 40:1093–1098
Femiano F, Rullo R, di Spirito F, Lanza A, Festa VM, Cirillo N (2011) A comparison of salivary substitutes versus natural sialogouge (citric acid) in patients complaining of dry mouth as an adverse drug reaction: a clinical, randomized controlled study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 112(1):e15–e20
Cohen J (1988) Statistical power analysis for the behavioral sciences. Lawrence Erlbaum, New Jersey
Oh DJ, Lee JY, Kim YK, Kho HS (2008) Effects of carboxymethylcellulose (CMC)-based artifical saliva in patients with xerostomia. Int J Oral Maxillofac Surg 37:1027–1031
Dirix P, Nuyts S, Vander Poorten V, Delaere P, Van den Bogaert W (2007) Efficiacy of the BioXtra dry mouth care system in the treatement of radiotherapy-induced xerostomia. Support Care Cancer 15:1429–1436
Rhodus NL, Bereuter J (2000) Clinical evaluation of a commercially available oral moisturizer in relieving signs and symptoms of xerostomia in postirradiation head and neck cancer patients and patients with Sjögren’s syndrome. J Otolaryngol 29:28–34
Gil-Montoya JA, Guardia-López I, Gonzáles-Moles MA (2008) Evaluation of the clinical efficiacy of a mouthwash and oral gel containing the antimicrobial proteins lactoperoxidase, lysozyme and lactoferrin in elderly patients with dry mouth—a pilot study. Gerodontology 25:3–9
Aframian DJ, Mizrahi B, Granot I, Domb AJ (2010) Evaluation of a mucoadhesive lipid-based tablet compared with Biotène mouthwash for dry mouth relief—a pilot study. Quintessence Int 41:36–42
Mouly SJ, Orler JB, Tillet Y, Coudert AC, Oberli F, Preshaw P et al (2007) Efficacy of a new lubricant solution in the management of psychotropic drug-induced xerostomia: a randomized controlled trial. J Clin Psychopharmacol 27:437–443
Gómez-Moreno G, Guardia J, Aguilar-Salvatierra A, Cabrera-Ayala M, Maté-Sánchez de-Val JE, Calvo-Guirado JL (2013) Effectiveness of malic acid 1 % in patients with xerostomia induced by antihypertensive drugs. Med Oral Pathol Oral Cir Bucal 18:e49–e55
Alpöz E, Güneri P, Onder G, Cankaya H, Kabasakal Y, Köse T (2008) The efficacy of Xialine in patients with Sjögren’s syndrome: a single-blind, cross-over study. Clin Oral Investig 12:165–172
Sweeney MP, Bagg J, Baxter WP, Aitchison TC (1997) Clinical trial of a mucin-containing oral spray for treatment of xerostomia in hospice patients. Palliat Med 11:225–232
Mouly S, Salom M, Tillet Y, Coudert AC, Oberli F, Preshaw PM et al (2007) Management of xerostomia in older patients: a randomised controlled trial evaluating the efficacy of a new oral lubricant solution. Drugs Aging 24:957–965
Shirodaria S, Kilbourn T, Richardson M (2006) Subjective assessment of a new moisturizing mouth spray for the symptomatic relief of dry mouth. J Clin Dent 17:45–51
Shahdad SA, Taylor C, Barclay SC, Steen IN, Preshaw PM (2005) A double-blind, crossover study of Biotène Oralbalance and BioXtra systems as salivary substitutes in patients with post-radiotherapy xerostomia. Eur J Cancer Care (Engl) 14:319–326
Andersson G, Johansson G, Attström R, Edwardsson S, Glantz PO, Larsson (1995) Comparison of the effect of the linseed extract Salinum and a methyl cellulose preparation on the symptoms of dry mouth. Gerodontology 12:12–17
Johansson G, Andersson G, Attström R, Glantz PO, Larsson K (1994) The effect of Salinum on the symptoms of dry mouth: a pilot study. Gerodontology 11:46–49
Alpöz E, Cankaya H, Güneri P, Epstein JB, Boyacioglu H, Kabasakal Y et al (2014) Impact of Buccotherm® on xerostomia: a single blind study. Spec Care Dent. doi:10.1111/scd.12074
Acknowledgments
We are thankful to Associate Professor Stjepan Spalj for the valuable suggestions regarding statistical analysis.
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The authors declare that they have no conflicts of interest.
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Skrinjar, I., Vucicevic Boras, V., Bakale, I. et al. Comparison between three different saliva substitutes in patients with hyposalivation. Clin Oral Invest 19, 753–757 (2015). https://doi.org/10.1007/s00784-015-1405-8
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DOI: https://doi.org/10.1007/s00784-015-1405-8