Xerostomia is defined as dry mouth resulting from reduced or absent saliva flow. Xerostomia is not a disease, but it may be a symptom of various medical conditions, a side effect of a radiation to the head and neck, or a side effect of a wide variety of medications. It may or may not be associated with decreased salivary gland function(Greenspan D, 1996). Xerostomia is a common complaint found often among older adults, affecting approximately 20 percent of the elderly (Dyke S, 2000; Pray WS, 2000).However, xerostomia does not appear to be related to age itself as much as to the potential for elderly to be taking medications that cause xerostomia as a side effect.
Functions of saliva – saliva possesses many important functions including antimicrobial activity, mechanical cleansing action, control of pH, removal of food debris from the oral cavity, lubrication of the oral cavity, remineralization and maintaining the integrity of the oral mucosa (Hamada T, et al., 1999; McDonald E et al., 1991).
Complications associated with xerostomia – xerostomia is often a contributing factor for both minor and serious health problems. It can affect nutrition and dental, as well as psychological, health. Some common problems associated with xerostomia include a constant sore throat, burning sensation, difficulty speaking and swallowing, hoarseness and/or dry nasal passages (American Dental Association, 2000). Xerostomia is an original hidden cause of gum disease and tooth loss in three out of every 10 adults (California Dental Hygienists’ Association, 2000). If left untreated, xerostomia decreases the oral pH and significantly increases the development of plaque and dental caries. Oral candidiasis is one of the most common oral infections seen in association with xerostomia (Greenspan D, 1996).
Signs and symptoms of xerostomia – individuals with xerostomia often complain of problems with eating, speaking, swallowing and wearing dentures. Dry, crumbly foods, such as cereals and crackers, may be particularly difficult to chew and swallow. Denture wearers may have problems with denture retention, denture sores and the tongue sticking to the palate. Patients with xerostomia often complain of taste disorders (dysgeusia), a painful tongue (glossodynia) and an increased need to drink water, especially at night. Xerostomia can lead to markedly increased dental caries, parotid gland enlargement, inflammation and fissuring of the lips (cheilitis), inflammation or ulcers of the tongue and buccal mucosa, oral candidiasis, salivary gland infection (sialadenitis), halitosis and cracking and fissuring of the oral mucosa (McDonald E et al., 1991; Flynn AA, 1993).
Dry mouth has numerous causes, including:
Management of xerostomia – ideally, the management of xerostomia will include the identification of the underlying cause. In the event that steps can be taken to minimize the effect of the underlying cause, this should be done. For many patients, however, little can be done to alter the underlying cause. For those whose xerostomia is related to medication use, effective symptomatic treatment may be important to maintain compliance with their medication regime. Symptomatic treatment typically includes four areas: increasing existing saliva flow, replacing lost secretions, control of dental caries and specific measures such as treatment of infections (Kuntz R et al., 2000).
There are several over-the-counter products that are available to provide assistance in the management of xerostomia. These products range from saliva substitutes and stimulants to products designed to minimize dental problems.
Salivary stimulants (also called sialagogues) include sugarless candies, mints, chewing gums, sorbitol, xylitol, organic acids such as citric acid, malic acid and some prescription medications.
Artificial saliva or saliva substitutes can be used to replace moisture and lubricate the mouth. Artificial salvias are formulated to mimic natural saliva, but they do not stimulate salivary gland production. Commercially available products come in a variety of formulations including solutions, sprays, gels, and lozenges.
The product meeting both described above requirements is MucoDry X. MucoDry X is a spray flask with 20 ml liquid substance consisting of a mixture of salivary substitutes (glycerin, water, xanthan), salivary stimulants (citric acid, xylitol) and excipients. The mode of action of MucoDry X is based on replacement of natural saliva with a saliva substitute and stimulation. The active ingredients moisten, lubricate, provide coating on oral mucosa in absence of saliva, stimulate of saliva production and decrease bacteria growth in mouth.
Before launch of our product, the effectiveness of glycerin, xanthan, xylitol and citric acid in treating xerostomia has been demonstrated in seven randomized double blind, placebo-controlled trials.