ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title The Use of Xylitol Products in Patients With Xerostomia May Relieve Symptoms of Oral Dryness and Discomfort
Clinical Question In patients suffering from xerostomia, will the use of xylitol products relieve symptoms of oral dryness and discomfort?
Clinical Bottom Line In patients suffering from xerostomia, the use of xylitol products has been shown to provide relief from oral dryness and discomfort. This is supported by a double blind, randomized, crossover clinical trial of 67 subjects and a case series involving 15 subjects.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 22260209Morales-Bozo/201267 adult subjects with xerostomiaRandomized Controlled Trial
Key resultsThe 67 patients all presented with symptoms of oral dryness and discomfort secondary to conditions of arthritis, autoimmune disorders, medications and immunocompromised diseases. The study involved two mouth rinses, the first one containing Xylitol, cetylpyridinium chloride, sodium chloride, sodium fluoride, and spearmint flavoring. The second rinse contained the exact same composition as the first rinse as well as the addition of aloe vera, propylene glycol, glycerine and citric acid. The participant groups were divided based on the number of medications they took. Rinse one was effective in alleviating the symptoms of dry mouth and difficulty swallowing in patients taking three or more medications (n=34). Rinse two was also effective in relieving xerostomia related symptoms in patients taking three or more medications (n=3). Neither of the rinses reduced xerostomia for patients taking two or less medications. This clinical trial showed that both rinses containing Xylitol were effective at reducing symptoms of oral dryness.
#2) 22040224Burgess/201215 subjects with morning oral drynessCase series
Key resultsThe 15 subjects were adults from the ages of 19 to 66 with a medical diagnosis ranging from allergies, asthma, diabetes, Sjrogen’s syndrome and others. All subjects self-reported experiencing morning oral dryness. They were all instructed to place Xylimelt discs (containg xylitol) on the buccal mucosa near the first maxillary molar throughout the day with the addition of two discs at night before bedtime. All study participants reported an increase in morning oral wetness (P < 0.001) and decrease in morning oral discomfort (P < 0.02) after one week of using the Xylitol containing discs. Though Xylitol discs showed significant improvement in morning oral dryness, they also reduced nighttime oral disturbance. However, the sample (N) size was small, so the results should be interpreted with caution.
#3) 17824884Ship/200740 adults with polypharmacy induced xerostomiaCrossover study
Key resultsThe 40 patients in this study were all on medications causing salivary hypo function. The patients were divided randomly into two groups – one group was told to continue with their normal dry mouth regimen for seven days (N=20), and the other half of the group received topical products for their dry mouth, which contained olive oil, betaine and Xylitol (N=40). After seven days, the groups were crossed over to the other regimen. The results showed that the use of topical mouth products containing olive oil, betaine and Xylitol showed a decrease in the patient’s xerostomia and increased their salivary flow rates significantly (P = 0.033). This crossover trial showed the topical products containing xylitol are significantly effective in reducing symptoms of dry mouth and discomfort by increasing salivary flow.
Evidence Search PubMed search “Xylitol”[Mesh] and “Xerostomia”[Mesh]
Comments on
The Evidence
Morales-Bozo/2012 was a randomized double blind clinical trial showing improvement in oral dryness symptoms in patients with xerostomia after the use of mouth rinses with xylitol. The evidence was valid. The patients were divided into two different groups and each group used slightly different mouth rinses, both containing xylitol, and both groups reported improvements in their dry mouth condition. Burgess/2012 was a case series. That study is considered to be a lower level of evidence since there were only 15 subject participants, and other determinant factors such as age, diseases, and medications were not consistent. This study concluded that there was a decrease in morning oral dryness for all the subjects. However, with the small number of subjects studied, the results should be interpreted with caution. Ship/2007 was a crossover clinical trial in which topical dry mouth products containing xylitol were compared to a placebo treatment regimen. The results showed the products containing xylitol, betaine and olive oil may significantly increase salivary flow in patients with polypharmacy-induced xerostomia.
Applicability The evidence presented in these studies is very relevant to the practice of dentistry today. Many individuals suffer from symptoms of dry mouth stemming from either polypharmacy or certain diseases of hereditary nature. These studies involved cost-effective remedies for reducing the discomfort caused by dry mouth while limiting and/or preventing xerostomia.
Specialty/Discipline (General Dentistry)
Keywords Xylitol, xerostomia
ID# 3001
Date of submission: 03/09/2016spacer
E-mail shahm6@livemail.uthscsa.edu
Author Maria Shah
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Moshtagh Farokhi, DDS, MPH
Faculty mentor/Co-author e-mail farokhi@uthscsa.edu
Basic Science Rationale
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