Title	Alleviation of Xerostomia Symptoms with the Use of Biotene Products
Clinical Question	In a patient with xerostomia, is the uses of Biotene products more effective than no treatment in alleviating the symptoms of xerostomia?
Clinical Bottom Line	The use of oral gel and mouthrinse does improve symptoms related to xerostomia in elderly patients and those who have undergone radiotherapy. (See Comments on the CAT below)
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 18194332 Gil-Montoya /2008 Elderly Randomized, double blind Key results The variables used to compare the effects of mouthwash and oral gel against a placebo for the 20 elderly subjects with xerostomia include subjective dry mouth sensation (p=0.414), the severity of discomfort assessed by means of a visual analogical scale (p=0.679), the Oral Health Impact Profile (p=0.022), the presence of signs and symptoms of dry mouth (p=0.052), sialometry (p=0.226) and candida albicans culture (p=0.372). Even though mouthwash and oral gel improved some aspects of dry mouth, the presence of placebo effect cannot be ignored. 16098116 Shahdad/2005 Adult with radiotherapy xerostomia Randomized, double blind Key results In 20 patients with post-radiotherapy xerostomia, Biotene Oralbalance was proven to be less superior to Bioxtra in its improvement of dry mouth, speech, and taste (P<0.05). However, based on the visual analogue scales, there were no significant differences between the two products (P>0.05). In conclusion, both were found effective. 10789961 Warde/2000 Adults with radical radiation therapy xerostomia Clinical Study Key results After two months of treatment for the twenty-eight patients involved in the study, 15 (54%) reported improvement in dryness while 10 (36%) reported major improvement. For ability to eat normally, 46% reported improvement while 25% reported major improvement. 17 (61%) patients reported improvement in oral discomfort while 12 (43%) reported major improvement. Results suggest that radiation-induced xerostomia symptoms can be improved with the use of Biotene products.
Evidence Search	Clinical Trial, Limits: Randomized Controlled Trial, Limits: English, Systematic Reviews, Meta-Analysis, EnglishSearch "Biotene "[Substance Name]Search "Xerostomia"[Mesh]
Comments on The Evidence	The need for further study and stronger evidence in the improvement of xerostomia with the use of Biotene products is quite evident.
Applicability	The results to these studies are mainly applicable for patients who have xerostomia because of old age or radiotherapy. Recommending the use of Biotene products is quite feasible because the focus of the studies represent a large patient pool and the non-invasive nature of the treatment.
Specialty	(General Dentistry) (Restorative Dentistry) (Dental Hygiene)
Keywords	Xerostomia, Biotene
ID#	585
Date of submission	04/01/2010
E-mail	Hoangv@livemail.uthscsa.edu
Author	Vi Linh Hoang
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Howard Dang, PhD
Faculty mentor e-mail	DANG@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) by Christopher Lewis, Katie Bemis, Derrick LIn (San Antonio, TX) on 01/07/2013 Currently, there is no new research published on the topic. Given that most studies show inconclusive evidence for Biotene’s improvement on xerostomia, we agree with the CAT that more evidence is needed. We also agree that Biotene could still be a useful product due to its reported improvements clinically and its non invasive treatment.