ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Salivary Stimulants and Saliva Substitutes Are Equally Effective in Terms of Patient-Perceived Comfort in Patients with Xerostomia
Clinical Question In a patient with xerostomia, how do salivary stimulants compare to salivary substitutes in patient-perceived comfort following therapy?
Clinical Bottom Line In patients with xerostomia, there is no statistically significant difference in patient-perceived comfort following therapy with salivary stimulants compared to salivary substitutes.
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) 22161442Furness/20111597 patients in 36 trialsMeta-Analysis
Key resultsWhile patients may prefer salivery stimulants, such as chewing gum, to salivary substitutes, there is no evidence that one improves patient-perceived comfort better than the other. In addition there is no strong evidence that any topical therapy effectively relieves the symptoms of dry mouth, though chewing gum does appear to increase saliva production.
Evidence Search "Xerostomia"[Mesh] AND "Saliva, Artificial"[Mesh]
Comments on
The Evidence
The article by Furness provided a review of many treatments for xerostomia, including 36 trials with a total of 1597 patients, comparing salivary stimulants and salivary substitutes. The authors used only randomized controlled trials, performed a comprehensive, detailed search for relevant trials, and assessed each study for validity. A meta-analysis was done.
Applicability The Furness review included patients with xerostomia for many reasons, including medication-induced, autoimmune diseases, and previous radiation therapy. Since there is no significant difference in patient-perceived comfort following therapy with salivary stimulants compared to salivary substitutes, one potential patient benefit is the ability to choose his or her preference. This may result in better patient compliance. Potential harms to the patient include increased risk for tooth demineralization with the use of those products with a high acid or sugar content.
Specialty/Discipline (Public Health) (Oral Medicine/Pathology/Radiology) (General Dentistry) (Periodontics) (Prosthodontics) (Restorative Dentistry)
Keywords Xerostomia, Salivary stimulant, Salivary substitute, Artificial saliva, Chewing gum
ID# 2188
Date of submission: 04/02/2012spacer
E-mail eisenricht@livemail.uthscsa.edu
Author Tara Eisenrich
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Diane Sullivan, DDS
Faculty mentor/Co-author e-mail sullivanD@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?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Jeremy Morgan and Caroline Brown (San Antonio, TX) on 11/28/2017
A search of PubMed in November 2017, yielded 2012 study by Bossola et al. (PMID 22249779) regarding the treatment of xerostomia in patients post-hemodialysis. Although specific to hemodialysis patients, the outcomes support the original clinical bottom line; that there is no significant difference in stimulants and saliva substitutes when treating xerostomia. Additional research performed specific to the many causes of xerostomia would be beneficial to provide the clarity of one method being more effective than the other.
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