ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Combating Xerostomia
Clinical Question Cholinergic Agonists Bring Relief to Adult Patients Suffering from Xerostomia
Clinical Bottom Line Pilocarpine has shown positive results in combating xerostomia. (See Comments on the CAT below)
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) 17379156von Bultzingslowen /2007patients with xerostomiaSystematic Review
Key resultsPilocarpine and cevimeline are recommended for treating hyposalivation and xerostomia. These results were found by doing a systematic review 25 studies of which 15 of these were A or B level high quality evidence articles, 7 contained useful management consideration information and three studies were not very useful and were not used further in this review.
#2) 12436835Brennan/2002Patients with idiopathic xerostomia, Sjogren’s Syndrome and postradiation salivary dysfunctionSystematic Review
Key resultsThis review reports that “pilocarpine is the only therapeutic agent that has a strong evidence base supporting its use for treatment of xerostomia.” These results were found by using A level evidence and B level evidence. These levels are separated by the number of minor and major flaws involved in the various studies.
#3) 15153695Fox/2004Xerostomia patientsReview
Key resultsPilocarpine has been shown to improve symptoms of xerostomia but there is a need for secretegogues with greater potency, increased duration and fewer side effects.
Evidence Search Search "Cholinergic Agonists"[Mesh] AND "Xerostomia"[Mesh] Limits: Review, Search "Cholinergic Agonists"[Mesh] AND "Xerostomia"[Mesh],Search "Cholinergic Agonists"[Mesh] AND "Xerostomia"[Mesh] Limits: Systematic Reviews Search "Cholinergic Agonists"[Mesh] AND "Xerostomia"[Mesh] Limits: Meta-Analysis, Search "Xerostomia"[Mesh] AND "Cholinergic Agonists"[Mesh] Limits: Meta-Analysis ...view in PubMed
Comments on
The Evidence
Good evidence for Cevimeline and Pilocarpine
Applicability The evidence for combating xerostomia shows that there are two good options for combating xerostomia which include the use of the secretagogues pilocarpine and cevimeline. Cevimeline has a longer duration of action than pilocarpine. More research needs to be done however, to find a secretagogue that had a greater intensity and even longer duration while exhibiting fewer side effects.
Specialty/Discipline (General Dentistry) (Periodontics) (Restorative Dentistry)
Keywords xerostomia, cholnergic agonists
ID# 631
Date of submission: 04/15/2010spacer Revised: 09/21/2011
E-mail RaymondS@livemail.uthscsa.edu
Author Sarah Raymond
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Carl W. Haveman, DDS
Faculty mentor/Co-author e-mail HAVEMAN@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)
post a comment
by Alsaati, Mohammed & Lamb, Eldon (San Antonio, Texas) on 08/08/2013
I conducted a PubMed Search on this topic and found more recent publication by Visvanathan V 2010: PubMed ID 19817913 . This review strengthen the Conclusion of this CAT, the study concluded using salivary stimulants like Cevimeline and Pilocarpine for treatment of xerostomia.
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