|
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) 17379156 | von Bultzingslowen /2007 | patients with xerostomia | Systematic Review | Key results | Pilocarpine 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) 12436835 | Brennan/2002 | Patients with idiopathic xerostomia, Sjogren’s Syndrome and postradiation salivary dysfunction | Systematic Review | Key results | This 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) 15153695 | Fox/2004 | Xerostomia patients | Review | Key results | Pilocarpine 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: |
04/15/2010 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 | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS 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. | |
|
|