ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Intraoral Electrostimulation May Be Effective In The Short Term For Relieving Symptoms of Xerostomia
Clinical Question In patients with xerostomia, does intraoral electrostimulation reduce the sense of dryness compared to saliva substitute products?
Clinical Bottom Line Intraoral electrostimulation may reduce dryness both subjectively and objectively in xerostomic patients. (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) 17305624 Strietzel / 200723 xerostomic adultsRandomized crossover double blind multicenter placebo-controlled trial
Key resultsSubjective outcome measure: In 38 of 158 experiments, subjects had no preference for sham vs active intervention. In 72 of the remaining 120 experiments, subjects preferred active over sham (p<0.05). Objective outcome measure: was only available in about 50 of 158 experiments due to technical problems with data download from sensor. In these approximately 50 experiments, active significantly exceeded sham in reducing dryness. Adverse events were mild and occurred in a minority of subjects, including erythema at electrode site, tray impingement needing adjustment, and tingling sensation.
#2) 1411081Talal / 199277 adults with Sjogren'splacebo controlled randomized
Key resultsObjective outcome measure: whole saliva flow, measured by weight, at week 0, week 2, and week 4. Active treatment resulted in greater saliva flow (p<0.02). Subjective outcome measure: patient responses to questionnaire. Dysphagia and glossodynia symptoms at week 4 were less for the active treatment group (p<0.008).
Evidence Search ("Xerostomia"[Mesh]) AND ("Electric Stimulation Therapy"[Mesh] OR "Electric Stimulation"[Mesh]) ...view in PubMed
Comments on
The Evidence
Streitzel conducted 158 pairs of sham-vs-active exposures for 5 to 10 minute duration, separated by 35 minute rest period, randomized crossover design, in 20 women and 3 men, mean age 61.5 (range 28-79). Electrostimulator and dryness monitor were embedded in a custom-fabricated mandibular occlusal splint worn only during experiments. Talal randomized 40 subjects to active and 37 to placebo (sham stimulator identical to active stimulator, without current delivery). Electrostimulator was hand-held, used at home 3 times per day for 4 weeks, 3 minutes per treatment controlled by automatic timer.
Applicability The subjects in the Streitzel study were all Caucasian. 10 had primary Sjogren's, 7 had medication-induced xerostomia, and the remaining 6 had idiopathic xerostomia. All had residual salivary function stimulatable by paraffin-chewing. Talal studied patients with confirmed Sjogren's, ranging from 20-86 years of age. 31% were 60-69 years old.
Specialty/Discipline (General Dentistry)
Keywords Xerostomia, Electrostimulation, Sjogren's syndrome
ID# 855
Date of submission: 04/01/2011spacer
E-mail banjar@uthscsa.edu
Author Arwa Banjar
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author S. Thomas Deahl, II, DMD, PhD
Faculty mentor/Co-author e-mail DEAHL@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 Kelly Lemke, Debbie Lee (San Antonio, Texas) on 10/03/2014
A PubMed search on xerostomia and electric stimulation was performed in October 2014. A more recent publication by the same author was found: Strietzel/2011, PMID: 20882668. This multicenter RCT compared a sham device to an active electrostimulator device in 114 patients. This study showed that the active device performed significantly better than the sham device for xerostomia severity (P<.002), xerostomia frequency (P<0.05), quality of life impairment (P<0.01), and swallowing difficulty (P<0.02), supporting the conclusions of this CAT.
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