UTCAT855, Found CAT view, CRITICALLY APPRAISED TOPICs

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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 / 2007	23 xerostomic adults	Randomized crossover double blind multicenter placebo-controlled trial
Key results	Subjective 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) 1411081	Talal / 1992	77 adults with Sjogren's	placebo controlled randomized
Key results	Objective 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) (Dental Hygiene)

Keywords

xerostomia, Electrostimulation, Sjogren's syndrome

ID#

855

Date of submission:

04/01/2011

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

Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)

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