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Manage drug-induced dry mouth with drug regimen changes, lifestyle interventions and topical or oral symptom-relieving products

  • Adis Medical WritersEmail author
Drug Reactions and Interactions
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Abstract

Drug-induced dry mouth (i.e. xerostomia and hyposalivation) has negative effects on general and oral health, as well as on health-related quality of life, and can lead to potentially serious complications. Options for treatment include changing the regimen of the causative drug, lifestyle interventions (e.g. increasing fluid intake and improving dental care), topical symptom-relieving products (e.g. oral moisturizers, salivary substitutes and salivary stimulators) and/or oral drugs with cholinergic salivation-stimulating properties (e.g. cevimeline and pilocarpine).

Notes

Compliance with ethical standards

Conflict of interest

The article was adapted from Drugs & Aging; 2018;35(10):877-85 by employees of Adis/Springer, who are responsible for the article content and declare no conflicts of interest.

Funding

The preparation of this review was not supported by any external funding.

References

  1. 1.
    Barbe AG. Medication-induced xerostomia and hyposalivation in the elderly: culprits, complications, and management. Drugs Aging. 2018;35(10):877–85.CrossRefGoogle Scholar
  2. 2.
    Sreebny L. Saliva in health and disease: an appraisal and update. Int Dent J. 2000;50(3):140–6.CrossRefGoogle Scholar
  3. 3.
    Guggenheimer J, Moore PA. Xerostomia: etiology, recognition and treatment. J Am Dent Assoc. 2003;134(1):61–9.CrossRefGoogle Scholar
  4. 4.
    Dawes C. How much saliva is enough for avoidance of xerostomia? Caries Res. 2004;38(3):236–40.CrossRefGoogle Scholar
  5. 5.
    van der Putten GJ, Brand HS, Schols JM, et al. The diagnostic suitability of a xerostomia questionnaire and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents. Clin Oral Investig. 2011;15(2):185–92.CrossRefGoogle Scholar
  6. 6.
    Gupta A, Epstein JB, Sroussi H. Hyposalivation in elderly patients. J Can Dent Assoc. 2006;72(9):841–6.Google Scholar
  7. 7.
    Villa A, Wolff A, Aframian D, et al. World Workshop on Oral Medicine VI: a systematic review of medication-induced salivary gland dysfunction: prevalence, diagnosis, and treatment. Clin Oral Investig. 2015;19(7):1563–80.CrossRefGoogle Scholar
  8. 8.
    Villa A, Abati S. Risk factors and symptoms associated with xerostomia: a cross-sectional study. Aust Dent J. 2011;56(3):290–5.CrossRefGoogle Scholar
  9. 9.
    Pedersen AM, Bardow A, Jensen SB, et al. Saliva and gastrointestinal functions of taste, mastication, swallowing and digestion. Oral Dis. 2002;8(3):117–29.CrossRefGoogle Scholar
  10. 10.
    Visvanathan V, Nix P. Managing the patient presenting with xerostomia: a review. Int J Clin Pract. 2010;64(3):404–7.CrossRefGoogle Scholar
  11. 11.
    Han P, Suarez-Durall P, Mulligan R. Dry mouth: a critical topic for older adult patients. J Prosthodont Res. 2015;59(1):6–19.CrossRefGoogle Scholar
  12. 12.
    Wolff A, Joshi RK, Ekström J, et al. A guide to medications inducing salivary gland dysfunction, xerostomia, and subjective sialorrhea: a systematic review sponsored by the world workshop on oral medicine VI. Drugs R D. 2017;17(1):1–28.CrossRefGoogle Scholar
  13. 13.
    Thomson WM, Chalmers JM, Spencer AJ, et al. The Xerostomia inventory: a multi-item approach to measuring dry mouth. Community Dent Health. 1999;16(1):12–7.Google Scholar
  14. 14.
    Sreebny LM, Valdini A. Xerostomia: a neglected symptom. Arch Intern Med. 1987;147(7):1333–7.CrossRefGoogle Scholar
  15. 15.
    Nederfors T. Xerostomia and hyposalivation. Adv Dent Res. 2000;14:48–56.CrossRefGoogle Scholar
  16. 16.
    Kleiner SM. Water: an essential but overlooked nutrient. J Am Diet Assoc. 1999;99(2):200–6.CrossRefGoogle Scholar
  17. 17.
    Wolff A, Fox PC, Porter S, et al. Established and novel approaches for the management of hyposalivation and xerostomia. Curr Pharm Des. 2012;18(34):5515–21.CrossRefGoogle Scholar
  18. 18.
    Furness S, Worthington HV, Bryan G, et al. Interventions for the management of dry mouth: topical therapies. Cochrane Database Syst Rev. 2011;12:104.Google Scholar
  19. 19.
    van der Reijden WA, Vissink A, Veerman EC, et al. Treatment of oral dryness related complaints (xerostomia) in Sjogren’s syndrome. Ann Rheum Dis. 1999;58(8):465–74.CrossRefGoogle Scholar
  20. 20.
    Hahnel S, Behr M, Handel G, et al. Saliva substitutes for the treatment of radiation-induced xerostomia—a review. Support Care Cancer. 2009;17(11):1331–43.CrossRefGoogle Scholar
  21. 21.
    Strietzel FP, Lafaurie GI, Mendoza GR, et al. Efficacy and safety of an intraoral electrostimulation device for xerostomia relief: a multicenter, randomized trial. Arthritis Rheum. 2011;63(1):180–90.CrossRefGoogle Scholar
  22. 22.
    Alajbeg I, Falcao DP, Tran SD, et al. Intraoral electrostimulator for xerostomia relief: a long-term, multicenter, open-label, uncontrolled, clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113(6):773–81.CrossRefGoogle Scholar
  23. 23.
    Khosravani N, Birkhed D, Ekström J. The cholinesterase inhibitor physostigmine for the local treatment of dry mouth: a randomized study. Eur J Oral Sci. 2009;117(3):209–17.CrossRefGoogle Scholar
  24. 24.
    Cevimeline hydrochloride 30 mg capsules: US prescribing information. Cranbury (NJ): Sun Pharmaceuticl Industries, Inc.; 2018.Google Scholar
  25. 25.
    Committee for Proprietary Medicinal Products. Meeting report 24 to 25 April 2001. London: European Agency for the Evaluation of Medicinal Products; 2001.Google Scholar
  26. 26.
    Pilocarpine hydrochloride 5 and 7.5 mg film-coated tablets: US prescribing information. Amityville (NY): Amici Pharmaceuticals. 2018.Google Scholar
  27. 27.
    Wiseman LR, Faulds D. Oral pilocarpine: a review of its pharmacological properties and clinical potential in xerostomia. Drugs. 1995;49(1):143–55.CrossRefGoogle Scholar
  28. 28.
    Takakura AC, Moreira TS, Laitano SC, et al. Central muscarinic receptors signal pilocarpine-induced salivation. J Dent Res. 2003;82(12):993–7.CrossRefGoogle Scholar
  29. 29.
    Schneyer CA, Hall HD. Autonomic pathways involved in a sympathetic-like action of pilocarpine on salivary composition. Proc Soc Exp Biol Med. 1966;121(1):96–100.CrossRefGoogle Scholar
  30. 30.
    Salagen® (pilocarpine hydrochloride) 5 mg film-coated tablets: EU prescribing information. Amsterdam: Norgine B.V.; 2017.Google Scholar
  31. 31.
    Barbe AG, Schmidt-Park Y, Hamacher S, et al. Efficacy of GUM® Hydral versus Biotène® Oralbalance mouthwashes plus gels on symptoms of medication-induced xerostomia: a randomized, double-blind, crossover study. Clin Oral Investig. 2018;22(1):169–80.CrossRefGoogle Scholar
  32. 32.
    Braga MA, Tarzia O, Bergamaschi CC, et al. Comparison of the effects of pilocarpine and cevimeline on salivary flow. Int J Dent Hyg. 2009;7(2):126–30.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.SpringerAucklandNew Zealand

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