Skip to main content
SpringerLink
Log in

Management of Xerostomia in Older Patients

A Randomised Controlled Trial Evaluating the Efficacy of a New Oral Lubricant Solution

  • Original Research Article
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Abstract

Background

Xerostomia is a subjective sensation of mouth dryness that may frequently occur in older patients.

Objective

To compare the clinical efficacy and acceptability of a new oxygenated glycerol triester (OGT) oral spray taken five times daily with that of a commercially available saliva substitute (Saliveze®) in the treatment of xerostomia.

Methods

Forty-one institutionalised patients (28 women, 13 men; mean age 84 ± 7 years) were randomly assigned to receive either OGT or Saliveze® in a 2-week, randomised, parallel-group study. Clinical assessment of xerostomia included evaluation of mouth dryness using a self-rated, 10cm long visual analogue scale (VAS), objective assessment of oral tissue condition using a four-point ordinal scale and subjective assessment of symptoms of xerostomia using dichotomous responses to a questionnaire. The primary endpoint was the day (D) 14 patient-based mouth dryness score measured on a self-rated VAS.

Results

At D14, OGT resulted in significantly greater efficacy with respect to mouth dryness (mean between-treatment difference 2.1 ± 0.1, 95% CI 1.9, 2.3; p = 0.001), swallowing difficulty (1.8 ± 0.3, 95% CI 1.5, 2.1; p = 0.001), speech difficulty (1.1 ± 0.2, 95% CI 1.0, 2.4; p = 0.04) and overall sensation of symptom relief (2.7 ± 1.2, 95% CI 1.9, 3.8; p = 0.001). Objective assessment of oral tissues also showed significantly better improvement with OGT spray with respect to dryness (p = 0.01), stickiness (p = 0.005) and dullness (p = 0.001) of oral mucosa; severity of mucositis (p = 0.01); and thickening of the tongue (p = 0.03). A significant difference in taste acceptability was also noted in favour of OGT (1.4 ± 0.6, 95% CI 1.2, 1.9; p = 0.04).

Conclusion

OGT lubricant oral spray was superior to Saliveze® in improving xerostomia and oral tissue condition in older institutionalised patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Table II

Similar content being viewed by others

Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

References

  1. Navazesh M, Denny P, Sobel S. Saliva: a fountain of opportunity. J Calif Dent Assoc 2002; 30: 783–8

    PubMed  Google Scholar 

  2. Mason DK, Chishlom DM. Salivary glands and their secretions. In: Mason DK, Chishlom DM, editors. Salivary glands in health and disease. London: Saunders, 1975: 3–69

    Google Scholar 

  3. Wilborn WH, Schackleford JM. Microanatomy of human salivary glands. In: Manaken L, editor. The biologic basis of dental caries. Hagerstown: Harper & Row, 1980: 3–62

    Google Scholar 

  4. Madinier I, Jehl-Pietri C, Monteil RA. Les hyposialies d’origine medicamenteuse. Ann Med Int 1997; 148: 398–405

    CAS  Google Scholar 

  5. Handelman SL, Baric JM, Espeland MA, et al. Prevalence of drugs causing hyposalivation in an institutionalized geriatric population. Oral Surg Oral Med Oral Pathol 1986; 62: 26–31

    Article  PubMed  CAS  Google Scholar 

  6. Hendelman SL, Baric JM, Saunders RH, et al. Hyposalivary drug use, whole stimulated salivary flow and mouth dryness in older long-term care residents. Spec Care Dent 1989; 1: 12–8

    Article  Google Scholar 

  7. Mornstad H, Von Knorring L, Forsgren L, et al. Long-term effects of two principally different antidepressant drugs on saliva secretion and composition. Scand J Dent Res 1986; 94: 461–70

    PubMed  CAS  Google Scholar 

  8. Sreeby LM, Valdini A, Yu A. Xerostomia: part II. Relationship to nonoral symptoms, drugs, and diseases. Oral Surg Oral Med Oral Pathol 1989; 68: 419–27

    Article  Google Scholar 

  9. Fox PC. Management of dry mouth. Dent Clin North Am 1997; 41: 863–75

    PubMed  CAS  Google Scholar 

  10. Matear DW, Locker D, Stephens M, et al. Associations between xerostomia and health status indicators in the elderly. J R Soc Health 2006; 126: 79–85

    Article  Google Scholar 

  11. Rejnefelt I, Andersson P, Renvert S. Oral health status in individuals with dementia living in special facilities. Int J Dent Hyg 2006; 4: 67–71

    Article  PubMed  CAS  Google Scholar 

  12. Locker D. Xerostomia in older adults: a longitudinal study. Gerodontology 1995; 12: 18–25

    Article  PubMed  CAS  Google Scholar 

  13. Peltola P, Vehkalahti MM, Wuolijoki-Saaristo K. Oral health and treatment needs of the long-term hospitalized elderly. Gerodontology 2004; 21: 93–9

    Article  PubMed  Google Scholar 

  14. Sreenby LM, Valdini A. Xerostomia: a neglected symptom. Arch Int Med 1987; 147: 1333–7

    Article  Google Scholar 

  15. Guijarro Guijarro B, Lopez Sanchez AF, Hernandez Vallejo G. Treatment of xerostomia: a review. Med Oral 2001; 6: 7–18

    PubMed  CAS  Google Scholar 

  16. Navazesh M. Dry mouth: aging and oral health. Compend Contin Educ Dent 2002; 23: 41–8

    PubMed  Google Scholar 

  17. Andersson G, Johansson G, Attstrom R, et al. Comparison of the effect of the linseed extract salinum and a methyl cellulose preparation on the symptoms of dry mouth. Gerodontology 1995; 12: 12–7

    Article  PubMed  CAS  Google Scholar 

  18. Niedermeier W, Huber M, Fischer D, et al. Significance of saliva for the denture-wearing population. Gerodontology 2000; 17: 104–18

    Article  PubMed  CAS  Google Scholar 

  19. Epstein JB, Emerton S, Le ND, et al. A open-labelled crossover trial of oral balance gel and biotene toothpaste versus placebo in patients with xerostomia following radiation therapy. Oral Oncol 1999; 35: 132–7

    Article  PubMed  CAS  Google Scholar 

  20. Navazesh M, ADA Council on Scientific Affairs and Division of Science. How can oral health care providers determine if patients have dry mouth? J Am Dent Assoc 2003; 134: 613–20; quiz 633

    PubMed  Google Scholar 

  21. Epstein JB, Scully C. The role of saliva in oral health and the causes and effects of xerostomia. J Can Dent Assoc 1992; 58: 217–21

    PubMed  CAS  Google Scholar 

  22. Vered M, Buchner A, Boldon P, et al. Age-related histomorphometric changes in labial salivary glands with special reference to the acinar component. Exp Gerontol 2000; 35: 1075–84

    Article  PubMed  CAS  Google Scholar 

  23. Moreira CR, Azevedo LR, Lauris JR, et al. Quantitative age-related differences in human sublingual gland. Arch Oral Biol 2006; 51: 960–6

    Article  PubMed  Google Scholar 

  24. Nyarady Z, Nemeth A, Ban A, et al. A randomized study to assess the effectiveness of orally administered pilocarpine during and after radiotherapy of head and neck cancer. Anti-cancer Res 2006; 26: 1557–62

    CAS  Google Scholar 

  25. Sweeney MP, Bagg J, Baxter WP, et al. Clinical trial of a mucin-containing oral spray for treatment of xerostomia in hospice patients. Palliat Med 1997; 11: 225–32

    Article  PubMed  CAS  Google Scholar 

  26. Davies AN. A comparison of artificial saliva and chewing gum in the management of xerostomia in patients with advanced cancer. Palliat Med 2000; 14: 197–203

    Article  PubMed  CAS  Google Scholar 

  27. Moritsuka M, Kitasako Y, Burrow MF, et al. Quantitative assessment for stimulated saliva flow rate and buffering capacity in relation to different ages. J Dent 2006; 34: 716–20

    Article  PubMed  Google Scholar 

  28. Davies AN, Daniels C, Pugh R, et al. A comparison of artificial saliva and pilocarpine in the management of xerostomia in patients with advanced cancer. Palliat Med 1998; 12: 105–11

    Article  PubMed  CAS  Google Scholar 

  29. Navazesh M, Christensen C, Brightman V. Clinical criteria for the diagnosis of salivary hypofunction. J Dent Res 1992; 71: 1363–9

    Article  PubMed  CAS  Google Scholar 

  30. Meyer-Lueckel H, Kielbassa AM. Utilisation de succedanes salivaires chez les patients souffrant de xerostomie. Rev Mens Suisse Odontostomatol 2002; 112: 1049–58

    Google Scholar 

  31. Navazesh M. Xerostomia in the aged. Dent Clin North Am 1989; 33: 75–80

    PubMed  CAS  Google Scholar 

Download references

Acknowledgements

This study was funded by Laboratoires Carilène, Montesson, France. The authors are indebted to the nurses at the Department of Geriatry, Clinique Leopold Bellan, Magnanville, France for their precious contribution to the study. Dr Stéphane Mouly received an honorarium from Laboratoires Carilène for preparation of the article. Dr Anne-Claude Coudert and Dr Stéphane Desjonquères are employees of Laboratoires Carilène. The other authors have no conflicts of interest that are directly relevant to the content of this study.

Author information

Authors and Affiliations

  1. Assistance Publique-Hôpitaux de Paris, Unit of Therapeutic Research, Department of Internal Medicine, Lariboisière Hospital, Paris, France

    Stéphane Mouly & Jean-François Bergmann

  2. Department of Geriatry, Clinique Leopold Bellan, Magnanville, France

    Michel Salom

  3. White-Tillet Consultants & Experts, Chelles, France

    Yves Tillet

  4. Laboratoires Carilène, Montesson, France

    Anne-Claude Coudert & Stéphane Desjonquères

  5. Dermscan-Pharmscan, Lyon, France

    Frantz Oberli

  6. School of Dental Sciences, University of Newcastle, Newcastle, UK

    Philip M. Preshaw

Authors
  1. Stéphane Mouly
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michel Salom
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yves Tillet
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anne-Claude Coudert
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Frantz Oberli
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Philip M. Preshaw
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Stéphane Desjonquères
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jean-François Bergmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stéphane Mouly.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mouly, S., Salom, M., Tillet, Y. et al. Management of Xerostomia in Older Patients. Drugs Aging 24, 957–965 (2007). https://doi.org/10.2165/00002512-200724110-00007

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002512-200724110-00007

Keywords

Search

Navigation