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).
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References
Barbe AG. Medication-induced xerostomia and hyposalivation in the elderly: culprits, complications, and management. Drugs Aging. 2018;35(10):877–85.
Sreebny L. Saliva in health and disease: an appraisal and update. Int Dent J. 2000;50(3):140–6.
Guggenheimer J, Moore PA. Xerostomia: etiology, recognition and treatment. J Am Dent Assoc. 2003;134(1):61–9.
Dawes C. How much saliva is enough for avoidance of xerostomia? Caries Res. 2004;38(3):236–40.
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.
Gupta A, Epstein JB, Sroussi H. Hyposalivation in elderly patients. J Can Dent Assoc. 2006;72(9):841–6.
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.
Villa A, Abati S. Risk factors and symptoms associated with xerostomia: a cross-sectional study. Aust Dent J. 2011;56(3):290–5.
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.
Visvanathan V, Nix P. Managing the patient presenting with xerostomia: a review. Int J Clin Pract. 2010;64(3):404–7.
Han P, Suarez-Durall P, Mulligan R. Dry mouth: a critical topic for older adult patients. J Prosthodont Res. 2015;59(1):6–19.
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.
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.
Sreebny LM, Valdini A. Xerostomia: a neglected symptom. Arch Intern Med. 1987;147(7):1333–7.
Nederfors T. Xerostomia and hyposalivation. Adv Dent Res. 2000;14:48–56.
Kleiner SM. Water: an essential but overlooked nutrient. J Am Diet Assoc. 1999;99(2):200–6.
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.
Furness S, Worthington HV, Bryan G, et al. Interventions for the management of dry mouth: topical therapies. Cochrane Database Syst Rev. 2011;12:104.
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.
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.
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.
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.
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.
Cevimeline hydrochloride 30 mg capsules: US prescribing information. Cranbury (NJ): Sun Pharmaceuticl Industries, Inc.; 2018.
Committee for Proprietary Medicinal Products. Meeting report 24 to 25 April 2001. London: European Agency for the Evaluation of Medicinal Products; 2001.
Pilocarpine hydrochloride 5 and 7.5 mg film-coated tablets: US prescribing information. Amityville (NY): Amici Pharmaceuticals. 2018.
Wiseman LR, Faulds D. Oral pilocarpine: a review of its pharmacological properties and clinical potential in xerostomia. Drugs. 1995;49(1):143–55.
Takakura AC, Moreira TS, Laitano SC, et al. Central muscarinic receptors signal pilocarpine-induced salivation. J Dent Res. 2003;82(12):993–7.
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.
Salagen® (pilocarpine hydrochloride) 5 mg film-coated tablets: EU prescribing information. Amsterdam: Norgine B.V.; 2017.
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.
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.
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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.
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Adis Medical Writers. Manage drug-induced dry mouth with drug regimen changes, lifestyle interventions and topical or oral symptom-relieving products. Drugs Ther Perspect 35, 226–229 (2019). https://doi.org/10.1007/s40267-019-00618-8
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DOI: https://doi.org/10.1007/s40267-019-00618-8