Abstract
Saliva stimulation relieves dry mouth symptoms for those who have functioning salivary glands. Chewing gum and lozenges are the two major forms of saliva stimuli for dry mouth patients. Their mechanism of action is a combination of two oral stimuli, that is, taste and mastication. Taste stimulation provides an acute increase of saliva and thus instant relief, whereas masticatory stimulation is long lasting, keeping the relief prolonged. Comparative studies suggest that chewing gum, lozenges, and also artificial saliva work equally effectively against self-perceived dry mouth symptoms. Individual conditions as well as etiology influence the effect of these products and thus the preference for use. Patients’ preference is an important factor for improving long-term compliance. Acid-free and sugar-free products should be recommended in order to maximize the saliva’s protective properties for the dentition. In addition to stimulated saliva, unstimulated (resting) saliva is also of importance in the management of dry mouth because it functions for maintenance of oral lubrication and is present in the oral cavity for a much longer period than stimulated saliva. Unstimulated salivary flow is influenced by an individual’s masticatory functions, particularly by bite force. Maintaining good functional occlusal areas and jaw-closing muscle strength is critical for keeping an adequate bite force level, especially in the elderly. The working hypothesis is that mastication, saliva, and oral health are interdependent factors to maintain oral functions that are compromised when the mouth is dry. Good oral hygiene practice, in addition to regular exercise of the muscles of mastications, is important for maintaining the unstimulated salivary flow rate and therefore preventing dry mouth.
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References
van Nieuw AA, Veerman EC, Vissink A. Saliva: properties and functions. In: Wong DT, editor. Salivary diagnostics. 1st ed. Ames: Wiley-Blackwell; 2008. p. 27–36.
Sreebny LM. Saliva in health and disease: an appraisal and update. Int Dent J. 2000;50(3):140–61.
van der Putten G-J, Brand HS, de Visschere LMJ, Schols JMGA, Baat C. Saliva secretion rate and acidity in a group of physically disabled older care home residents. Odontology. 2013;101(1):108–15.
Ikebe K, Matsuda K, Morii K, Hazeyama T, Kagawa R, Ogawa T, et al. Relationship between bite force and salivary flow in older adults. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(4):510–5.
Dawes C. Factors influencing salivary flow rate and composition. In: Edgar M, Dawes C, O’Mullane D, editors. Saliva and oral health. 4th ed. London: Stephen Hancocks Limited; 2012. p. 37–55.
Dawes C, Watanabe S. The effect of taste adaptation on salivary flow rate and salivary sugar clearance. J Dent Res. 1987;66(3):740–4.
Dawes C, Kubieniec K. The effects of prolonged gum chewing on salivary flow rate and composition. Arch Oral Biol. 2004;49(8):665–9.
Polland KE, Higgins F, Orchardson R. Salivary flow rate and pH during prolonged gum chewing in humans. J Oral Rehabil. 2003;30(9):861–5.
Bots CP, Brand HS, Veerman EC, van Amerongen BM, Nieuw Amerongen AV. Preferences and saliva stimulation of eight different chewing gums. Int Dent J. 2004;54(3):143–8.
Macpherson LM, Chen WY, Dawes C. Effects of salivary bicarbonate content and film velocity on pH changes in an artificial plaque containing Streptococcus oralis, after exposure to sucrose. J Dent Res. 1991;70(9):1235–8.
Rosenhek M, Macpherson LM, Dawes C. The effects of chewing-gum stick size and duration of chewing on salivary flow rate and sucrose and bicarbonate concentrations. Arch Oral Biol. 1993;38(10):885–91.
Femiano F, Rullo R, di Spirito F, Lanza A, Festa VM, Cirillo N. A comparison of salivary substitutes versus a natural sialogogue (citric acid) in patients complaining of dry mouth as an adverse drug reaction: a clinical, randomized controlled study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(1):e15–20.
Pramanik R, Osailan SM, Challacombe SJ, Urquhart D, Proctor GB. Protein and mucin retention on oral mucosal surfaces in dry mouth patients. Eur J Oral Sci. 2010;118(3):245–53.
Satoh-Kuriwada S, Iikubo M, Shoji N, Sakamoto M, Sasano T. Diagnostic performance of labial minor salivary gland flow measurement for assessment of xerostomia. Arch Oral Biol. 2012;57(8):1121–6.
Abelson DC, Barton J, Mandel ID. The effect of chewing sorbitol-sweetened gum on salivary flow and cemental plaque pH in subjects with low salivary flow. J Clin Dent. 1990;2(1):3–5.
Edgar WM. Sugar substitutes, chewing gum and dental caries–a review. Br Dent J. 1998;184(1):29–32.
Olsson H, Spak CJ, Axell T. The effect of a chewing gum on salivary secretion, oral mucosal friction, and the feeling of dry mouth in xerostomic patients. Acta Odontol Scand. 1991;49(5):273–9.
Dodds MW, Hsieh SC, Johnson DA. The effect of increased mastication by daily gum-chewing on salivary gland output and dental plaque acidogenicity. J Dent Res. 1991;70(12):1474–8.
Al-Haboubi M, Zoitopoulos L, Beighton D, Gallagher JE. The potential benefits of sugar-free chewing gum on the oral health and quality of life of older people living in the community: a randomized controlled trial. Community Dent Oral Epidemiol. 2012;40(5):415–24.
Simons D, Brailsford SR, Kidd EA, Beighton D. The effect of medicated chewing gums on oral health in frail older people: a 1-year clinical trial. J Am Geriatr Soc. 2002;50(8):1348–53.
Dawes C, Macpherson LM. Effects of nine different chewing-gums and lozenges on salivary flow rate and pH. Caries Res. 1992;26(3):176–82.
Aagaard A, Godiksen S, Teglers PT, Schiødt M, Glenert U. Comparison between new saliva stimulants in patients with dry mouth: a placebo-controlled double-blind crossover study. J Oral Pathol Med. 1992;21(8):376–80.
Bots CP, Brand HS, Veerman EC, Valentijn-Benz M, Van Amerongen BM, Nieuw Amerongen AV, et al. The management of xerostomia in patients on haemodialysis: comparison of artificial saliva and chewing gum. Palliat Med. 2005;19(3):202–7.
Risheim H, Arneberg P. Salivary stimulation by chewing gum and lozenges in rheumatic patients with xerostomia. Scand J Dent Res. 1993;101(1):40–3.
Karami NM, Janghorbani M, Kowsari IR, Hosseini BM. Effects of chewing different flavored gums on salivary flow rate and pH. Int J Dent. 2012. Available from: http://dx.doi.org/10.1155/2012/569327.
Bjornstrom M, Axell T, Birkhed D. Comparison between saliva stimulants and saliva substitutes in patients with symptoms related to dry mouth. A multi-centre study. Swed Dent J. 1990;14(4):153–61.
Stewart CM, Jones AC, Bates RE, Sandow P, Pink F, Stillwell J. Comparison between saliva stimulants and a saliva substitute in patients with xerostomia and hyposalivation. Spec Care Dentist. 1998;18(4):142–7.
Davies AN. A comparison of artificial saliva and chewing gum in the management of xerostomia in patients with advanced cancer. Palliat Med. 2000;14(3):197–203.
Dawes C. The unstimulated salivary flow rate after prolonged gum chewing. Arch Oral Biol. 2005;50(6):561–3.
Wolff M, Kleinberg I. Oral mucosal wetness in hypo- and normosalivators. Arch Oral Biol. 1998;43(6):455–62.
Dawes C. Salivary clearance and its effect on oral health. In: Edgar M, Dawes C, O’Mullane D, editors. Saliva and oral health. 4th ed. London: Stephan Hancocks Limited; 2012. p. 81–96.
Hector MP, Sullivan A. Migration of erythrosin-labelled saliva during unilateral chewing in man. Arch Oral Biol. 1992;37(9):757–8.
Mese H, Matsuo R. Salivary secretion, taste and hyposalivation. J Oral Rehabil. 2007;34(10):711–23.
Bourdiol P, Mioche L, Monier S. Effect of age on salivary flow obtained under feeding and non-feeding conditions. J Oral Rehabil. 2004;31(5):445–52.
Dodds MW, Johnson DA, Yeh CK. Health benefits of saliva: a review. J Dent. 2005;33(3):223–33.
Wang XP, Zhong B, Chen ZK, Stewart ME, Zhang C, Zhang K, et al. History of frequent gum chewing is associated with higher unstimulated salivary flow rate and lower caries severity in healthy Chinese adults. Caries Res. 2012;46(6):513–8.
Bots CP, Brand HS, Veerman EC, Korevaar JC, Valentijn-Benz M, Bezemer PD, et al. Chewing gum and a saliva substitute alleviate thirst and xerostomia in patients on haemodialysis. Nephrol Dial Transplant. 2005;20(3):578–84.
Jenkins GN, Edgar WM. The effect of daily gum-chewing on salivary flow rates in man. J Dent Res. 1989;68(5):786–90.
Vissink A, Wolff A, Veerman EC. Saliva collections. In: Wong DT, editor. Salivary diagnostics. 1st ed. Ames: Wiley-Blackwell; 2008. p. 37–59.
Ono K, Morimoto Y, Inoue H, Masuda W, Tanaka T, Inenaga K. Relationship of the unstimulated whole saliva flow rate and salivary gland size estimated by magnetic resonance image in healthy young humans. Arch Oral Biol. 2006;51(4):345–9.
Ono K, Inoue H, Masuda W, Morimoto Y, Tanaka T, Yokota M, et al. Relationship of chewing-stimulated whole saliva flow rate and salivary gland size. Arch Oral Biol. 2007;52(5):427–31.
Samnieng P, Ueno M, Shinada K, Zaitsu T, Wright FA, Kawaguchi Y. Association of hyposalivation with oral function, nutrition and oral health in community-dwelling elderly Thai. Community Dent Health. 2012;29(1):117–23.
Ibayashi H, Fujino Y, Pham T-M, Matsuda S. Intervention study of exercise program for oral function in healthy elderly people. Tohoku J Exp Med. 2008;215(3):237–45.
Farella M, De Oliveira ME, Gallo LM, Läubli T, Tomatis L, Müller C, et al. Firing duration of masseter motor units during prolonged low-level contractions. Clin Neurophysiol. 2011;122(12):2433–40.
Yeh CK, Johnson DA, Dodds MWJ, Sakai S, Rugh JD, Hatch JP. Association of salivary flow rates with maximal bite force. J Dent Res. 2000;79(8):1560–5.
Ikebe K, Matsuda K, Kagawa R, Enoki K, Okada T, Yoshida M, et al. Masticatory performance in older subjects with varying degrees of tooth loss. J Dent. 2012;40(1):71–6.
Matsuda K, Ikebe K, Ogawa T, Kagawa R, Maeda Y. Increase of salivary flow rate along with improved occlusal force after the replacement of complete dentures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(2):211–5.
Hector MP, Linden RWA. The possible role of periodontal mechanoreceptors in the control of parotid secretion in man. Exp Physiol. 1987;72(3):285–301.
Kerr AC. The effects of chewing on the production of salivary secretions. In: The physiological regulation of salivary secretions in man: a study of the response of human salivary glands to reflex stimulation. Oxford: Pergamon Press; 1961. p. 48–60.
Ikebe K, Matsuda K, Kagawa R, Enoki K, Yoshida M, Maeda Y, et al. Association of masticatory performance with age, gender, number of teeth, occlusal force and salivary flow in Japanese older adults: is ageing a risk factor for masticatory dysfunction? Arch Oral Biol. 2011;56(10):991–6.
Grünheid T, Langenbach GEJ, Korfage JAM, Zentner A, van Eijden TMGJ. The adaptive response of jaw muscles to varying functional demands. Eur J Orthod. 2009;31(6):596–612.
Trulsson M, van der Bilt A, Carlsson GE, Gotfredsen K, Larsson P, Müller F, et al. From brain to bridge: masticatory function and dental implants. J Oral Rehabil. 2012;39(11):858–77.
Weisensee KE, Jantz RL. Secular changes in craniofacial morphology of the Portuguese using geometric morphometrics. Am J Phys Anthropol. 2011;145(4):548–59.
von Cramon-Taubadel N. Global human mandibular variation reflects differences in agricultural and hunter-gatherer subsistence strategies. Proc Natl Acad Sci U S A. 2011;108(49):19546–51.
Pereira LJ, Duarte Gaviao MB, van der Bilt A. Influence of oral characteristics and food products on masticatory function. Acta Odontol Scand. 2006;64(4):193–201.
van der Bilt A, Mojet J, Tekamp FA, Abbink JH. Comparing masticatory performance and mixing ability. J Oral Rehabil. 2010;37(2):79–84.
Österberg T, Tsuga K, Rothenberg E, Carlsson GE, Steen B. Masticatory ability in 80-year-old subjects and its relation to intake of energy, nutrients and food items. Gerodontology. 2002;19(2):95–101.
Mioche L, Bourdiol P, Monier S, Martin J-F, Cormier D. Changes in jaw muscles activity with age: effects on food bolus properties. Physiol Behav. 2004;82(4):621–7.
Dry Mouth (Xerostomia) Bethesda: National Institute of Dental and Craniofacial Research; 2013. Updated 18 Jul 2013; cited 30 Aug 2013. Available from: http://www.nidcr.nih.gov/oralhealth/topics/drymouth/.
Treating Sjogren’s syndrome London: National Health Service; 2013. Updated 10 Sept 2012; cited 30 Aug 2013. Available from: http://www.nhs.uk/Conditions/Sjogrens-syndrome/Pages/Treatment.aspx.
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Inui, T. (2015). The Beneficial Effects of Regular Chewing. In: Carpenter, G. (eds) Dry Mouth. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55154-3_12
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