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Saliva is essential to overall health and is needed to moisten/cleanse our mouths, digest food and prevent infection and tooth decay by controlling bacteria and fungi in the mouth. When we don’t make enough saliva, our mouths become dry and uncomfortable. Fortunately, many treatment options are available that can help with dry mouth, also called xerostomia.

Common Causes

  • Medications: Dry mouth is a common side effect of over 400 medications including over-the-counter drugs for allergies and cold symptoms, and many prescription drugs for hypertension and mental health. It’s important to consider each patient’s current drug regimen to see if any alternative treatments could prevent the condition altogether.
  • Radiation therapy: If exposed to radiation during cancer treatment, saliva glands can be damaged.
  • Chemotherapy: Saliva tends to get thicker from some of the medications prescribed for cancer treatment.
  • Nerve damage: Certain nerves carry messages between the brain and the salivary glands. Injury to the head or neck can damage the nerves that tell salivary glands to make saliva.
  • Diseases: Some diseases, such as diabetes, affect the salivary glands.

 

A Few Treatment Tips

Serious oral health consequences can arise from long-term dry mouth conditions. Some lifestyle suggestions to give your patients should include brushing teeth at least twice daily, regular flossing and normal dental checkups.

A few other tips to recommend:

  • Drinking sugarless and caffeine-free beverages
  • Chewing sugarless gum and/or lozenges
  • Using a humidifier at night to add moisture in the air

 

The Pharmacist Advantage

PCCA’s Research and Development team saw the need for a product that was going to work on the mucous membranes – something that was going to adhere well. So, they created MucoLox™, an effective saliva replacement for relieving dry mouth, even in the absence of APIs. Undiluted MucoLox seems to be the most effective nighttime treatment for duration of action; however, some patients may prefer a more diluted preparation which isn’t as thick but still coats effectively.

Get Creative

One innovative way to prepare MucoLox (that has an extremely refreshing feel) is to actually package the base in popsicle sleeves and have the patient freeze the compound. The combination of extreme cooling and the MucoLox coating properties is very soothing for patients suffering from dry mouth.

 

Enhance The Treatment With APIs

The addition of APIs can further enhance the function of MucoLox. Below are just two examples of APIs that can prove beneficial when working in tandem with MucoLox.

  • Pilocarpine provides an initial saliva substitute and also “jump starts” the stimulation of the salivary glands’ own production of saliva.
  • Xylitol can also be added to inhibit bacterial growth as well as provide some stimulation to salivary gland activity.

 

Dosage Form Option

  • Patients suffering from medication induced dry mouth could use Malic Acid 1% Oral Spray. Gómez-Moreno et al. have shown the efficacy of this preparation in two separate trials for each causative medication.1,2 Use of the spray on a routine basis led to a significant increase of both stimulated and non-stimulated salivary production.

This is just one treatment option for dry mouth and prevention of the significant effects that can take place with this condition. It is most important to choose a treatment that the patient is comfortable with and will use as prescribed. Work closely with the prescriber as well as the patient to determine the most appropriate dosage form and ingredients, and as always, please contact PCCA’s Pharmacy Consulting Department with any questions you may encounter.

 

References

1. Gómez-Moreno G, Guardia J, Aguilar-Salvatierra A, Cabrera-Ayala M, Maté- Sánchez de-Val JE, Calvo-Guirado JL. Effectiveness of malic acid 1% in patients with xerostomia induced by antihypertensive drugs. Med Oral Patol Oral Cir Bucal. 2013 Jan 1;18(1):e49-55. PubMed PMID: 22926481
2. Gómez-Moreno G, Aguilar-Salvatierra A, Guardia J, Uribe-Marioni A, CabreraAyala M, Delgado-Ruiz RA, Calvo-Guirado JL. The efficacy of a topical sialogogue spray containing 1% malic acid in patients with antidepressant-induced dry mouth: a double-blind, randomized clinical trial. Depress Anxiety. 2013 Feb;30(2):137-42. doi: 10.1002/da.22017. Epub 2012 Nov 1. PubMed PMID: 23124914.

 

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