Clinical and antimicrobial evaluation of a mouthwash and toothpaste for xerostomia: a randomized, double-blind, crossover study

Objectives

Specific toothpaste and mouthwash for xerostomia based on triclosan, fluoride, and mineral salts were studied in order to evaluate their efficacy in improving the quality of life as well as their in vitro antimicrobial action.

Materials and methods

30 patients with dry mouth and hyposalivation confirmed by sialometry were included in a randomized, double-blind, crossover study, during two weeks for each experimental phase. Dryness and oral comfort, difficulty in speaking, chewing, swallowing and using dental prostheses, as well as taste and sleep disorders were evaluated. Values of minimal biocidal and minimal inhibitory concentrations of both products against microorganisms that often cause oral disorders in these patients were determined and compared.

Results

The use of the mouthwash and toothpaste studied improved the dry mouth symptoms, whilst no significant differences when compared with the salivary enzyme substitutes were observed. The test products showed, in general, a higher biocidal and inhibitory action than the control products, with particularly noteworthy action against cariogenic bacteria.

Conclusions

The use of a toothpaste and mouthwash based on triclosan, fluoride, gingival revitalizers and mineral salts, improves the quality of life of patients suffering xerostomia.     

Salese to Buffer Saliva in Elderly Patients with Xerostomia: a Pilot Study

Purpose: The objective of this study was to compare the pH of saliva from xerostomic patients before and after the use of Salese lozenges (Nuvora Inc., Santa Clara, CA). Materials and Methods: After IRB approval, ten subjects were selected to participate in this pilot study to evaluate the efficacy of Salese. The inclusion criteria were patients on multiple medications who demonstrated xerostomia and acidic salivary pH. Saliva was collected from the patients at baseline and after the use of Salese at selected intervals up to 120 minutes. The pH of the collected saliva was measured, and the data were analyzed using an ANOVA. Results: Use of Salese lozenges showed a shift toward a more neutral pH in the first half hour. The pH remained at the same level after the primary shift for at least 2 hours. Conclusions: This pilot study indicates that patients suffering with xerostomia can use Salese lozenges for at least 10‐30 minutes to induce a salivary pH shift to a more neutral level. More research should be performed to investigate the buffering capacity of Salese lozenges.     

Increased thirst and drinking in Huntington's disease and the R6/2 mouse

While Huntington's disease (HD) is a condition that primarily involves the basal ganglia, there is evidence to suggest that the hypothalamus is also affected. Because the osmoreceptors regulating thirst are situated in the circumventricular region of the hypothalamus, we were interested in whether altered thirst is a part of the HD phenotype. We used the LABORAS behavioural monitoring system and water consumption to show that drinking behaviour was abnormal in R6/2 mice. By 10 weeks of age, R6/2 mice spent significantly more time drinking and drank a greater volume than their wild-type (WT) littermates. The numbers of immunoreactive vasopressin neurons in the paraventricular nucleus (PVN) of the hypothalamus in R6/2 mice were significantly decreased from 8 weeks of age, suggesting that the change in drinking behaviour may be the result of hypothalamic dysfunction. We gave a xerostomia (dry mouth) questionnaire to HD patients and control subjects, and also measured their urine osmolality and serum vasopressin. The mean total xerostomia score was significantly higher in HD patients than in controls, indicating greater thirst in HD patients. Urine osmolality was unaffected in HD patients up to clinical stage III, and none of the patients had diabetes. However, serum vasopressin was increased, suggesting a dysregulation in the control of hypothalamic vasopressin release. A dry mouth can affect taste, mastication and swallowing, all of which may contribute to the significant weight loss seen in both HD patients and R6/2 mice, as can dehydration. We suggest that increased thirst may be an important and clinically relevant biomarker for the study of disease progression in HD.