orabase and Xerostomia

Topics: Carboxymethylcellulose Sodium; Drug Combinations; Glycerol; Humans; Minerals; Mouthwashes; Radiotherapy; Saliva, Artificial; Sodium Fluoride; Viscosity; Xerostomia

The aim of this study was to investigate the effect of trehalose oral spray to relieve radiation-induced xerostomia on a randomized controlled trial (RCT).. Prior to RCT, the effect of trehalose (5-20%) on the epithelial growth of fetal mouse salivary gland (SG) explants was evaluated to confirm if 10% trehalose exerted the best epithelial outcomes. Participants who completed radiotherapy for head and neck cancer (HNC) treatment were enrolled in a double-blind RCT, according to inclusion and exclusion criteria as per the CONSORT statement. The experimental group (n = 35) received 10% trehalose spray, while the control group (n = 35) received carboxymethylcellulose (CMC) spray to apply intra-orally 4 times/day for 14 days. Salivary pH and unstimulated salivary flow rate were recorded pre- and post-interventions. The Xerostomia-related Quality of Life scale (XeQoLs) was filled, and scores assessed post-interventions.. In the SG explant model, pro-acinar epithelial growth and mitosis was supported by 10% topical trehalose. As for RCT outcomes, salivary pH and unstimulated salivary flow rate were significantly improved after use of 10% trehalose spray when compared to CMC (p < 0.05). Participants reported an improvement of XeQoLs dimension scores after using trehalose or CMC oral sprays in terms of physical, pain/discomfort, and psychological dimensions (p < 0.05), but not social (p > 0.05). When comparing between CMC and trehalose sprays, XeQoLs total scores were not statistically different (p > 0.05).. The 10% trehalose spray improved salivary pH, unstimulated salivary flow rate, and the quality-of-life dimensions linked with physical, pain/discomfort, and psychological signs. The clinical efficacy of 10% trehalose spray was equivalent with CMC-based saliva substitutes for relieving radiation-induced xerostomia; therefore, trehalose may be suggested in alternative to CMC-based oral spray.(Thai Clinical Trials Registry; https://www.thaiclinicaltrials.org/ TCTR20190817004).

Topics: Carboxymethylcellulose Sodium; Head and Neck Neoplasms; Humans; Oral Sprays; Trehalose; Xerostomia

Hyposalivation is caused by various syndromes, diabetes, drugs, inflammation, infection, or radiotherapy of the salivary glands. Patients with hyposalivation often show an increased caries incidence. Moreover, hyposalivation is frequently accompanied by oral discomfort and impaired oral functions, and saliva substitutes are widely used to alleviate oral symptoms. However, preference of saliva substitutes due to taste, handling, and relief of oral symptoms has been discussed controversially. Some of the marketed products have shown demineralizing effects on dental hard tissues in vitro. This demineralizing potential is attributed to the undersaturation with respect to calcium phosphates. Therefore, it is important to modify the mineralizing potential of saliva substitutes to prevent carious lesions. Thus, the aim of the present study was to evaluate the effects of a possible remineralizing saliva substitute (SN; modified Saliva natura) compared to a demineralizing one (G; Glandosane) on mineral parameters of sound bovine dentin and enamel as well as on artificially demineralized enamel specimens in situ. Moreover, oral well-being after use of each saliva substitute was recorded.. Using a randomized, double-blind, crossover, phase II/III in situ trial, volunteers with hyposalivation utilize removable dentures containing bovine specimens during the experimental period. The volunteers are divided into two groups, and are required to apply both saliva substitutes for seven weeks each. After both test periods, differences in mineral loss and lesion depth between values before and after exposure are evaluated based on microradiographs. The oral well-being of the volunteers before and after therapy is determined using questionnaires. With respect to the microradiographic analysis, equal mineral losses and lesion depths of enamel and dentin specimens during treatment with SN and G, and no differences in patients' experienced oral comfort after SN compared to G usage are expected (H0).. Up to now, 14 patients have been included in the study, and no reasons for early termination of the trial have been identified. The design seems suitable for determining the effects of saliva substitutes on dental hard tissues in situ, and should provide detailed information on the oral well-being after use of different saliva substitutes in patients with hyposalivation.. ClinicalTrials.gov ID. NCT01165970.

Topics: Animals; Carboxymethylcellulose Sodium; Cattle; Cross-Over Studies; Dental Enamel; Dentin; Double-Blind Method; Humans; Microradiography; Mucins; Research Design; Saliva, Artificial; Surveys and Questionnaires; Tooth Demineralization; Tooth Remineralization; Xerostomia

The purpose of this study was to investigate the effects of carboxymethylcellulose (CMC)-based artificial saliva according to residual secretory potency, assessed by the salivary flow rate in patients with dry mouth. Fifty patients (6 men and 44 women, 57.8+/-13.2 year of age) with a chief complaint of dry mouth were asked a standardized series of questions regarding dry mouth-related symptoms and behaviors. Whole salivary flow rates were measured under unstimulated and stimulated conditions. After using CMC-based artificial saliva for 2 weeks, each patient completed the same questionnaire. Use of the artificial saliva decreased the severity of 'oral dryness at night or on awakening', 'oral dryness at other times of the day', and 'the effect of oral dryness on daily life' (P<0.05). Patients with an undetectable flow rate of stimulated whole saliva responded better on 'oral dryness during eating' compared with the other patients (P<0.05). The use of CMC-based artificial saliva also improved dry mouth-related behaviors, especially 'awakening from sleep at night because of oral dryness'. In conclusion, CMC-based artificial saliva demonstrated moderate effects in reducing dry mouth-related symptoms and behaviors with more significant effects appearing in patients whose residual secretory potency was severely compromised.

Topics: Aged; Carboxymethylcellulose Sodium; Female; Humans; Male; Middle Aged; Saliva; Saliva, Artificial; Salivary Glands; Secretory Rate; Severity of Illness Index; Xerostomia

Salivary substitutes are sometimes valuable for elderly people and radiotherapy patients, and may be used indefinitely. It is possible that this change in the ecology may effect the oral flora.. To analyse the presence of micro-organisms on oral mucous membranes during use of saliva substitutes.. Cross-over single-blind study.. Clinic for Maxillofacial Surgery, Malmö University Hospital and Department of Oral Microbiology, Malmö University.. 19 patients with low salivary secretion who had been radiated for cancer in the head and neck region.. Two saliva substitutes: linseed extract and a carboxymethyl cellulose preparation (Salinum and MAS-84) were used for 3 week periods.. Microbial samples taken, processed and analysed.. No differences were observed when comparing baseline values with the results after the saliva substitutes and no significant differences between the use of different agents.. The study suggests that use of linseed extract and carboxymethyl cellulose preparation during periods of weeks does not influence flora commonly related to caries, periodontitis or infections in the oral mucous membranes.

Topics: Adult; Carboxymethylcellulose Sodium; Cross-Over Studies; Female; Flax; Humans; Lactobacillus; Male; Mouth Mucosa; Plant Extracts; Saliva; Saliva, Artificial; Single-Blind Method; Streptococcus mutans; Treatment Outcome; Xerostomia; Xylitol; Yeasts

The effect of a linseed extract Salinum and a sodium carboxymethyl cellulose preparation called MAS-84 was compared with regard to its effect on the symptoms of dry mouth. Twenty patients with xerostomia, who had been treated for cancer in the head and neck by radiation were recruited from the clinic for maxillofacial surgery, Malmo University Hospital. Following radiation treatment the salivation was severely reduced. The symptoms of a general feeling of a dry mouth, difficulties in chewing and swallowing, taste disturbances, problems with speech and mouth burning were registered on a subjective verbal rating scale. In addition plaque index and gingival bleeding were determined. The study design was crossover and performed single blind. The experimental period was 7 weeks. The patients were randomly divided into 2 groups. One group used Salinum and the other MAS-84 for 3 weeks. The fourth week was a wash out period and for the next three weeks the patients shifted preparation. Each of the preparations was used ad libitum. Registrations of the various parameters were undertaken on days 0, 7 and 21 of the respective period. At the initial examination all patients reported considerable disturbances from mouth-dryness. These symptoms were reduced in 15 patients during the Salinum period and in 9 during the MAS-84 period. The relief was significantly more pronounced during the use of Salinum compared to that during the use of the methyl cellulose preparation. On day 21 plaque and gingival bleeding were significantly reduced during the Salinum period but not during the MAS-84 period. The results of the present study confirm those of a previous pilot study and indicate that the linseed mucilage significantly reduced the symptoms of dry mouth. This effect increased with increasing time of saliva substitute use. The linseed mucilage Salinum appeared to be a suitable saliva replacement in mouth dry patients.

Topics: Aged; Carboxymethylcellulose Sodium; Cranial Irradiation; Cross-Over Studies; Dental Plaque Index; Female; Head and Neck Neoplasms; Humans; Linseed Oil; Male; Middle Aged; Periodontal Index; Saliva, Artificial; Salivary Glands; Salivation; Secretory Rate; Single-Blind Method; Statistics, Nonparametric; Xerostomia

Twenty-five xerostomic patients were given an artificial saliva substitute we had prepared. In this study we evaluated its effect, period of relief, frequency of use, taste, smell, colour, aftertaste, consistency and desire for continued use. Improvement in the patients' complaints after use was assessed by means of a Chi-square test. Although the majority of patients were satisfied with the artificial saliva and there was a change for the better in their condition, only the dry mouth complaint showed a statistically significant level of improvement.

Topics: Carboxymethylcellulose Sodium; Chi-Square Distribution; Female; Humans; Male; Middle Aged; Patient Satisfaction; Saliva, Artificial; Severity of Illness Index; Viscosity; Xerostomia

The lubrication properties of mucin and carboxymethylcellulose (CMC)-containing saliva substitutes and water were evaluated in a double-blind trial. After mouthrinsing with the substitutes, the patients answered a questionnaire (subjective effect) and the change of oral mucosal friction was measured with a probe (objective effect). Mucin and CMC-containing saliva substitutes showed almost the same objective effects, with changed friction values of about 15 min, which was more than twice as long as for water. Both water and the two saliva substitutes relieved the symptoms of dry mouth to some extent but they did not have a sufficiently long-lasting effect.

Topics: Aged; Carboxymethylcellulose Sodium; Female; Humans; Lip; Lubrication; Male; Mouth Mucosa; Mucins; Patient Satisfaction; Saliva, Artificial; Time Factors; Xerostomia; Xylitol

Five saliva stimulants (Salivin, V6, Mucidan, Ascoxal-T and Nicotinamide) and three saliva substitutes (Saliment, Salisynt and an ex témpore solution) were evaluated in 106 patients with a low salivay flow rate and a long history of dry mouth. The study was carried out as a multi-centre study in collaboration with ten different hospital dental clinics. The participants were interviewed about their complaints related to dry mouth. Each patient was then asked to use the eight saliva stimulants and substitutes for 14 days in a randomized order with one week intervals. After the 14-day-periods, the patients were interviewed about the effect of the various products by a dentist using a standardized questionnaire. Paraffin-stimulated whole saliva samples were collected after each test period. The most serious complaints among the patients were, besides dryness of the mouth, difficulty to talk and difficulty to swallow. The results showed that all eight tested saliva stimulants and substitutes relieved the symptoms of dry mouth to some extent. However, V6 chewing gum and Salivin lozenge were ranked as the two best products by the patients. No long-term effect was found with any of the eight products on the flow rate of paraffin-stimulated whole saliva.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Ascorbic Acid; Carboxymethylcellulose Sodium; Drug Combinations; Female; Glycerol; Humans; Lactates; Lactic Acid; Middle Aged; Niacinamide; Saliva; Saliva, Artificial; Secretory Rate; Sorbitol; Xerostomia

Topics: Carboxymethylcellulose Sodium; Clinical Trials as Topic; Double-Blind Method; Drug Combinations; Female; Glycerol; Humans; Male; Methylcellulose; Mouthwashes; Oral Hygiene; Prospective Studies; Random Allocation; Saliva, Artificial; Sorbitol; Xerostomia

The aim of this investigation was to describe and to compare the effectiveness of a CMC- and a mucin-containing saliva substitute. 22 post-radiation patients, 17 Sjögren's Syndrome patients and 3 patients with xerostomia of unknown origin used a CMC- and a mucin-containing saliva substitute, each for 1 week in an arbitrary sequence. Neither the patient, the assistant, nor the physician were aware of the substitute being used. Each patient had to complete a questionnaire at 3 different intervals during the trial. One of the conclusions of this study is that mucin-containing substitutes are preferred by patients when compared to CMC-containing substitutes.

Topics: Adolescent; Adult; Aged; Carboxymethylcellulose Sodium; Double-Blind Method; Female; Humans; Male; Methylcellulose; Middle Aged; Mouthwashes; Mucins; Radiation Injuries; Saliva, Artificial; Sjogren's Syndrome; Xerostomia

The stimulatory effect of a recently introduced saliva substitute (Saliment) on the parotid salivary secretion was experimentally investigated in 10 healthy individuals without signs or symptoms of xerostomia and in 11 patients with xerostomia due to Sjögren's syndrome. Further, in 15 patients with Sjögren's syndrome, the effect of Saliment on the sensation of xerostomia was examined in a double-blind clinical study with cross-over. The use of Saliment was followed by a significant stimulation in the parotid salivary secretion (P less than 0.01) and the subjection sensation of xerostomia was significantly reduced (P less than 0.01).

Topics: Adolescent; Adult; Aged; Carboxymethylcellulose Sodium; Clinical Trials as Topic; Double-Blind Method; Drug Combinations; Female; Glycerol; Humans; Male; Methylcellulose; Middle Aged; Parotid Gland; Saliva; Secretory Rate; Sjogren's Syndrome; Sorbitol; Time Factors; Xerostomia

The aim of this series of studies on rheological, sensory, and mucoadhesive properties was to evaluate the potential of using a combined polymer system to more closely represent the adaptive nature of saliva, while providing long lasting relief from the symptoms of xerostomia.. The rheological investigations were conducted on 1% polymer solutions 24 hours after preparation, during which time they were stored in sealed glass containers at room temperature. The rheometer was controlled via peltier to 35 degrees C +/- 0.1 degrees C, and a shear rate range of 0.1 to 300 s(-1) was applied; thirty measurements were taken during each run. Eight panelists were recruited from the in-house sensory panel at GlaxoSmithKline (GSK) Weybridge to take part in the sensory evaluation. A brief training session was conducted at the start of the study in order to standardize the panelists' responses to the sensory term "tacky." For each test, panelists were given 10 ml of the respective polymer solution and instructed to swirl this solution around their mouths for 20 seconds before expectorating. The panelists were then asked to evaluate the solution in terms of "tack," measured by tapping the tongue on the roof of the mouth. A new formulation, based upon the rheology and sensory testing, was evaluated versus other commercially available sprays for the relief of xerostomia. The new formulation, named OASIS, contains a combination of Xanthan gum, carboxymethyl cellulose and a polyvinyl pyrollidone backboned polymer. To evaluate mucoadhesion of this final product, a 16 mm diameter cylindrical aluminium probe was selected. The probe and the base platform were both coated with a thin layer of artificial polyurethane membrane to more closely mimic the oral mucosal surface. The probe was set to travel downward at 2.0 mm/sec until it made contact with the base platform with a force of 1000 g. The two surfaces were then left in contact for 30 seconds before the probe receded from the base platform at 0.5 mm/sec to a distance of 10 mm. A plot of force versus distance was obtained, and the area under the curve (defined as the Work of Adhesion, energy required to separate the two surfaces) was used as a measure of the mucoadhesion of the materials.. For rheology, the Xanthan gum solution showed high initial viscosity of 32 Pa.s at 0.1 s(-1) with rapid shear thinning to 4.0 Pa.s. By 1.2 s(-1) the viscosity continued to drop with increasing shear rate to 0.05 Pa.s at 300 s(-1). For the sensory assessment, the CMC single solution was perceived to be significantly (p = 0.04) more tacky than the CMC + PVP solution. The Xanthan + PVP solution was perceived to be less tacky (slightly/moderately tacky) than the Xanthan solution (moderately tacky). The Xanthan + CMC + PVP solution was perceived to be less tacky (slightly tacky) than the Xanthan + CMC solution (moderately tacky). Overall, there was a significant difference in favor of the inclusion of PVP across the products (p = 0.038), which was also shown to be a consistent effect across the different polymer solutions.. The sensory solution work indicates that the addition of a PVP backbone polymer within an anionic polymer solution (OASIS) enables higher concentrations of mucoadhesive polymer to be included within a dry mouth formulation, while at the same time giving improved mouth-feel due to reduced tack.

Topics: Analysis of Variance; Carboxymethylcellulose Sodium; Humans; Polysaccharides, Bacterial; Povidone; Rheology; Saliva, Artificial; Time Factors; Viscosity; Xerostomia

The feeling of a dry mouth may affect individual dietary habits, nutritional status, oral hygiene, speech, and gustatory sensitivity. The present study aimed to specifically investigate gustatory function before and after saliva replacement therapy.. Whole-mouth gustatory function was assessed in 25 patients suffering from xerostomia (6 male, 19 female; age range 42-82 years) before and after 4 to 6 weeks of saliva replacement therapy using a preparation containing carboxymethylcellulose. The results were compared with those from healthy controls matched for age and sex (6 male, 19 female; age range 42-82 years). Using a whole-mouth test, gustatory function was assessed for sucrose, citric acid, sodium chloride, and caffeine.. All subjects detected the four taste qualities at the highest concentration. However, the patients with xerostomia had lower scores in the gustatory test compared with the healthy controls (p < .001). No correlation was found between gustatory scores and the duration or severity of the disorder. Therapy had no effect on measured gustatory function (p = .33); however, saliva replacement led to a significant improvement in other xerostomia-related symptoms (p < .001).. This study confirms previous work indicating that xerostomia is accompanied by decreased gustatory sensitivity. Lubricants based on carboxymethylcellulose may have a positive effect on some of the symptoms of xerostomia. However, these "simple" lubricants based on carboxymethylcellulose have little or no effect on whole-mouth gustatory function.

Topics: Adult; Aged; Aged, 80 and over; Carboxymethylcellulose Sodium; Electronic Data Processing; Female; Humans; Male; Middle Aged; Saliva, Artificial; Taste Disorders; Time Factors; Treatment Outcome; Xerostomia

Salivary gland hypofunction is a common sequela of Sjögren's syndrome and irradiation treatment of tumors in head and neck region. The aim of the present study was to evaluate the therapeutic effect of a recently developed hydroxy-propyl-methyl-cellulose (HPMC) containing artificial saliva and to compare it with that of the carboxy-methyl-cellulose (CMC) based saliva substitute. The therapeutic effects of both preparations were assessed by means of self-administered questionnaires which had to be completed before and after the use of each type of artificial saliva after one week treatment. We found significant improvement in symptoms of nocturnal discomfort and difficulty in speech, and results were better in case of HPMC based artificial saliva. The retention time in oral cavity and the frequency of daily administration also were better in case of HPMC containing preparation. It is concluded that the use of HPMC containing artificial saliva can be recommended in the treatment of salivary hypofunction.

Topics: Aged; Carboxymethylcellulose Sodium; Female; Humans; Male; Methylcellulose; Middle Aged; Saliva, Artificial; Salivary Glands; Xerostomia

An instrument based on friction measurement has been developed to evaluate oral mucosal dryness objectively. The purpose of this study was to compare the friction instrument with instruments measuring in vitro rheologic properties. Measurements were performed against steel and irreversible hydrocolloid after application of different concentrations of aqueous solutions of carboxymethylcellulose and chitosan lactate. The results of the measurements were logical, with inversely proportional values for the friction instrument as compared with values obtained using the instrument measuring rheologic properties; that is, increased viscosity led to decreased friction values.

Topics: Alginates; Carboxymethylcellulose Sodium; Chelating Agents; Chitin; Chitosan; Colloids; Evaluation Studies as Topic; Friction; Humans; Rheology; Saliva, Artificial; Steel; Surface Properties; Viscosity; Wettability; Xerostomia

Topics: Adolescent; Adult; Bendroflumethiazide; Carboxymethylcellulose Sodium; Chitin; Chitosan; Dental Instruments; Electric Conductivity; Electric Impedance; Equipment Design; Female; Friction; Humans; Male; Middle Aged; Mouth Mucosa; N-Methylscopolamine; Placebos; Reproducibility of Results; Rheology; Saliva; Scopolamine Derivatives; Spectrophotometry, Infrared; Surface Tension; Wettability; Xerostomia

Contact angle measurements were employed so that we could study the wetting properties of human whole saliva and saliva substitutes containing mucins or carboxymethylcellulose (CMC) on human oral mucosa (in vivo) and on ground and polished human enamel (in vitro). A new approach was introduced for measuring contact angles on human oral mucosa in vivo. It was shown that the wetting properties of CMC- and mucin-containing saliva substitutes on human enamel were significantly better than those of human whole saliva. On human oral mucosa, the wetting properties of CMC-containing saliva substitutes and human whole saliva were comparable, but were surpassed by those of the mucin-containing saliva substitutes. Mucin-containing substitutes thus provide good wetting properties on ground and polished enamel as well as on oral mucosa.

Topics: Aged; Carboxymethylcellulose Sodium; Dental Enamel; Female; Humans; In Vitro Techniques; Male; Middle Aged; Mouth Mucosa; Mouthwashes; Mucins; Saliva; Saliva, Artificial; Surface Tension; Water; Xerostomia

Topics: Carboxymethylcellulose Sodium; Dental Care; Drug Combinations; Drug-Related Side Effects and Adverse Reactions; Humans; Minerals; Mouthwashes; Saliva; Saliva, Artificial; Sodium Fluoride; Xerostomia

In this investigation, the subjective impressions of patients, suffering from severe xerostomia, have been recorded after symptomatic treatment with different CMC- and mucin-containing artificial saliva over 3 years. A total number of 137 patients divided into 3 groups participated. Group I (40 patients) used CMC-containing artificial saliva, group II (61 patients) alternately used CMC- and mucin-containing artificial saliva and group III (36 patients) used mucin-containing artificial saliva. From this study it is concluded that artificial saliva containing mucins proved to be of benefit to patients suffering from xerostomia.

Topics: Adult; Aged; Carboxymethylcellulose Sodium; Consumer Behavior; Evaluation Studies as Topic; Female; Humans; Male; Methylcellulose; Middle Aged; Mouthwashes; Mucins; Saliva, Artificial; Xerostomia

Topics: Adult; Aged; Carboxymethylcellulose Sodium; Citrus; Double-Blind Method; Evaluation Studies as Topic; Female; Glycerol; Humans; Male; Middle Aged; Mouthwashes; Saliva, Artificial; Water; Xerostomia

Seventy-one patients complaining of mouth dryness were examined. Decreased salivary rate of flow was found in fifty-six. Twenty-two patients did not respond to stimulation and were treated with artificial saliva. The thirty-four responding patients were treated with a mouthwash containing citric acid (Saliram). Of the patients using Saliram, 91 percent were satisfied with the results, and in 16 percent of these an increase in salivation was observed and persisted after treatment was discontinued.

Topics: Aged; Carboxymethylcellulose Sodium; Chlorhexidine; Citrates; Female; Humans; Male; Middle Aged; Mouthwashes; Saliva; Xerostomia

Topics: Carboxymethylcellulose Sodium; Drug Combinations; Female; Fluorides; Humans; Methylcellulose; Middle Aged; Minerals; Saliva; Sjogren's Syndrome; Sodium Fluoride; Xerostomia

Topics: Aerosols; Aged; Carboxymethylcellulose Sodium; Female; Humans; Male; Middle Aged; Saliva; Xerostomia

Topics: Animals; Bacillus; Biological Products; Carboxymethylcellulose Sodium; Cattle; Evaluation Studies as Topic; Humans; Mucins; Radiotherapy; Saliva; Salivary Glands; Xerostomia