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Lookup NU author(s): Professor Marco Carrozzo
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ObjectivesThe objective of this study was to identify systemic diseases associated with hyposalivation and xerostomia and develop evidence-based management recommendations for hyposalivation/xerostomia. Study designLiterature searches covered the English language medical literature from 1966 to 2005. An evidence-based review process was applied to management studies published from 2002 to 2005. ResultsSeveral systemic diseases were identified. From studies published 2002 to 2005, 15 were identified as high-quality studies and were used to support management recommendations: pilocarpine and cevimeline are recommended for treating hyposalivation and xerostomia in primary and secondary Sjögren’s syndrome (SS). IFN-α lozenges may enhance saliva flow in primary SS patients. Anti-TNF-α agents, such as infliximab or etanercept, are not recommended to treat hyposalivation in SS. Dehydroepiandrosterone is not recommended to relieve hyposalivation or xerostomia in primary SS. There was not enough evidence to support any recommendations for the use of local stimulants, lubricants, and protectants for hyposalivation/xerostomia. However, professional judgment and patient preferences may support the use of a specific product for an individual patient. ConclusionsThese evidence-based management recommendations should guide the clinician’s management decisions for patients with salivary dysfunction related to systemic disease. Future treatment strategies may include new formulations of existing drugs, e.g., local application of pilocarpine. Recent discoveries on gene expression and a better understanding of the etiopathogenesis of SS may open new treatment options in the future.
Author(s): von Bultzingslowen I, Sollecito TP, Fox PC, Daniels T, Jonsson R, Lockhart PB, Wray D, Brennan MT, Carrozzo M, Gandera B, Fujibayashi T, Navazesh M, Rhodus NL, Schiodt M
Publication type: Article
Publication status: Published
Journal: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology
Pages: S57, e1-15.
ISSN (print): 1079-2104
ISSN (electronic): 1528-395X
Publisher: Mosby, Inc.
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