What do systematic reviews say?

Buffered 'Prophylin' prophylactic gel vs Placebo gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No difference between buffered gel, unbuffered gel and water for oral pH, cariogenic bacteria or Candida species.
  1 study · 14 participants
  GRADE not reported

Betaine (BET) toothpaste (4%) vs SLS toothpaste (1%) and combined BET+SLS toothpaste

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Rantanen 2003 (crossover): relief of oral dryness BET 44% vs BET+SLS 22% (P = 0.002) vs SLS 18% (P = 0.022) vs reference toothpaste 7% (P < 0.001); betaine-only significantly better than the other toothpastes. No…
  1 study
  GRADE not reported

Xanthum gum-containing spray (Xialine) vs Placebo spray

Xanthum gum-containing spray (Xialine) showed no clear difference in xerostomia (EORTC dry mouth score) compared with placebo spray (base without xanthum); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Jellema 2001 (crossover, n=30, post-radiotherapy): no statistically significant difference between Xialine (xanthum gum) spray and placebo on the EORTC dry mouth score (Analysis 1.2). van der Reijden 1996: xanthum…
  2 studies · 30 participants
  GRADE not reported

Carboxymethylcellulose (CMC) spray vs Salinum linseed oil spray

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Statistically significant preference for linseed spray: of 17 with a preference, more favoured linseed (Chi2 4.77, df=1; P = 0.029); 3 expressed no preference.
  1 study · 20 participants
  GRADE not reported

Oxygenated glycerol triester (OGT) spray vs Saliveeze (aqueous electrolyte) spray

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Mouly 2007b: overall mouth condition improved in both groups; no significant differences between the treatment groups.
  1 study
  GRADE not reported

Consumption of xylitol chewing gum by women (mothers) vs Profylin lozenge (xylitol/sorbitol + CMC)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Risheim 1993 (crossover, high risk of bias, n=18, rheumatic patients): both products gave good subjective relief of dry mouth in slightly less than one third of participants; crossover design not accounted for, no…
  1 study · 18 participants
  GRADE not reported

Oxygenated glycerol triester (OGT) spray vs Saliveeze (aqueous electrolyte) spray

Oxygenated glycerol triester (OGT) spray showed no clear difference in patient satisfaction compared with saliveeze (aqueous electrolyte) spray; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Mouly 2007b: patient satisfaction measured by VAS for global acceptability (Analysis 3.4); no significant difference between treatments for overall oral condition. Satisfaction for taste favoured OGT (mean VAS…
  1 study
  GRADE not reported

CMC/sorbitol pre-moistened swabs vs Lemon glycerin swabs

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Poland 1987 (crossover, high risk of bias, n=20): CMC/sorbitol reported superior to lemon glycerin for reducing oral dryness; brief report, incomplete data, period effect noted; not usable for meta-analysis.
  1 study · 20 participants
  GRADE not reported

Mucin-containing lozenge vs placebo control

Mucin-containing lozenge showed no clear difference in xerostomia (VAS mouth dryness) compared with placebo lozenge; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Gravenmade 1993 (crossover, high risk of bias, n=42, Sjogren's syndrome): no statistically significant difference between mucin lozenge and placebo for mouth dryness on a VAS (Analysis 1.2).
  1 study · 42 participants
  GRADE not reported

Carbopol (polyacrylic acid/acetate) spray vs Placebo spray

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Patient preference for active sprays vs placebo nearly attained significance (Chi2 7.259, df=3; P = 0.064); 15/43 participants expressed no desire to continue any spray after the trial.
  1 study · 43 participants
  GRADE not reported

Physostigmine gel (1.8 mg) vs Placebo gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Approximately fivefold increase in saliva secretion; mean AUC salivary volume 43.4 +/- 9.4 (physostigmine) vs 8.3 +/- 6.6 (placebo), P < 0.001. Adverse effects: 8 mild gastrointestinal upsets, 1 sweating.
  1 study · 17 participants
  GRADE not reported

Commercial mouthcare system (Biotene Oral Balance / Xerostom) vs Usual care or CMC-based control

Commercial mouthcare system (Biotene Oral Balance / Xerostom) led to higher xerostomia (VAS mouth dryness) compared with usual care or CMC-based control; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  SMD 1.11 [0.33, 1.89]
  1 study
  GRADE not reported

Commercial mouthcare system (Biotene Oral Balance / Xerostom) vs Bioxtra mouthcare system

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No difference between systems for overall xerostomia-related quality of life (15-item survey). Bioxtra rated better for taste; no difference for mouth 'feel'. Trial likely underpowered.
  1 study · 20 participants
  GRADE not reported

Pilocarpine lozenge (3 mg or 5 mg) vs placebo control

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes

  Single dose (up to 3 hours)
  Statistically significant increase in saliva production vs placebo (P <= 0.05); maximum salivary output 60 to 90 minutes post-lozenge; no data presented.
  1 study · 33 participants
  GRADE not reported

Intraoral device releasing Biotene Oral Balance gel vs Manually administered bolus of the same gel

Intraoral device releasing Biotene Oral Balance gel showed no clear difference in patient satisfaction compared with manually administered bolus of the same gel; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Patient satisfaction scores favoured the gel bolus over the intraoral device (Analysis 3.4).
  1 study · 22 participants
  GRADE not reported

Carboxymethylcellulose (CMC) spray vs Placebo (spray base without CMC / water)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Patient preference evenly split between CMC spray and spray base.
  1 study · 15 participants
  GRADE not reported

Salinum (linseed) mouthwash vs Salinum plus chlorhexidine mouthwash

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Johansson 2001 (crossover, n=33, Sjogren's syndrome): both products improved oral dryness and chewing/swallowing; Salinum alone reduced speaking problems and burning mouth. Paired data not accounted for; no usable…
  1 study · 33 participants
  GRADE not reported

Intraoral device releasing Biotene Oral Balance gel vs Manually administered bolus of the same gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No difference between device and bolus in unstimulated whole saliva, oral microbial profile or generalised inflammation.
  1 study · 22 participants
  GRADE not reported

Mucin spray (Saliva Orthana) vs Placebo spray (base without mucin)

Mucin spray (Saliva Orthana) led to lower improvement in dry mouth (dichotomous) compared with placebo spray (base without mucin); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Sweeney 1997 (parallel, n=31, terminal cancer): both sprays improved dry mouth symptoms but no statistically significant difference between mucin spray and placebo for improved dry mouth (Analysis 1.1; RR not…
  1 study · 31 participants
  GRADE not reported

Commercial mouthcare system (Biotene Oral Balance / Xerostom) vs Bioxtra mouthcare system

Biotene Oral Balance mouthcare system led to higher xerostomia (VAS mouth dryness) compared with bioxtra mouthcare system; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  SMD 0.69 [0.08, 1.30]
  1 study · 20 participants
  GRADE not reported