Findings

What do systematic reviews say?

17 questions · 24 findings · 2 reviews · Oral medicine and oral cancer

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No studies found 2 · 8.3%GRADE not reported 17 · 70.8%Very low 1 · 4.2%Low 4 · 16.7%Moderate 0 · 0%High 0 · 0%

Selenium vs no intervention

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
6 weeks after end of RT
No evidence that selenium reduced xerostomia; data unusable (bar charts with no standard deviations) (Buntzel 2010)
1 study
GRADE not reported

Antimicrobial lozenge vs placebo

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Antimicrobial lozenge showed no clear difference in xerostomia compared with placebo; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 3 months postRT
RR 1.16 [0.97, 1.40]
1 study · 133 participants
GRADE not reported

Venalot Depot (coumarin plus troxerutin) vs placebo

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
RTOG scores were a composite of radiation side effects on different sites and could not be used for assessing xerostomia (Grotz 2001)
1 study
GRADE not reported

Antiseptic mouthrinse vs placebo

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No data on xerostomia were reported.
0 studies
No studies found

Biperiden plus pilocarpine vs no treatment

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No xerostomia data related to the effectiveness of biperiden and pilocarpine were reported (Rode 1999).
0 studies
No studies found

Chinese medicine vs no treatment/placebo

Xerostomia (VAS) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
Difference in favour of Chinese medicine on VAS xerostomia (P < 0.05); standard deviations not available (Wang 1998)
1 study · 50 participants
GRADE not reported

Polaprezinc vs Azulene oral rinse

Xerostomia (severe) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Polaprezinc led to lower xerostomia (severe) compared with azulene oral rinse; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
RR 0.17 [0.04, 0.65]
1 study · 31 participants
GRADE not reported

Pilocarpine vs no treatment/placebo

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Pilocarpine led to lower xerostomia (objective, LENT-SOMA scale) compared with no treatment/placebo; GRADE not reported.

3 findings from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
6 months postRT
MD -0.40 [-0.69, -0.11]
1 study · 39 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT; 3 months postRT
RR 1.00 [0.92, 1.08]
2 studies · 48 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 6 months postRT
SMD -0.35 [-1.04, 0.33]
2 studies · 126 participants
Very low

Bethanechol vs Artificial saliva

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Bethanechol showed no clear difference in xerostomia (dry mouth, yes/no) compared with artificial saliva; GRADE not reported.

2 findings from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
8 to 40 weeks postRT
RR 0.56 [0.30, 1.05]
1 study · 30 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
RR 0.63 [0.30, 1.29]
1 study · 36 participants
GRADE not reported

Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs placebo

Xerostomia (grade >= 2, 0-4 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Palifermin showed no clear difference in xerostomia (grade >= 2, 0-4 scale) compared with placebo (low certainty).

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 3 months postRT
RR 0.97 [0.77, 1.22]
3 studies · 471 participants
Low

Amifostine vs no treatment/placebo

Xerostomia (grade >= 2, 0-4 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Amifostine may leads to lower xerostomia (grade >= 2, 0-4 scale) compared with no treatment/placebo (low certainty).

3 findings from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
RR 0.35 [0.19, 0.67]
3 studies · 119 participants
Low
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
12 months postRT
RR 0.70 [0.40, 1.23]
7 studies · 682 participants
Low
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 3 months postRT
RR 0.66 [0.48, 0.92]
5 studies · 687 participants
Low

Amifostine (intravenous) vs Amifostine (subcutaneous)

Xerostomia (grade >= 2, 0-4 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Amifostine (intravenous) led to lower xerostomia (grade >= 2, 0-4 scale) compared with amifostine (subcutaneous); GRADE not reported.

2 findings from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
12 months postRT
RR 0.61 [0.42, 0.88]
1 study · 127 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 3 months postRT
RR 1.03 [0.76, 1.40]
1 study · 263 participants
GRADE not reported

Bethanechol vs placebo

Xerostomia (grade >= 2, 0-3 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Bethanechol led to lower xerostomia (grade >= 2, 0-3 scale) compared with placebo; GRADE not reported.

2 findings from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
RR 0.43 [0.28, 0.66]
1 study · 84 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 3 months postRT
RR 0.81 [0.65, 1.01]
1 study · 84 participants
GRADE not reported

Amifostine 200 mg/m2 three times weekly vs Amifostine 200 mg/m2 five times weekly

Xerostomia (grade >= 2, 0-4 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Amifostine 200 mg/m2 three times weekly showed no clear difference in xerostomia (grade >= 2, 0-4 scale) compared with amifostine 200 mg/m2 five times weekly; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
12 months postRT
RR 0.94 [0.58, 1.53]
1 study · 49 participants
GRADE not reported

Chinese medicine vs no treatment/placebo

Xerostomia (other Chinese medicines) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT; 1 month after RT
No evidence of a difference for Tianwang Buxin Mini-pills (Lin 2014, 71 participants) or Jinlong capsules (Han 2010, 95 participants)
2 studies
GRADE not reported

Chinese medicine vs no treatment/placebo

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Chinese medicine led to lower xerostomia (dichotomous, Shenqi Fanghou recipe) compared with no treatment/placebo; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
RR 0.39 [0.28, 0.55]
1 study · 140 participants
GRADE not reported

Gum chewing (sugar-free) vs No chewing gum

Dry mouth (xerostomia) · Elderly (>60 years) and medically compromised adults with xerostomia / dry mouth

Gum chewing was linked with improved self-reported xerostomia / dry mouth in most studies (12 of 17 positive, 5 no effect); heterogeneous instruments precluded meta-analysis.

1 finding from 1 review

The effect of gum chewing on xerostomia and salivary flow rate in elderly and medically compromised subjects: a… 2023 All outcomes
Various (single session to 3 months) · Haemodialysis units, elderly / geriatric care, cancer and palliative care, and xerostomia / hyposalivation clinics (studies from multiple countries)
Narrative vote-count: of 17 studies measuring self-reported xerostomia / dry mouth, 12 found a positive effect of gum chewing [18,19,21,23,24,25,26,27,30,31,38,40] and 5 detected no effect [17,29,33,34,37]. No study…
17 studies
GRADE not reported