What do systematic reviews say?

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

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Blixt-Johansen 1992 (parallel, elderly long-term care, poor oral mucosa): oral mucosa improved in both groups but a much greater reduction in oral pathology in the mucin spray group; no data presented.
  1 study
  GRADE not reported

Carbopol (polyacrylic acid/acetate) spray vs Placebo spray

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  van der Reijden 1996 (crossover, Sjogren's syndrome): carbopol spray found partially effective; none of the sprays were completely effective; no data suitable for inclusion.
  1 study
  GRADE not reported

Intraoral device releasing Biotene Oral Balance gel vs usual care without an aid

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Frost 2002 (crossover, n=30, Sjogren's syndrome): overall mouth dryness favoured the device but only nearly significant (median 4 (IQR 2 to 4) device vs 3 (2 to 4) control; P = 0.056). Speech (P = 0.003) and swallowing…
  1 study · 30 participants
  GRADE not reported

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

Mucin spray (Saliva Orthana) showed no clear difference in duration of relief of dryness compared with placebo spray (base without mucin); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Duxbury 1989: no difference between mucin spray and placebo in the duration of relief of dryness (Analysis 1.4).
  1 study
  GRADE not reported

Chewing gum vs Saliva substitute spray

Chewing gum (mechanical saliva stimulant) led to lower patient preference compared with saliva substitute spray; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Bots 2005: statistically significant preference for chewing gum over Xialine spray, 39/49 (80%) preferred gum vs 10/49 (20%) spray (Chi2 17.16, df=1; P < 0.001) (Analysis 2.3). Davies 2000: more people preferred gum,…
  1 study · 65 participants
  GRADE not reported

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

CMC spray / aloe vera gel / canola oil spray vs Mucin spray (and between each other)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Momm 2005 (crossover, n=123): all four treatments significantly reduced dryness vs baseline (mean xerostomia score, scale 1 to 6: baseline 4.5 +/- 0.11; post-treatment aloe vera 3.7 +/- 0.11, CMC 3.8 +/- 0.12, canola…
  1 study · 123 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