What do systematic reviews say?

Various saliva stimulants (chewable tablet, lozenges, chewing gum, CMC mouthrinse/sprays; 8-arm) vs Saliva substitutes / other products

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No product had a long-term effect on stimulated whole saliva production.
  1 study · 106 participants
  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
  CMC/sorbitol also improved dentition and gingival scores; no supporting data presented.
  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
  No significant difference in patient preference between the treatments (Chi2 3.67, df=3; P = 0.30).
  1 study · 123 participants
  GRADE not reported

Reservoir biteguard device releasing a saliva substitute (with KY jelly + Saliva Orthana) vs Biteguard without reservoir (with KY jelly + Saliva Orthana)

Reservoir biteguard device releasing a saliva substitute (with KY… showed no clear difference in xerostomia (Xerostomia Inventory) compared with biteguard without reservoir (with KY jelly + Saliva Orthana); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  SMD -0.06 [-0.48, 0.37]
  1 study · 86 participants
  GRADE not reported

Mucoadhesive disk (carbomer/triglycerides + antimicrobial agents) vs Placebo disk

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Kerr 2010 (crossover, high risk of bias): no difference in oral dryness between active and placebo disks; increase in subjective oral moistness with both, persisting up to 2 weeks after last use (likely carryover);…
  1 study
  GRADE not reported

Chewing gum vs Saliva substitute spray

Chewing gum (mechanical saliva stimulant) showed no clear difference in xerostomia (mouth dryness, VAS/scale) compared with saliva substitute spray; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  SMD -0.11 [-0.33, 0.11]
  2 studies
  GRADE not reported

Buffered 'Prophylin' prophylactic gel vs Placebo gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Persson 2007 (crossover, n=14, institutionalised elderly): no dry mouth symptom data after treatment were presented.
  1 study · 14 participants
  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
  More participants preferred the intraoral device (66%) compared with usual care; data not suitable for meta-analysis.
  1 study · 30 participants
  GRADE not reported

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

Intraoral device releasing Biotene Oral Balance gel showed no clear difference in salivary flow (unstimulated whole saliva) compared with usual care (no intraoral device); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  MD 0.05 [-0.04, 0.14]
  1 study · 30 participants
  GRADE not reported

Chewing gum vs Saliva substitute spray

Chewing gum (mechanical saliva stimulant) showed no clear difference in salivary flow (unstimulated whole saliva) compared with saliva substitute spray; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  MD 0.01 [-0.01, 0.04]
  2 studies
  GRADE not reported

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

Mucin spray (Saliva Orthana) showed no clear difference in xerostomia (VAS mouth 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 (crossover): statistically significant improvement in dry mouth on a VAS favouring the mucin spray group (Analysis 1.2; SMD not numerically reported).
  1 study
  GRADE not reported

Physostigmine gel (1.8 mg) vs Placebo gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Khosravani 2009 (crossover, low risk of bias, n=17): reduction in oral dryness (VAS area-under-curve over first 180 minutes) after 1.8 mg physostigmine gel; reported graphically, not usable for meta-analysis.
  1 study · 17 participants
  GRADE not reported

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

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Ship 2007 reported xerostomia-related quality of life; no usable comparative data.
  1 study
  GRADE not reported

Mucoadhesive disk (carbomer/triglycerides + antimicrobial agents) vs Placebo disk

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No difference in salivary flow rates between active and placebo disks.
  1 study
  GRADE not reported

Mucin-containing lozenge vs placebo control

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Patient preference strongly favoured the mucin lozenge (P < 0.001, binomial test).
  1 study · 42 participants
  GRADE not reported

Buffered 'Prophylin' prophylactic gel vs Placebo gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Attempts to measure saliva secretion failed because the elderly participants were unable to co-operate.
  1 study · 14 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
  Andersson 1995 (crossover, n=20): more participants experienced a reduction in oral dryness with linseed (Salinum) spray than with CMC spray; crossover data not accounted for, no usable estimate.
  1 study · 20 participants
  GRADE not reported

Various saliva stimulants (chewable tablet, lozenges, chewing gum, CMC mouthrinse/sprays; 8-arm) vs Saliva substitutes / other products

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Bjornstrom 1990 (8-arm crossover, high risk of bias, 106 enrolled, 55 used all 8 products): all products relieved dry mouth and difficulty talking/swallowing 'to some extent'; V6 chewing gum and Salivin lozenge ranked…
  1 study · 106 participants
  GRADE not reported

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

Oxygenated glycerol triester (OGT) spray led to higher xerostomia (mouth dryness scale) compared with saliveeze (aqueous electrolyte) spray; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  SMD 0.77 [0.38, 1.15]
  2 studies
  GRADE not reported

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

Mucin spray (Saliva Orthana) led to lower patient satisfaction / desire to continue treatment 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: majority in both groups wished to continue the allocated spray, no significant difference (Analysis 1.3). Duxbury 1989: 14/30 (46.6%) and 15/30 (50%) wished to continue Saliva Orthana and the spray base…
  2 studies
  GRADE not reported