What do systematic reviews say?

Saliva stimulant lozenge (sorbitol, Sorbee) vs Saliva substitute spray

Saliva stimulant lozenge (sorbitol, Sorbee) led to lower patient preference compared with saliva substitute spray (MouthKote); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Stewart 1998: no statistically significant difference in patient preference between lozenge and spray (Analysis 2.3).
  1 study · 80 participants
  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
  Patients ranked gum and lozenge equal for preference.
  1 study · 18 participants
  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
  No change in stimulated whole saliva.
  1 study · 18 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
  Mean plaque and gingival indices were reduced during the Salinum (linseed) period; incomplete comparative data.
  1 study · 20 participants
  GRADE not reported

Carboxymethylcellulose (CMC) mouthwash vs Glycerin mouthwash

Carboxymethylcellulose (CMC) mouthwash led to higher improvement in dry mouth ('excellent benefit', dichotomous) compared with glycerin mouthwash; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  RR 3.95 [1.17, 13.36]
  1 study · 148 participants
  GRADE not reported

Saliva stimulant lozenge (sorbitol, Sorbee) vs Saliva substitute spray

Saliva stimulant lozenge (sorbitol, Sorbee) showed no clear difference in salivary flow (unstimulated whole saliva) compared with saliva substitute spray (MouthKote); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  MD -0.01 [-0.03, 0.02]
  1 study · 80 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
  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