Cochrane · intervention · CD008934

Interventions for the management of dry mouth: topical therapies

Furness, S, Worthington, HV, Bryan, G, et al. · Cochrane Database of Systematic Reviews · 2011 · Cochrane Library

Oral HealthOral medicine and oral cancer2 versionsAMSTAR 2: not assessed
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
64
current version
GRADE rated
0
No studies
0
Included studies
36
as reported
No studies 0 · 0%Ungraded 64 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

ElementPlanned (methods)Found (results)
PopulationAdults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. Sjogren's syndrome, rheumatoid arthritis, SLE, diabetes, graft-versus-host disease, haemodialysis, medication use, prior radiotherapy)All included trials in adults (15 to 106 participants, mean 44). Cause of xerostomia: current/previous radiotherapy (n=8), Sjogren's syndrome (n=5), combination of factors (n=12), medication (n=6), advanced cancer/haemodialysis/old age (n=3), unclear (n=2)
InterventionAny topical treatment for xerostomia: saliva substitutes (sprays, gels, oils, mouthwashes, mouthrinses, pastilles or viscous liquids); saliva stimulants (lozenges, chewing gums, toothpastes)Pilocarpine lozenge (n=1); Physostigmine gel (n=1); Mucin spray Saliva Orthana (n=4); Mucin lozenge (n=1); Mucoadhesive disk (n=1); Carbopol spray (n=1); CMC spray/mouthwash/swabs (n=6); Xanthum gum spray Xialine (n=2); Buffered prophylin gel (n=1); Chewing gum (n=7); Linseed oil spray/mouthwash Salinum (n=2); OGT spray (n=2); Betaine/SLS toothpaste (n=1); Mouthcare systems Biotene/Bioxtra/Xerostom (n=5); Intraoral gel-releasing devices (n=3)
ComparisonPlacebo, no treatment, or another active topical treatmentPlacebo (n=12); Usual/standard care (n=2); Active topical comparator (n=22)
OutcomesPrimary: Xerostomia short term (at end of treatment) and longer term (3 months after end of treatment). Secondary: Salivary flow (unstimulated whole saliva); Quality of life; Patient satisfaction/preference; Oral health assessmentXerostomia/dry mouth (n=36); Unstimulated whole saliva (n=15); Quality of life (n=1); Patient satisfaction/preference (n=14); Oral health assessment (n=5)
Study designsRandomised controlled trials (parallel and crossover; crossover required random order and a minimum 8-hour washout)Randomised controlled trials (parallel and crossover)
TimingShort term (at end of treatment); longer term (3 months after end of treatment)Not reported (treatment phases ranged from a single dose to 4 weeks)

Search date: 2011-10. Databases: The Cochrane Oral Health Group Trials Register; The Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE via OVID; EMBASE via OVID; CINAHL via EBSCO; AMED via OVID; CANCERLIT via PubMed

Questions and results

Show all 2 versions

Pilocarpine lozenge (3 mg or 5 mg) vs Placebo lozenge

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
2 questions
OutcomeEffectEvidenceStatus / GRADE
Xerostomia (oral dryness)
Single dose (up to 3 hours)
Taweechaisupapong 2006 (crossover): participants reported a statistically significant improvement in oral dryness after both 3 mg and 5 mg pilocarpine lozenges vs placebo (P <= 0.05); no usable data presented. No…1 study · 33 participantsUngraded
Salivary flow (saliva production)
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 participantsUngraded

Physostigmine gel (1.8 mg) vs Placebo gel

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
2 questions
OutcomeEffectEvidenceStatus / GRADE
Xerostomia (VAS mouth dryness, AUC over 180 min)
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 participantsUngraded
Salivary flow (saliva secretion)
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 participantsUngraded

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

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
5 questions
OutcomeEffectEvidenceStatus / GRADE
Oral health assessment
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 studyUngraded
Xerostomia (VAS mouth dryness)
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 studyUngraded
Duration of relief of dryness
Duxbury 1989: no difference between mucin spray and placebo in the duration of relief of dryness (Analysis 1.4).1 studyUngraded
Patient satisfaction / desire to continue treatment
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 studiesUngraded
Improvement in dry mouth (dichotomous)
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 participantsUngraded

Mucin-containing lozenge vs Placebo lozenge

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
2 questions
OutcomeEffectEvidenceStatus / GRADE
Patient preference
Patient preference strongly favoured the mucin lozenge (P < 0.001, binomial test).1 study · 42 participantsUngraded
Xerostomia (VAS mouth dryness)
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 participantsUngraded

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

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
2 questions
OutcomeEffectEvidenceStatus / GRADE
Xerostomia (oral dryness/moistness)
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 studyUngraded
Salivary flow
No difference in salivary flow rates between active and placebo disks.1 studyUngraded

Carbopol (polyacrylic acid/acetate) spray vs Placebo spray

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
2 questions
OutcomeEffectEvidenceStatus / GRADE
Xerostomia (oral dryness)
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 studyUngraded
Patient preference
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 participantsUngraded

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

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
2 questions
OutcomeEffectEvidenceStatus / GRADE
Xerostomia (oral dryness)
Donatsky 1982 (crossover, n=15, Sjogren's syndrome): CMC spray had a similar effect on oral dryness to the spray base, but was more effective than water. Paired crossover data not presented; effect size not estimable.1 study · 15 participantsUngraded
Patient preference
Patient preference evenly split between CMC spray and spray base.1 study · 15 participantsUngraded

Xanthum gum-containing spray (Xialine) vs Placebo spray (base without xanthum)

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
1 question
OutcomeEffectEvidenceStatus / GRADE
Xerostomia (EORTC dry mouth score)
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 participantsUngraded

Buffered 'Prophylin' prophylactic gel vs Placebo (unbuffered gel / water)

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
3 questions
OutcomeEffectEvidenceStatus / GRADE
Salivary flow (salivary secretion rate)
Attempts to measure saliva secretion failed because the elderly participants were unable to co-operate.1 study · 14 participantsUngraded
Xerostomia (dry mouth symptoms)
Persson 2007 (crossover, n=14, institutionalised elderly): no dry mouth symptom data after treatment were presented.1 study · 14 participantsUngraded
Oral health (oral pH, cariogenic bacteria, Candida)
No difference between buffered gel, unbuffered gel and water for oral pH, cariogenic bacteria or Candida species.1 study · 14 participantsUngraded

Chewing gum (mechanical saliva stimulant) vs Saliva substitute spray

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
3 questions
OutcomeEffectEvidenceStatus / GRADE
Patient preference
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 participantsUngraded
Xerostomia (mouth dryness, VAS/scale)
SMD -0.11 [-0.33, 0.11]2 studiesUngraded
Salivary flow (unstimulated whole saliva)
MD 0.01 [-0.01, 0.04]2 studiesUngraded

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

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
2 questions
OutcomeEffectEvidenceStatus / GRADE
Patient preference
Stewart 1998: no statistically significant difference in patient preference between lozenge and spray (Analysis 2.3).1 study · 80 participantsUngraded
Salivary flow (unstimulated whole saliva)
MD -0.01 [-0.03, 0.02]1 study · 80 participantsUngraded

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

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
2 questions
OutcomeEffectEvidenceStatus / GRADE
Xerostomia (dry mouth relief)
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 participantsUngraded
Salivary flow (stimulated whole saliva)
No product had a long-term effect on stimulated whole saliva production.1 study · 106 participantsUngraded

Dentirol chewing gum (xylitol) vs Profylin lozenge (xylitol/sorbitol + CMC)

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
3 questions
OutcomeEffectEvidenceStatus / GRADE
Patient preference
Patients ranked gum and lozenge equal for preference.1 study · 18 participantsUngraded
Salivary flow (stimulated whole saliva)
No change in stimulated whole saliva.1 study · 18 participantsUngraded
Xerostomia (dry mouth relief)
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 participantsUngraded

Carboxymethylcellulose (CMC) spray vs Salinum linseed oil spray

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
3 questions
OutcomeEffectEvidenceStatus / GRADE
Patient preference
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 participantsUngraded
Oral health (plaque and gingival indices)
Mean plaque and gingival indices were reduced during the Salinum (linseed) period; incomplete comparative data.1 study · 20 participantsUngraded
Xerostomia (oral dryness)
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 participantsUngraded

CMC spray / HCC spray / HCC gel vs Liquid margarine (and between each other)

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
2 questions
OutcomeEffectEvidenceStatus / GRADE
Xerostomia (median oral dryness)
Furumoto 1998 (crossover, n=28, medians/IQR): median day-10 oral dryness (lower = less dry): CMC spray 28.00 (3.06), HCC spray 28.75 (2.23), HCC gel 27.75 (3.62), margarine 29.25 (5.06). Only HCC gel showed a…1 study · 28 participantsUngraded
Patient satisfaction
HCC gel rated better than margarine for convenience, perceived value, minutes of relief and overall rating; no other significant between-group differences.1 study · 28 participantsUngraded

Carboxymethylcellulose (CMC) mouthwash vs Glycerin mouthwash

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
1 question
OutcomeEffectEvidenceStatus / GRADE
Improvement in dry mouth ('excellent benefit', dichotomous)
RR 3.95 [1.17, 13.36]1 study · 148 participantsUngraded

CMC/sorbitol pre-moistened swabs vs Lemon glycerin swabs

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
3 questions
OutcomeEffectEvidenceStatus / GRADE
Oral health (dentition and gingival scores)
CMC/sorbitol also improved dentition and gingival scores; no supporting data presented.1 study · 20 participantsUngraded
Xerostomia (oral dryness)
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 participantsUngraded
Patient preference
Patient preference favoured CMC/sorbitol (Chi2 10.89, df=1; P = 0.001).1 study · 20 participantsUngraded

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

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
2 questions
OutcomeEffectEvidenceStatus / GRADE
Xerostomia (mean xerostomia score)
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 participantsUngraded
Patient preference
No significant difference in patient preference between the treatments (Chi2 3.67, df=3; P = 0.30).1 study · 123 participantsUngraded

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

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
3 questions
OutcomeEffectEvidenceStatus / GRADE
Xerostomia (mouth dryness scale)
SMD 0.77 [0.38, 1.15]2 studiesUngraded
Oral health (overall mouth condition)
Mouly 2007b: overall mouth condition improved in both groups; no significant differences between the treatment groups.1 studyUngraded
Patient satisfaction
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 studyUngraded

Salinum (linseed) mouthwash vs Salinum plus chlorhexidine mouthwash

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
1 question
OutcomeEffectEvidenceStatus / GRADE
Xerostomia (oral dryness)
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 participantsUngraded

OASIS moisturising mouthwash vs Experimental mouthwash formulation

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
1 question
OutcomeEffectEvidenceStatus / GRADE
Xerostomia (dry mouth)
Shirodaria 2006 (crossover): OASIS reported to give a statistically significant improvement over subjects' normal remedies, but the report did not present the randomised OASIS-versus-experimental comparison; no data…1 studyUngraded

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

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
1 question
OutcomeEffectEvidenceStatus / GRADE
Xerostomia (relief of oral dryness)
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 studyUngraded

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

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
3 questions
OutcomeEffectEvidenceStatus / GRADE
Salivary flow (unstimulated whole saliva)
MD 0.02 [-0.02, 0.06]2 studiesUngraded
Quality of life (xerostomia-related)
Ship 2007 reported xerostomia-related quality of life; no usable comparative data.1 studyUngraded
Xerostomia (VAS mouth dryness)
SMD 1.11 [0.33, 1.89]1 studyUngraded

Biotene Oral Balance mouthcare system vs Bioxtra mouthcare system

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
2 questions
OutcomeEffectEvidenceStatus / GRADE
Quality of life (xerostomia-related)
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 participantsUngraded
Xerostomia (VAS mouth dryness)
SMD 0.69 [0.08, 1.30]1 study · 20 participantsUngraded

Intraoral device releasing Biotene Oral Balance gel vs Usual care (no intraoral device)

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
3 questions
OutcomeEffectEvidenceStatus / GRADE
Patient preference
More participants preferred the intraoral device (66%) compared with usual care; data not suitable for meta-analysis.1 study · 30 participantsUngraded
Salivary flow (unstimulated whole saliva)
MD 0.05 [-0.04, 0.14]1 study · 30 participantsUngraded
Xerostomia (mouth dryness, median)
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 participantsUngraded

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

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
3 questions
OutcomeEffectEvidenceStatus / GRADE
Xerostomia (Xerostomia Inventory)
SMD -1.01 [-1.44, -0.58]1 study · 22 participantsUngraded
Patient satisfaction
Patient satisfaction scores favoured the gel bolus over the intraoral device (Analysis 3.4).1 study · 22 participantsUngraded
Salivary flow / oral health
No difference between device and bolus in unstimulated whole saliva, oral microbial profile or generalised inflammation.1 study · 22 participantsUngraded

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

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
2 questions
OutcomeEffectEvidenceStatus / GRADE
Oral health (oral impacts on daily performances)
More in the reservoir group experienced relief of an oral impact and fewer a new impact (OIDP), but no difference in the total impact score between groups.1 study · 86 participantsUngraded
Xerostomia (Xerostomia Inventory)
SMD -0.06 [-0.48, 0.37]1 study · 86 participantsUngraded

V6 chewing gum / mucin chewing gum vs Placebo gum (and between each other)

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
2 questions
OutcomeEffectEvidenceStatus / GRADE
Patient preference
Preference favoured mucin gum (61%) over V6 (21%) and placebo (5%).1 study · 43 participantsUngraded
Salivary flow (unstimulated whole saliva)
Aagaard 1992 (crossover, n=43): approximately 50% of participants had an increase in unstimulated whole saliva from all products; unclear how many completed the trial; no usable data.1 study · 43 participantsUngraded

V6 chewing gum vs PTC chewing gum (xylitol/sorbitol/mannitol)

Population: Adults seeking treatment for the symptom of dry mouth (xerostomia) due to any cause (e.g. medication, Sjogren's syndrome, radiotherapy, haemodialysis)
1 question
OutcomeEffectEvidenceStatus / GRADE
Salivary flow (saliva secretion)
Olsson 1991 (crossover, high risk of bias, n=14): both gums increased saliva secretion, peaking 17.5 minutes after chewing started; significant treatment-by-period interaction; no per-group data presented.1 study · 14 participantsUngraded