Treatment of xerostomia with polymer-based saliva substitutes in patients with Sjögren's syndrome.
OBJECTIVE
To determine the efficacy of 3 types of polymer-based saliva substitutes in reducing oral dryness in patients with Sjögren's syndrome (SS).


METHODS
Subjective efficacy of 3 different saliva substitutes (determined by self-administered questionnaire) was evaluated in a double-blind, placebo-controlled trial in 43 patients with primary and secondary SS. High-viscosity versus low-viscosity xanthan gum-based saliva substitutes were also compared in 33 SS patients. Salivary flow rates (SFR) were determined to examine correlations between the SFR and the subjective efficacy of the saliva substitute.


RESULTS
Neither the saliva substitutes nor the placebo was truly effective. Preference for a particular saliva substitute over placebo was equally distributed among the 3 types of substitutes. The SFR of patients who preferred polyacrylic acid-based saliva substitutes was lower than that in patients who preferred the porcine mucin-based substitute (P < 0.05). Patients whose oral dryness was reduced by low-viscoelastic substitutes had a low stimulated SFR ( < 0.20 ml/minute; P < 0.05).


CONCLUSIONS
The optimal properties of a saliva substitute are not the same for all patients with SS, but are dependent on such parameters as the individual SFR. Thus, to determine the best saliva substitute for a particular patient, it is necessary to have the patient try a number of substitutes of different viscoelastic properties.
Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands.
W A
WA
van der Reijden
H
H
van der Kwaak
A
A
Vissink
E C
EC
Veerman
A V
AV
Amerongen
D000180:Acrylic Resins / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000818:Animals; D004311:Double-Blind Method; D005260:Female; D005752:Gastric Mucins / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011135:Polysaccharides, Bacterial / Q000627:therapeutic use*; D015203:Reproducibility of Results; D012859:Sjogren's Syndrome / Q000150:complications*; D011795:Surveys and Questionnaires; D013552:Swine; D016896:Treatment Outcome; D014987:Xerostomia / Q000150:complications / Q000188:drug therapy*
D000180:Acrylic Resins; D005752:Gastric Mucins; D011135:Polysaccharides, Bacterial; C006903:carbopol 940; C002563:xanthan gum