What are some good over-the-counter dry mouth products that I can recommend to my patients?
It really depends on patient needs. A range of pH-neutralizing products, such as rinses, gels, mouth sprays, lozenges, mucosal-adhering discs, and toothpastes, have been around for a long time, and these may be a good place to start.
Fluoride mouthrinses are helpful due to their effectiveness in caries prevention. People with dry mouth do not have the buffering capacity as those with normal salivation, and are therefore more susceptible to developing caries. Adding this rinse to a patient’s daily self-care regimen will help reduce that dry mouth feeling with the added therapeutic effect of fluoride. However, the patient does need to wait 30 minutes after use before eating and drinking to obtain fluoride’s therapeutic impact. Fluoride-free mouthrinses designed to add moisture to the oral cavity are also available.
To support remineralization among patients with xerostomia and thus heightened caries risk, oral care products with arginine bicarbonate and calcium carbonate, amorphous calcium phosphate (ACP), casein phosphopeptide-ACP, calcium sodium phosphosilicate, tricalcium phosphate, and hydroxyapatite may be beneficial. Shorter intervals for recare appointments and professionally applied and at-home fluoride products are also useful.1,2
Lozenges, gums, gels, and sprays that act as salivary substitutes can be suggested. The most important factor when looking for a lozenge or gum is to make sure it is sugar free. Products containing hyaluronic acid offer lubricating qualities.3 I would recommend looking for a product that lists xylitol among the first ingredients. Xylitol is a sugar substitute that has been shown to be noncariogenic and even anticariogenic, and has claims in reducing the population of mutans streptococci. Xylitol-containing products must be kept away from pets, as xylitol is toxic to animals.
Lozenges are different than chewing gums or mints, as they are not meant to be chewed, but placed in the mouth and allowed to dissolve over time. Chewing gums are meant to be chewed throughout the day. Be sure to read the directions on the individual labels.
Providing patients with instructions on how to purchase dry mouth products is also necessary. Not every pharmacy will carry such items, and they may need to be ordered online. It is also important to educate your patients on the product’s active ingredients and what kind of therapeutic effect those products will produce. This will allow you to customize the self-care plan for patients with hyposalivation.
Although none of these products are as beneficial as natural saliva, they can all be used to help your patients manage their dry mouth with some added therapeutic benefits. In addition, remind patients to drink water regularly throughout the day and to limit snacking on sugary foods.
References
- Cantore R, Petrou I, Lavender S, et al. In situ clinical effects of new dentifrices containing 1.5% arginine and fluoride on enamel de- and remineralization and plaque metabolism. J Clin Dent. 2013;24(Spec No A):A32–A44.
- Trushkowsky R. Xerostomia management. Dimensions of Dental Hygiene. 2014;12(3):3–39.
- Kobayashi T, Chanmee T, Itano N. Hyaluronan: metabolism and function. Biomolecules. 2020;10:1525.
From Dimensions of Dental Hygiene. December 2020;18(11):46.
