How effective are non-pharmacological interventions in the relief of dry mouth?

This summary is based on the review published in the Cochrane database of systematic reviews: Interventions for the management of dry mouth: non-pharmacological interventions (September 2013)

Furness S, Bryan G, McMillan R, Birchenough S, Worthington HV

Context

Xerostomia is the subjective sensation of dry mouth. Common causes of xerostomia include adverse effects of many commonly prescribed medications, disease (e.g. Sjogren’s Syndrome) and radiotherapy treatment for head and neck cancers.

Non-pharmacological techniques such as acupuncture or mild electrostimulation may be used to improve symptoms.

Purpose of the Review

To assess the effects of non-pharmacological interventions administered to stimulate saliva production for the relief of dry mouth.

Key Findings

• There is low quality evidence that acupuncture is no different from placebo acupuncture with regard to dry mouth symptoms, which is the most important outcome. This may be because there were insufficient participants included in the two trials to show a possible effect or it may be that there was some benefit due to ’placebo’ acupuncture which could have biased the effect to the null.
• There is insufficient evidence to determine the effects of electrostimulation devices on dry mouth symptoms.
• It is well known that dry mouth symptoms may be problematic even when saliva production is increased, yet only two of the trials that evaluated acupuncture reported dry mouth symptoms, a worrying reporting bias.
• There is some low quality evidence that acupuncture results in a small increase in saliva production in patients with dry mouth following radiotherapy.
• There is insufficient evidence to determine the effects of electrostimulation devices on dry mouth symptoms or saliva production in patients with Sjögren’s Syndrome.
• Reported adverse effects of acupuncture are mild and of short duration, and there were no reported adverse effects from electrostimulation.

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