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What Works to Treat Dry Mouth?

by Dr. Sharon Orrange on May 9, 2017 at 4:14 pm

Dry mouth (also known as xerostomia), is a significant problem faced by adults and unless due to a side effect from medication, there is no real cure.

Often the reason for a case of dry mouth isn’t known, but some common causes include medications, head and neck radiation therapy for cancer, Sjogren’s syndrome, and type 2 diabetes. Over the counter gels, gum, and toothpastes sadly have not been shown to be very effective. So which prescriptions and over the counter treatments really do work?

Prescriptions that definitely work:

  • Salagen (pilocarpine) is a prescription medication taken as a 5 mg tablet, three times a day. It is effective for the treatment of dry mouth. Pilocarpine works by stimulating salivary gland function, so you make more saliva. Price can be a downside because even the generic is pricey—a one-month supply of 90 tablets costs from $40 up to over $100, even with a GoodRx discount.
  • Evoxac (cevimeline) is a 30 mg tablet taken three times a day. It also works by stimulating the salivary glands and has been shown to be quite effective in studies. Generic cevimeline is even more expensive, starting at about $85 per month.

Over the counter options (that provide only mild, temporary relief at best):

  • Topical pilocarpine and pilocarpine lozenges don’t work as well as pilocarpine tablets—but they work just as well as the many saliva substitutes available over the counter and online (Oasis mouth spray, Roxane, and so on). Studies show they are not significantly effective for relief of dry mouth.
  • Mouth care systems like Biotene gel and Biotene toothpaste work slightly better than doing nothing (placebo). A head to head study of Biotene gel vs BioXtra gel and toothpaste showed BioXtra to be more effective. BioXtra works by supplementing the natural protective and lubricating systems in saliva and contains more salivary peptides and proteins than Biotene which may be why it’s slightly more effective. Worth a try.
  • What about alternative therapies? An herbal compound used for 4 weeks containing Malva sylvestris and Alcea digitata powder worked better than artificial saliva. Interesting.

Studies show these options don’t work for dry mouth:

  • Aloe vera gel
  • Rapeseed oil
  • Acupuncture—it has been compared to sham acupuncture and does not work for relief of dry mouth

Has anything worked for you?

Dr O.

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