Advancements in effectively treating xerostomia

Xerostomia is not simply “a dry mouth.” Oral health and overall health can be severely impacted by the absence of saliva. 3M has announced the launch of 3M Xerostomia Relief Spray. What sets this new product apart? Jo-Anne Jones, RDH, uses the evidence-based decision-making model for determining how this new product might fit into your practice.

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Xerostomia is not simply “a dry mouth.” Oral health and overall health can be severely impacted by the absence of saliva. How prevalent is xerostomia in our population? “Estimates of xerostomia prevalence in the general population are imprecise because of limited data; estimates range from 0.9% to 64.8%.”1 We may conclude however that those who have Sjögren’s syndrome will experience severe xerostomia. Despite advancements in head and neck radiation therapy, cancer patients will continue to suffer with collateral damage to salivary glands resulting in severe xerostomia as well.

3M has announced the launch of 3M Xerostomia Relief Spray, a breakthrough innovative and effective solution to address the impact of xerostomia. What sets 3M Xerostomia Relief Spray apart?

To answer that question, we must remember that as dental professionals, our goal is to recommend a product that is not only efficacious, but also supported by strong science. How do we select such a product with confidence? We continue to look to a professional model to guide all our clinical decision making. The evidence-based decision making (EBDM) model is the integration of scientific evidence, experience, and judgement, patient preferences or values, and clinical and patient circumstances. The model presents a well-rounded approach to clinical decision making. Let’s examine this new product using the EBDM.

Scientific evidence

The key differentiator of 3M Xerostomia Relief Spray is the fact that it is lipid-based rather than water-based. The lipid-based formulations have a unique ability to adhere and protect the oral cavity through increased substantivity. In a 2011 systematic Cochrane Review comparing topical therapeutic interventions for dry mouth, it was concluded that OGT (oxidized glycerol triesters) or lipid-based technology show greater effectiveness when compared to water-based electrolyte sprays.2 In a clinical study, 92% of patients saw an improvement in their dry mouth symptoms and 84% indicated that 3M Xerostomia Relief Spray improved their quality of life.3 A lipid based approach to moisturizing and lubricating the oral cavity provides a protective film or barrier with superior adherence to the oral mucosa.

Experience and judgement

Experience is a wonderful teacher. We learn from our patients and listen in earnest to their feedback. There are numerous over-the-counter products designed for patients who suffer from xerostomia; the majority of which are all water-based with reports of a lack of ability to sustain comfort or relief. The need for frequent use often becomes cost prohibitive.

Patient preferences or values

Prescription-strength salivary stimulants and substitutes often present challenging side effects, such as nausea and excessive sweating. Many patients will discontinue use due to not being able to tolerate the side effects. As the saying goes, “the cure is worse than the disease.”

Another patient preference is convenience and simplicity of use. Many of the salivary substitutes involve the mixing of powder sachets with water, recommended up to 10 times per day, which is not always convenient or discreet. 3M Xerostomia Relief Spray is simple to use, discreet, and clinically proven to last up to four hours. The packaging consists of two 10 ml spray bottles, which constitute a 28-day supply. Patients are instructed to spray one dose (two sprays) into the mouth three to four times daily. Patients may then distribute the product onto inflamed and/or dry areas of the mouth with the tongue.

Clinical and patient circumstances

The ordering process for 3M Xerostomia Relief Spray is streamlined to capitalize on convenience for both the practice and the patient. The prescription form may be downloaded directly from the 3M site. The process is initiated in the dental practice with faxing the form or e-prescribing. The online pharmacy will follow up directly with the patient to obtain additional patient information and will also notify of when it is time to refill. Patient educational brochures are provided to each practice to distribute to the patient explaining features, benefits and ordering process of the spray. The product is shipped directly to the patient by the pharmacy.

Treating disease, improving quality of life for our dental patients, and meeting their needs are the focus of our day-to-day clinical decisions. It’s time to speak up for your patients who suffer with xerostomia.

References
1. Xerostomia (dry mouth). American Dental Association website. https://www.ada.org/en/member-center/oral-health-topics/xerostomia. Updated August 27, 2018. Accessed November 2018.
2. Furness S, Worthington HV, Bryan G, Birchenough S, McMillan R. Interventions for the management of dry mouth: topical therapies. Cochrane Database Syst Rev. 2011;(12):CD008934. doi: 10.1002/14651858.CD008934.pub2.
3. Mouly S, Orler JB, Tillet Y, et al. Efficacy of a new oral lubricant solution in the management of psychotropic drug-induced xerostomia. J Clin Psychopharmacol. 2007;27(5):437-43.


Jo-Anne Jones, RDH, is an international oral health lecturer and president of RDH Connection Inc. Jo-Anne joins the 2019 Dentistry Today CE Leaders for the ninth consecutive year. The Elizabeth Craig Award of Distinction was provided to Jo-Anne in recognition of her dedication to the dental hygiene profession. Jo-Anne may be reached at jjones@jo-annejones.com. Jo-Anne Jones serves in the capacity of a Key Opinion Leader for 3M Oral Care Division.

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