They Say, “Cotton Mouth Hurts”
Prepare for dry mouth before initiating therapy
The risk of dry mouth is widespread in those over the age of 65—particularly in those taking anticholinergic medications. Patients may complain about dry mouth during follow-up visits.
A physician may ask a patient who is complaining of symptoms the following questions:
- Do you have difficulty swallowing?
- Does your mouth feel dry when eating?
- Do you have to sip liquids when swallowing dry foods?
- Do you feel like there is too little saliva in your mouth?
Medication-induced dry mouth can interfere with treatment goals. Taken with other medications or therapy, Aquoral™ can help reduce the symptoms of dry mouth, leading to better quality of life and improved patient compliance with prescribed therapy for other conditions.
Study 1: use in psychotropic drug-induced dry mouth1
In this study, conducted by Mouly et al (2007), 74 patients who had been on long-term psychotropic drug therapy took part in this 2-week, open-label, randomized, parallel-group study.
Patients were randomized into 1 of 2 treatment groups:
- 37 patients used OGT (Aquoral)
- 37 patients treated with artificial saliva substitute (Saliveze™)
At baseline, 99% of patients complained of mouth dryness during the day, and 66% complained of mouth dryness at night.
The majority of Aquoral recipients began to experience a sensation of improvement, which lasted for up to 4 hours after each oral spray, on the second day of treatment. Relief was felt on day 1 in nearly 25% of patients, with more than 50% experiencing improvements by day 2 of treatment
patients continued Aquoral after study
By day 14, patients treated with Aquoral had experienced a substantial 70% improvement from baseline in dry mouth sensation (p<0.001) as well as improvements in chewing, swallowing, taste and speech, and a reduction in burning sensation. In addition, Aquoral had significantly better efficacy with respect to mouth dryness, speech difficulties and taste improvement (all p≤0.02) as compared with the artificial saliva substitute. Read the abstract on PubMed
Study 2: management of dry mouth in older patients2
In this study, also conducted by Mouly et al. (2007), 41 patients (28 women and 13 men), with an average age of 84 years, took part in this 2-week, open-label, randomized, parallel-group study. 22 patients received Aquoral and 19 patients received a prescription artificial saliva substitute. Please note that in addition to being older, these study participants were also on an average of 4.2 medications each—and and these were the medication classes typically associated with causing dry mouth (eg, diuretics, antihypertensives, antiarrhythmics, and antipsychotics).
At baseline, 98% of patients complained of mouth dryness during the day, and 76% complained of mouth dryness at night. After 2 weeks of treatment, Aquoral improved the overall sensation of mouth dryness by 66% (p<0.001 vs. baseline) and was again significantly more effective than the artificial saliva substitute (p=0.001). Aquoral was also significantly better at improving swallowing and speech than the saliva substitute. Relief from symptoms lasted 2-4 hours after Aquoral administration, similar to the duration of relief observed in the study that evaluated patients with psychotropic drug-induced dry mouth.
Minor adverse events were reported in four patients (9.8%) and included nausea (One patient in the control group) and unpleasant taste (2 patients receiving the other prescription medication and one patient in the Aquoral group). Read abstract on PubMed
patients continued Aquoral after study
Cochrane Systematic Reviews3
Cochrane Reviews are systematic reviews of primary research and look for evidence-based answers to specific questions about healthcare. This review set out to identify effective topical therapies for the relief of the symptom of dry mouth and included both saliva substitutes applied to the oral mucosa as liquids, gels, or sprays and saliva stimulants such as lozenges, chewing gum, or toothpastes. In this review, 36 randomized, controlled trials involving 1597 participants were evaluated. While no strong evidence supporting one type of intervention over another emerged, this review found that OGT (Aquoral) shows evidence of effectiveness compared with electrolyte sprays—an observation that provides independent confirmation and further support for the results of the 2 clinical trials described earlier.
1. Mouly SJ, Orler J-B, Tillet Y, et al. Efficacy of a new oral lubricant solution in the management of psychotropic drug-induced xerostomia: a randomized, controlled trial. J Clin Psychopharmacol. 2007;27(5):437-443. 2. Mouly SJ, Salom M, Tillet Y, et al. Management of xerostomia in older patients: a randomised controlled trial evaluating the efficacy of a new oral lubricant solution. Drugs Aging. 2007;24(1):957-965. 3. Furness S, Worthington HV, Bryan G, Birchenough S, McMillan R. Interventions for the management of dry mouth: topical therapies. Cochrane Database of Syst Rev. 2011;(12);CD008934. doi: 10.1002/14651858.CD008934.pub2.
2. Saliveze is a trademark of Wyvern Medical Limited, UK.