Journal of dentistry · 2025
Efficacy of topical treatments for xerostomia in older adults: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Spirig Liliane, Srisanoi Kittipit, Kamnoedboon Porawit, Srinivasan Murali
Аннотация
OBJECTIVE: This systematic review and meta-analysis evaluated the efficacy of topical applications, compared to placebo or other treatments, for the management of xerostomia in older adults. The PICO focus question set for this study was, "What is the most effective topical therapy as opposed to systemic or other therapies for the treatment of xerostomia and salivary gland hypofunction, in elderly patients?"
DATA AND SOURCES: Electronic searches of PubMed, CENTRAL, MEDLINE and Web of Science were conducted using the PICO framework. 7459 studies published until April of 2024 were screened. Prospective studies reporting on treatment of xerostomia and hyposalivation in elderly patients were selected.
STUDY SELECTION: Nineteen studies [17 randomized controlled trials (RCTs) and 2 quasi-experimental studies] were included. Seven RCTs provided information for meta-analysis. Pilocarpine mouthwash/mucoadhesive tablets, 1 % malic acid, thyme-honey mouth rinse, significantly reduced xerostomia when compared against placebo (Z = 5.78; p < 0.001; I2 = 34.0 %; 4 studies) but there was no change in the stimulated (Z = 1.14; p = 0.25; I2 = 15.0 %; 3 studies) or unstimulated (Z = 1.46; p = 0.14; I2 = 91.0 %; 3 studies) salivary flow rates. Comparison of oxygenated glycerol triester (OGT) oral spray versus other over-the-counter products demonstrated no differences (Z = 0.32; p = 0.75; I2 = 68.0 %; 2 studies) in alleviating xerostomia. Quality assessment of the included studies revealed a moderate- to high- risk of bias.
CONCLUSIONS: This systematic review concluded that the topical applications for the treatment of dry mouth provided symptomatic relief in older adults, however, their role in the improvement of salivary flow rates was inconclusive due to a lack of sufficient evidence.
CLINICAL SIGNIFICANCE: Topical applications in elderly patients with dry mouth may offer effective symptom relief, particularly when systemic approaches are contraindicated. Although, these interventions may not significantly improve salivation, clinicians should consider them as part of a multimodal approach to improve patients' comfort and quality of life.
PROSPERO REGISTRATION: CRD42024532652.
DATA AND SOURCES: Electronic searches of PubMed, CENTRAL, MEDLINE and Web of Science were conducted using the PICO framework. 7459 studies published until April of 2024 were screened. Prospective studies reporting on treatment of xerostomia and hyposalivation in elderly patients were selected.
STUDY SELECTION: Nineteen studies [17 randomized controlled trials (RCTs) and 2 quasi-experimental studies] were included. Seven RCTs provided information for meta-analysis. Pilocarpine mouthwash/mucoadhesive tablets, 1 % malic acid, thyme-honey mouth rinse, significantly reduced xerostomia when compared against placebo (Z = 5.78; p < 0.001; I2 = 34.0 %; 4 studies) but there was no change in the stimulated (Z = 1.14; p = 0.25; I2 = 15.0 %; 3 studies) or unstimulated (Z = 1.46; p = 0.14; I2 = 91.0 %; 3 studies) salivary flow rates. Comparison of oxygenated glycerol triester (OGT) oral spray versus other over-the-counter products demonstrated no differences (Z = 0.32; p = 0.75; I2 = 68.0 %; 2 studies) in alleviating xerostomia. Quality assessment of the included studies revealed a moderate- to high- risk of bias.
CONCLUSIONS: This systematic review concluded that the topical applications for the treatment of dry mouth provided symptomatic relief in older adults, however, their role in the improvement of salivary flow rates was inconclusive due to a lack of sufficient evidence.
CLINICAL SIGNIFICANCE: Topical applications in elderly patients with dry mouth may offer effective symptom relief, particularly when systemic approaches are contraindicated. Although, these interventions may not significantly improve salivation, clinicians should consider them as part of a multimodal approach to improve patients' comfort and quality of life.
PROSPERO REGISTRATION: CRD42024532652.