AUTHORS: Antonio Aguilar-Salvatierra, Javier Guardia, José Luis Calvo-Guirado, David Herrera, Gerardo Gómez-Moreno 

University of Granada, Faculty of Dentistry, Department of Stomatolgy 

Background 

Xerostomia is the subjective sensation of dry mouth that occurs when saliva production is reduced due to salivary gland malfunction. The most common causes of xersotomia are systemic diseases (Sjörgen’s Syndrome, diabetes, ...), head and neck radiation, anxiety, stress…, and mainly, xerostomizing medications. Principal treatment of xerostomia includes systemic and topical sialogogues (the latter causing less side effects). Some topical sialogogues are acids, such as malic acid. 

Objective 

The goal of this study was to evaluate the clinical efficacy of a topical 1% malic acid sialogogue spray in xerostomia patients whose condition is a result of taking antihypertensive or antidepressant medications. 

Materials and Methods 

After being granted authorization by its Ethical Committee, the University of Granada’s Faculty of Dentistry performed a study (between July and December 2010) on 25 patients diagnosed with antidepressant or antihypertensive drug-induced xerostomia. For two weeks, patients applied a topical 1% malic acid sialogogue spray (Xeros DENTAID Spray) as needed when they had a dry mouth sensation. 

In order to measure xerostomia, the Dry Mouth Questionnaire (DMQ) was used before and after spray application. Stimulated and non-stimulated salivary flow was quantified before and after applying the spray. Statistical analysis was carried out using SPSS v17.0 software (SPSS INC., Chicago, IL, USA). Differences between DMQ values at the start and at the finish (at 2 weeks) of the study were considered. The Wilcoxon test was applied to analyse stimulated and non-stimulated salivary flow. Significance level was set at 0.05 and power at 90%. 

Results 

DMQ values increased significantly (an improvement) from 8.72 to 16.18 points (p<0.05) after application of 1% malic acid spray (table 1). After 2 weeks of application, stimulated and non-stimulated salivary flow increased from 0.168 to 0.235 ml/min and from 0.657 to 0.895 ml/min, respectively (p<0.05) (figure 1). 

Conclusions 

The 1% malic acid spray reduced drug-induced xerostomia and stimulated saliva production.