How much saliva is enough? ''normal'' function defined

Article Abstract:

Since abnormal salivary flow can be associated with a variety of oral disorders, it is important to assess normal flow rates; however, the considerable variation in rates for an individual and for people with disease make determination of ''normal'' levels difficult. To learn more concerning salivary flow rates and their relationship to oral health in healthy people, 102 white, middle class subjects (50 men, 52 women) not under drug treatment for a systemic disease or medical problem were studied. The output of the subjects' parotid and submandibular glands (two of the salivary glands) was collected and measured in both the unstimulated and stimulated (by citric acid) states prior to the completion of a questionnaire concerning xerostomia (dry mouth). In addition, the number of teeth, number of cavities, and number of restorations present were recorded for each participant, and an evaluation was made of participants' periodontal health (condition of the gums and supporting structures). Results showed no effects on salivary flow rates due to age or sex. The flow rate for the lowest tenth percentile in the unstimulated condition was zero milliliters per minute; for the highest tenth percentile, it was more than 0.150 milliliter per minute. During stimulation, the lowest and highest percentile rates were, respectively, 0.201 and 0.180 milliliters per minute for males and females, and 0.800 milliliters per minute (for both sexes). Flow rates for the unstimulated submandibular gland were higher than for the parotid gland, while stimulated rates were approximately the same. Each participant had a wide range of flow rates. No differences in oral health variables were seen for subjects with different flow rates, with two exceptions: pocket depth (the space between the tooth root and the gum), which was greater in subjects in the highest tenth percentile of stimulated output; and percent of dental surfaces with gingival bleeding, which was greater for subjects in the lowest tenth percentile of stimulated output. Ultimately, the results did not answer the question ''How much saliva is enough?''; however, they show the tremendous range of salivary output among people. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Physiological aspects, Salivary glands, Saliva, Mouth, Stomatognathic system

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Oral pilocarpine for post-irradiation xerostomia in patients with head and neck cancer

Article Abstract:

Pilocarpine may be an effective treatment for xerostomia after radiation therapy in patients with head and neck cancer. Xerostomia is dryness of the mouth caused by little or no saliva production. Among 207 patients with head and neck cancer who had radiation therapy, 73 were treated with five milligrams (mg) of oral pilocarpine, 69 with 10 mg of oral pilocarpine and 65 received a placebo, an inactive substance. Of those who completed the study, 44% of the patients treated with 5 mg of pilocarpine had less dryness of the mouth, compared with 25% of the patients who received a placebo. Fifty-four percent of the patients in the 5 mg group had an overall improvement in the symptoms of xerostomia, compared with 25% of those in the placebo group. Improvement in patients treated with 10 mg of pilocarpine was similar to that of patients treated with 5 mg. Sweating was the most common side effect caused by pilocarpine.

Care and treatment, Evaluation, Complications and side effects, Drug therapy, Radiotherapy, Xerostomia, Head and neck cancer, Pilocarpine

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