Xerostomia: Causes and treatments

Dry mouth, or xerostomia, is worse than just the feeling we get when we’re thirsty. It’s a chronic condition among some elderly people, smokers, and people with certain systemic diseases. Some medications bring on xerostomia. In particular, xerostomia is a side effect of radiation and chemotherapy for cancer treatment.  Altogether, approximately 27 percent of the adult population suffer from xerostomia.

Like inflammation, dry mouth goes hand in hand with oxidative stress: Xerostomia seems to be caused by oxidative stress, an overabundance of reactive oxygen species (ROS) and free radical molecules. The decline of saliva and salivary antioxidants in xerostomia also causes the build-up of ROS, causing oxidative stress

Oxidative stress and DNA damage

Oxidative stress has been implicated in DNA damage to minor salivary glands in patients with xerostomia.  Additional studies have shown that radiation-induced genomic instability, that is, potential DNA damage, is related to increased levels of ROS. Research studies have shown that oxidative stress—caused by a deficient antioxidant defense mechanism—may be a causative factor for oral cancer. In short, insufficient antioxidants and overabundance of oxidative compounds is closely associated with DNA damage and oral cancer as well as xerostomia.

Antioxidants to the rescue

Standard treatment for dry mouth includes saliva substitutes. Now, in view of the importance of salivary antioxidants, recent treatment has included the application of additional antioxidants. For example, in studies of the effects of radiation on oral tissues when in treatment for cancer, physicians found that the antioxidant superoxide dismutase maintained salivary gland function. Novel antioxidant compounds, designed to work with and amplify bioavailable salivary antioxidants,  are also being tested in clinical practice as well as laboratory settings.

AO ProVantage, from PerioSciences, LLC, is a novel antioxidant-based gel that is applied directly to the oral tissues. Dental practices have reported that the use of the topical antioxidant gel from PerioSciences has alleviated the symptoms and causes of dry mouth, as illustrated by these case studies:

  • A 67-year-old patient experienced dry mouth related to medications for blood pressure and anti-anxiety. She used AO ProVantage gel twice a day for two weeks and reported noticeable improvement in her dry mouth symptoms.
  • A 59-year-old patient being treated with radiation for throat cancer suffered moderate to severe dry mouth but had no relief from traditional dry mouth products. After using AO ProVantage gel five times a day, the patient experienced immediate relief and now continues using it several times each day for sustained relief.

Topically applied antioxidants are particularly promising for people who are undergoing chemotherapy and radiation therapy that can decrease or eradicate salivary flow, leading to xerostomia. One dentist reports that several patients undergoing treatment for cancer found relief from their dry mouth when they used AO ProVantage from PerioSciences. These included a 57 year-old male and a 59 year-old male, both in remission from non-small cell adenocarcinoma of the lung with bone metastases; a 52 year-old male with stage III nasopharynx squamous cell carcinoma; a 74-year-old male with stage II laryngeal cancer; and a 72-year-old female with stage III neck cancer.

The same dentist treated a 22-year-old male with graft-versus-host disease subsequent to a stem cell transplant. This patient used a double-strength antioxidant formula and showed improvement in mucositis lesions and dry lips along with the relief from xerostomia.

As science investigates the chemistry and the causes of xerostomia, patients are finding genuine relief with topical antioxidants.