Management of patients suffering from xerostomia with a combined mouthrinse containing sea salt, xylitol and lysozyme

Dry mouth, including xerostomia, is a common symptom especially in older adults. The causes of dry mouth include medication, autoimmune disease (Sjögren’s Syndrome), radiotherapy or chemotherapy for cancer, hormone disorders and infections (1-3). There is a huge variety of therapeutic approaches for relieving dry mouth symptoms such as chewing-gum, sugar-free lozenges, moisturizers and toothpastes, but most of them are are frequently restricted to palliative treatment. A Cochrane review concluded that there is no strong evidence that any topical therapy is effective in relieving the symptom of dry mouth, and more studies are required to provide evidence to guide clinical care (4-7). The inclusion of antimicrobial agents, such as lysozyme, lactoferrin, lacoperoxidase, or xylitol in xerostomia healthcare products, was proposed as early as the 1990s, and appears to be a promising approach for the prevention of microbial-related diseases in xerostomic patients (8, 9). Despite the significant prevalence of xerostomia in the general population, however, no standard treatment guidelines exist. Successful treatments are typically individualized for the specific patient and should be targeted at the underlying pathophysiology of the disease (10-12). The aim of the present study was to evaluate the efficiency of a combined mouthrinse containing purified water, sea salt, xylitol, lysozyme, and menthol (H2Ocean Sea Salt Mouthwash) in the management of patients suffering from xerostomia and hyposalivation.