Dry mouth, or xerostomia, is a common complaint and dentists are often the first health professional with whom patient discuss the problem. It is important, therefore, for practitioners to be aware of both the causes and treatments of this disturbing condition.

This case report deals with the diagnosis and treatment of hyposalivation after radical radiation therapy and cytotoxic treatment of a metastasising nasopharyngeal carcinoma in an eight-year old girl. After cancer treatment the patient suffered from xerostomia, and pronounced hyposalivation was demonstrated. Frequent chewing of sugar-free gum and use of lozenges was recommended, and the patient was followed up for one year. During this time, the values for unstimulated whole saliva increased by a factor of five, and stimulated whole saliva values increased as well, but less so. Two years after cancer treatment, the patient no longer suffers from xerostomia.

Chewing gum is more than a popular confection. In people suffering from dry mouth, chewing gum produces transitory relief from symptoms by stimulating residual functional salivary glands to increase flow rates. Chewing sugarless gum also reduces the risk of carious attack secondary to dry mouth by neutralizing acid production in plaque.

The purpose of this work was to study the effect of chewing a sorbitol-sweetened gum on whole and parotid salivary flow rates, and on the cemental plaque pH response to a sucrose rinse challenge, in subjects with low salivary flow. The results show that chewing a flavoured sugarless gum significantly increases salivary flow rates in individuals with dry mouth. Additionally, chewing the sorbitol-sweetened gum effectively prevents the fall in cemental plaque pH generally seen in response to a sucrose challenge. This indicates that chewing a sorbitol-sweetened gum provides a palliative and possibly a protective benefit for people who suffer from dry mouth.

Adequate salivary flow is important for patient comfort and maintenance of oral health. Xerostomia, or dry mouth, is a common clinical complaint. Masticatory and gustatory activity can stimulate salivary flow from functional salivary tissue and the use of sugarless mints and gums have been recommended to individuals who complain of xerostomia, but there are minimum clinical data.  A clinical study assessing the effect on salivary flow rates and dental plaque pH of a sorbitol-sweetened chewing gum in subjects with the complaint of xerostomia was conducted. The chewing of the gum in this present study stimulated salivary flow in the subjects with xerostomia. Statistically significant stimulated whole mouth and parotid salivary flow rate increases were found when compared to unstimulated whole mouth and parotid salivary flow rates. Chewing of the sorbitol-sweetened gum also effectively reduced the drop in pH seen following the exposure to a fermentable carbohydrate. The findings of this present study indicate that chewing of a sorbitol-sweetened gum may be of benefit to patients with the complaint of xerostomia.

Comparison between new saliva stimulants in patients with dry mouth: a placebo-controlled double blind crossover study.

Salivary stimulation by chewing gum and lozenges in rheumatic patients with xerostomia.

Comparison between saliva stimulants and saliva substitutes in patients with symptoms related to dry mouth. A multi-centre study.

The management of xerostomia in patients on haemodialysis: comparison of artificial saliva and chewing gum. Palliat Med. 2005 Apr;19(3):202-7. PMID: 15920934 [PubMed - indexed for MEDLINE]

Chewing gum and a saliva substitute alleviate thirst and xerostomia in patients on haemodialysis. Nephrol Dial Transplant. 2005 Mar;20(3):578-84. Epub 2005 Jan 21. PMID: 15665029 [PubMed - indexed for MEDLINE]

In 2004, I have also written an article on the positive salivary stimulating effects of Wrigley's gum on the salivary flow rate.

Preferences and saliva stimulation of eight different chewing gums. Int Dent J. 2004 Jun;54(3):143-8. PMID: 15218894 [PubMed - indexed for MEDLINE]