DOI QR코드

DOI QR Code

Effect of Pilocarpine Mouthwash on Xerostomia

구강건조증에 대한 필로카핀 구강양치액의 효과

  • Kim, Ji-Hyun (Department of Orofacial Pain and Oral medicine, College of Dentistry, Yonsei University) ;
  • Park, Ju-Hyun (Department of Orofacial Pain and Oral medicine, College of Dentistry, Yonsei University) ;
  • Kwon, Jeong-Seung (Department of Orofacial Pain and Oral medicine, College of Dentistry, Yonsei University) ;
  • Ahn, Hyung-Joon (Department of Orofacial Pain and Oral medicine, College of Dentistry, Yonsei University)
  • 김지현 (연세대학교 치과대학 구강내과학교실) ;
  • 박주현 (연세대학교 치과대학 구강내과학교실) ;
  • 권정승 (연세대학교 치과대학 구강내과학교실) ;
  • 안형준 (연세대학교 치과대학 구강내과학교실)
  • Received : 2010.11.25
  • Accepted : 2011.02.10
  • Published : 2011.03.30

Abstract

Xerostomia is subjective feeling of dry mouth, a symptom that may or may not be accompanied by hyposalivation, an objective decrease in salivary flow. There are many causes induced xerostomia like drugs, salivary gland diseases, radiation therapy to the head and neck region, Sjogren syndrome, emotional stress etc. Insufficient salivary flow creates complications with oral candidiasis, dental caries, periodontitis, halitosis, dysgeusia. So finally, these complications lead to an overall decline in quality of life. Managements of xerostomia are eliminating or alterating the etiologic factors, relieving symptoms, preventing or correcting the consequences of salivary dysfunction, treating underlying disease and stimulating salivation. One of the salivation stimulation agents studied to treat xerostomia was the pilocarpine muscarinic agonist. Pilocarpine is one of salivation stimulants, a parasympathomimetic drug and non-selective muscarinic receptor agonist. Systemic pilocarpine has been used to stimulate salivary secretion. But systemic administration of pilocarpine has limitations such as increased risk of side effects and contraindications. Side effects of systemic pilocarpine administration are sweating, urinary and gastrointestinal disturbance, risk of cardiovascular and pulmonary disorders. This drug must be used carefully by patients with controlled asthma, chronic bronchitis, pulmonary or cardiac disease. Patient with acute asthma, narrow angle glaucoma, iritis should not use pilocarpine. Like this, systemic pilocarpine has many limitations. So, many investigators also have looked at the effectiveness of topical pilocarpine. Here we present patients with xerostomia which was relieved by pilocarpine mouthwash.

References

  1. Napenas JJ, Brennan MT, Fox PC. Diagnosis and treatment of xerostomia (dry mouth). Odontology 2009;97:76-83. https://doi.org/10.1007/s10266-008-0099-7
  2. Bernardi R, Perin C, Becker FL et al. Effect of pilocarpine mouthwash on salivary flow. Brazilian Journal of Medical and Biological Research 2002;35: 105-110. https://doi.org/10.1590/S0100-879X2002000100015
  3. Crispian Scully, Dry mouth (Xerostomia), Oral and maxillofacial medicine. 2nd ed., Philadelphia, 2008, Churchill livingstone Elsevier., pp. 79-86.
  4. Bertram G. Katzung, Cholinoceptor-activating & cholinesterase-inhibiting drugs, Basic & Clinical pharmacology. 8th ed., America, 2001, McGraw-Hill., pp. 92-106.
  5. Mikhail. Pilocarpine mouthwash for drymouth relief. United state patent 1980.
  6. M.M Furguson, P. Hayes, J. Highton, D.S. Jones, E.E.Macfadyen, D.G.Palmer. Pilocarpine oral solution. Letters 1991:251.
  7. 이선경, 현기용, 이승우. 필로카핀 투여 방법에 따른 구강 건조증 환자의 치료 효과에 관한 연구. 대한구강내과학회지 1994;19:25-44.
  8. Davies AN, Daniels C, Pugh R, Sharma K. A comparison of artificial saliva and pilocarpine in radiation induced xerostomia. The Journal of Laryngology and Otology 1994;108:663-665.
  9. Hamlar DD, Schuller DE, Gahbauer RA et al. Determination of the efficacy of topical oral pilocarpine for postirradiation xerostomia in patient with head and neck carcinoma. Laryngoscope 1996;106(8):972-6. https://doi.org/10.1097/00005537-199608000-00011
  10. Frydrych AM, Davies GR, Slack-Smith LM, Heywood J. An investigation into the use of pilocarpine as a sialagogue in patients with radiation induced xerostomia. Australian Dental Journal 2002;47:(3)249-253. https://doi.org/10.1111/j.1834-7819.2002.tb00337.x
  11. Eliasson L, Birkhed D, Carl?n A. Feeling of dry mouth in relation to whole and minor gland saliva secretion rate. Arc Oral Biol 2009;54:263-267. https://doi.org/10.1016/j.archoralbio.2008.09.001