evidence based mouth care policy - Doncaster and Bassetlaw ...

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REF: PAT/PA 17 v.1
Parotid function can be partially maintained by radiotherapy delivery that spares the contralateral
gland. The symptoms of Xerostomia can be helped by:
i) Frequent sips of cold water/milk or other sugar free non acidic cool drinks
ii) Saliva substitutes:
Saliva Orthana ) both contain flouride and are
) appropriate saliva
) substitutes for dentate
) people
* Oral Balance Mouthwash
Glandosane mouthwash
Salivix Pastilles ) for edentate patients only. These
) are acidic and consequently will
) rapidly erode natural teeth and
) cause tooth sensitivity.
* For these materials to be effective Oral Balance dentifrice must be
substituted for conventional toothpaste. The sodium lauryl
succinate in toothpaste destroys the bulking agent within the Oral
Balance saliva replacement gel.
iii) Flavourless salad oil or dietary fat at night time lubricates the lips and tongue
iv) Sugar free chewing gum stimulates saliva production (e.g. Orbit).
v) Salivary stimulants can cause unwanted side effects that are often more distressing than
the Xerostomia. The following have been used:
Pilocarpoine – ophthalmic drops – 5-10mgs. 3 times daily.
Whilst this stimulates salivary secretion it cannot resurrect a damaged gland i.e. parotids
in radiotherapy for head and neck cancer patients.
Anatholetrithione ( Sialor-sulfarlem, latema) 1-2 tablets can be used 3 times daily.
Pilocarpine and Anetholetrithione can be combined
vi) Ripe bananas are a good lubricant; however, they should be avoided for dentate patients
because of their high refined sugar content.
• When mouth is too painful for cleaning and mouthwash cannot be used, the oral
tissues should be swabbed with Polygon oral swabs (Rochaille Medical Ltd
Cambridge UK) or gauze.soaked in chlorhexidene 3 – 4 times daily. (Fitton 1989)
• Hydration and nutrition are frequently reported as important factors in oral hygiene
(Thurgood 1994). Reduced oral intake has the effect of reducing the production of
saliva thus the cleansing effect of saliva on the tongue and the mucous membrane is
lost. Much of the literature notes that a factor in the control of bacterial growth is the
production of saliva. Saliva contains several anti-bacterial factors which suppress
bacterial and fungal colonisation. Also, the mechanical action of mastication
promotes the washing action of saliva, and helps prevent the firm attachment of
micro organisms to the surfaces (Somerville 1999).