Managing your xerostomia (dry mouth)

What is xerostomia?
Xerostomia, another word for dry mouth, is defined as a reduction in daily saliva production to less than about 1 cup. Most healthy adults produce between 2 and 6 cups of saliva per day. Saliva, a liquid produced by the salivary glands, is very important to maintaining good oral health. It is 99% water and acts as a natural mouth rinse that cleans, lubricates, and protects teeth and gums. Saliva also aids digestion by moistening and softening food for swallowing.

Causes of dry mouth
Although many factors may contribute to dry mouth, the most prominent causes include the following:

Drug therapy—medications are the most common cause of xerostomia. In fact, over 400 medications include reduction in salivation among potential side effects (*1).

Age—studies suggest that although salivary function is maintained in healthy elderly people, reduced salivary rates in this population may be related to comorbid conditions and use of various medications(*2).

Sjögren’s syndrome—Sjögren’s syndrome is an autoimmune disease that impairs salivary and lacrimal (tear) gland secretory function. It affects about 1 million people in the United States and significantly more women than men (female:male ratio, 9:1).

Radiation treatment—salivary glands are usually included within the treatment area of head or neck radiation therapy. As mentioned earlier, each year in the United States, approximately 28,000 patients have high-dose external beam radiation for head and neck cancer, and salivary gland damage is the most common adverse effect of this therapy(*2). Unfortunately, salivary gland tissue affected by radiation therapy often results in permanent loss of function(*2.3).

Who suffers from xerostomia?
As many as 10% of adults may suffer from xerostomia. A sizeable number of these individuals are those who experience xerostomia as a side effect to radiation therapy to the head and neck. Patients with Sjögren’s syndrome also make up a large number of xerostomia sufferers. Additionally, normal aging and drug therapy cause a great deal of patients to suffer from xerostomia.

Dry mouth and quality of life depending on their severity, dry mouth symptoms can affect people in different ways. They can range from merely uncomfortable to extremely painful and debilitating. In addition to causing discomfort and embarrassment, dry mouth also accelerates tooth decay, impairs swallowing and speaking, alters taste, exacerbates gastroesophageal reflux, and increases dental caries (cavities), oral mucosal infections, and sensations of pain and burning.


What are the treatment options?
Because xerostomia is not a life-threatening issue, it is often a secondary concern in supportive care even though it may significantly impact the patient’s quality of life. Without saliva, many patients suffer from persistent discomfort. There are 2 primary methods by which xerostomia patients can alleviate their discomfort: stimulation of residual salivary gland secretion (e.g., chewing, taste stimuli, pharmacological agents) and moistening oral tissues (e.g., using mouth rinses or saliva substitutes).

Pharmacological agents, usually cholinergic agonists, trigger secretory function.

Alternatively, saliva secretion may be increased with bittertasting substances or mechanical stimulation, such as chewing sugar-free gum or sucking sugar-free sweets.

Although patients frequently sip water to relieve the symptoms of dry mouth, water does not have the protective effects associated with the many other components of saliva. Saliva substitutes provide longer lasting relief than water because they increase viscosity and lubrication of oral fluid. Additionally, some saliva substitutes contain citric acid and flavors that stimulate secretion.


New solutions for dry mouth
Numoisyn™ Lozenges are formulated to increase salivary secretion by stimulating gustatory (taste) pathways. They contain sorbitol and flavorings to stimulate normal salivation and provide temporary relief of dry mouth in patients who have some residual secretory function and taste perception. Numoisyn Lozenges support saliva’s natural protection of teeth so that teeth are not damaged with repeated use of the lozenges. The lozenges dissolve slowly as they are moved around in the mouth. They are safe and effective for long-term use and well tolerated by patients. Furthermore, use of Numoisyn Lozenges has been shown to improve subjective symptoms of dry mouth without causing bacteria or plaque formation or loss of tooth enamel hardness.


Numoisyn™ Liquid is an oral solution with a viscosity similar to that of natural saliva. It is used to replace saliva when salivary glands are damaged. Numoisyn Liquid protects teeth and gums by producing a film on both hard and soft oral surfaces(*4). The linseed extract in Numoisyn Liquid contains mucins that provide superior viscosity and reduced friction compared with water or carboxymethylcellulose (CMC) solutions. Numoisyn Liquid is long lasting, as each dose typically alleviates symptoms for 1 hour on average, and is best suited for patients with little or no salivary gland function(*5*6).


How can I obtain Numoisyn™ Lozenges/Liquid?
Numoisyn Lozenges/Liquid is a prescription only product.  Your physician will need to provide you with a prescription that you may take to your local or mail order pharmacy to get filled.  If your pharmacy has difficulty ordering Numoisyn, download this form and bring to your pharmacist.

Please refer to the Package Insert for Lozenges or Package Insert for Liquid for specific product and prescribing information.