Sugar-free

Refreshing Mint flavour

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Multiple Medications can lead to
Xerostomia*

Xerostomia is a clinical problem common for patients on medications like:*

Decongestans

Antihistamines

Bronchodilators

Anti-hypertensive

Reduced salivary secretions is the Primary pathological cause for dry mouth factor leading to xerostomia.

  • Alcohol leading to xerostomia
    Drinking alcohol in substantial quantities can change salivary flow rate. Alcohol acts as a diuretic. Body experiences a decrease in the body fluid volume on account of chronic alcohol intake, resulting in an increased thirst sensation or feeling of dehydration.a
  • Thyroid and xerostomia
    About half of people who are diagnosed with xerostomia have thyroid disease.b Lowed metabolism associated with a hypothyroid disease.c Hyperthyroid can lead to burning mouth syndrome or Sjogren’s syndrome.d The immune system targets the glands that make tears and saliva leading to Sjogren’s syndrome hence xerostomia.e
  • Diabetes mellitus
    Uncontrolled diabetic patients often report dry mouth, due to polyuria and poor hydration. Poorly controlled diabetic patients have reduced parotid flow rates causing xerostomia.f
  • Hypertension and xerostomia
    High blood pressure, medications (diuretics) have the side effect of reducing your salivary flow leading to dry mouth. g
  • ESRD&CKD and xerostomia
    Xerostomia is relatively common in patients on chronic hemodialysis for ESRD.h Reduced salivary flow secondary to atrophy and fibrosis of the salivary glands, use of certain medications leads to xerostomia in ESRD. ESRD and CKD are treated with diuretics which leads to xerostomia.

What is the pathophysiology of Xerostomia?

Isomalt lozenges can help provide rapid relief and help in salivary stimulation for managing xerostomia.

  • Isomalt lozenges help in salivary stimulation & providin rapid relief.2
  • Help in improving chewing & swallowing difficulties.2
  • Devoid of systemic & local Adverse effects such as burning or stinging.3

Xylitol Lozenges have been shown to be effective in reducing dryness of mouth and thirst without any safety concerns in patients with ESKD undergoing hemodialysis.

FAQ

A. Salivary fluid is an exocrine secretion1,2 consisting of approximately 99% water, containing a variety of electrolytes (sodium, potassium, calcium, chloride, magnesium, bicarbonate, phosphate) and proteins, represented by enzymes, immunoglobulins and other antimicrobial factors, mucosal glycoproteins, traces of albumin and some polypeptides and oligopeptides of importance to oral health. There are also glucose and nitrogenous products, such as urea and ammonia. 3,4 The components interact and are responsible for the various functions attributed to saliva.2 Saliva behaves as a buffer system to protect the mouth5. The hypotonicity of saliva and its capacity to provide the dissolution of substances allows the gustatory buds to perceive different flavors.1,4, Saliva forms a seromucosal covering that lubricates and protects the oral tissues against irritating agents. 6,7. Saliva is responsible for the initial digestion of starch, favoring the formation of the food bolus.

A. In xerostomia, “Xero” means Dry and “Stomia” means Mouth. Either the quantity or quality of saliva secreted is reduced from salivary glands leading to xerostomia. Xerostomia is not a disease, but it may be a symptom of various medical conditions. Persistent salivary gland hypofunction can produce permanent oral and pharyngeal disorders and impair a person’s quality of life.1,2. Individuals with xerostomia complain of problems with eating, speaking, swallowing, and wearing dentures. Some people also complain of salivary gland enlargement or changes in taste. Lack of saliva may predispose to oral infections such as candidiasis and dental caries. Xerostomia can lead to malnutrition as there is taste loss.

There are multiple causes of xerostomia and salivary gland hypofunction, over 400 medications and treatments are known to cause xerostomia, such as chronic diseases mainly thyroid, diabetes, hypertension, ESRD etc (The incidence of Xerostomia in India with ESRD is- 40%). Some autoimmune disorders can also lead to xerostomia such as Sjogren syndrome. Chronic alcoholism is also a discreet cause of xerostomia. Sometimes certain medications such as diuretics, anticholinergics, antidepressants, antihypertensive can induce the condition. Beside all these causes’ therapies such as chemotherapy, radiotherapy can also sometimes induce xerostomia.

Treatment of xerostomia can be through pharmacological or non-pharmacological interventions. Pharmacological treatment include Pilocarpine, Cevimeline, ACEi or ARBs.

Non pharmacological treatment include Transcutaneous electric nerve stimulation(TENS), Fluoride toothpaste, Acupressure, Salivary substitutes: Gels, Chewing gums, Non-alcoholic mouthwash, Lozenges.

Aquazyl is a isomatl lozenge used to stimulate salivary output in patients with xerostomia. Lozenges are flavored medicated dosage forms intended to be sucked and held in the mouth or pharynx 10,11 Sucking on lozenges helps stimulate saliva, which is good for xerostomia. Sucking on the lozenge works on masticatory muscles that also stimulate saliva flow Isomalt is a sugar substitute, a type of sugar alcohol used primarily for its sugar-like physical properties. It has little to no impact on blood sugar levels, and does not stimulate the release of insulin.

Aquazyl is an isomalt based, hard candy lozenge that enhances salivation when kept in the mouth, thereby keeping the mouth hydrated and happy. Its refreshing mint flavour and affordable pack size makes it an easy solution for a dry mouth.

Isomalt lozenges are preferred because they are sugar free, falls under as safe (GRAS) category of substitutes, it is K+ free, has a low economic cost and are good in taste.

References

*Ref: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3425100/ (Shetty S R et al. Contemp Clin Dent. 2012 Apr-Jun; 3(2): 173–175) a. Collins G.B., Brosnihan K.B., Zuti R.A., Messina M., Gupta M.K. Neuroendocrine, fluid balance, and thirst responses to alcohol in alcoholics. Alcohol Clin Exp Res. 1992;16:228–233 b.Changlai SP, Chen WK, Chung C, Chiou SM. Objective evidence of decreased salivary function in patients with autoimmune thyroiditis (chronic thyroiditis, Hashimoto’s thyroiditis). Nucl Med Commun. 2002;23:1029–33. c. Pinto A, Glick M. Management of patients with the thyroid disease: Oral health considerations. J Am Dent Assoc. 2002;133:849–58. [PubMed] [Google Scholar] d.Voulgarelis M, Tzioufas AG. Pathogenetic mechanisms in the initiation and perpetuation of Sjögren’s syndrome. Nature Reviews Rheumatology. 2010;6(9):529–537 e. Sultana N, Sham EM. Xerostomia: An overview. Int J Dent Clin 2011;3:58-61 f. Salivary flow and the prevalence of xerostomia in geriatric patients Morales-de la Luz R, Aldape-Barrios B g. https://pubmed.ncbi.nlm.nih.gov/22249779/ 2. Therapeutics and Clinical Risk Management 2015:11: 45-51 3. Wafer & Waffle 2017. Technology of Main Ingredients-Sweetness & Lipids.3(155)
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