Artificial Salivas: Why Are They Not More Useful?
The potential market for artificial salivas is huge, yet the actual usage is relatively low. One reason may be the lack of effectiveness of current brands. At best they only mimic the viscous nature of saliva but not the other physical properties, such as
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Guy Carpenter
Abstract
The potential market for artificial salivas is huge, yet the actual usage is relatively low. One reason may be the lack of effectiveness of current brands. At best they only mimic the viscous nature of saliva but not the other physical properties, such as elasticity. This leads to a poor retention of the product in the mouth which then requires frequent application to provide any kind of relief. Since most dry mouth sufferers have some residual secretory activity, it makes sense to formulate artificial salivas to supplement any pre-existing saliva. Due to their very low surface tension, artificial salivas may displace the pre-existing saliva. This chapter explores the components of some leading brands, examines their physical properties – both neat and when mixed with saliva – and suggests some potential future directions for new product development.
Introduction A large number of conditions cause dry mouth, yet the quality of artificial salivas is insufficient to provide sustained relief for any substantial period of time. The physical properties of saliva are as complex and diverse as its components, yet the artificial salivas only mimic one aspect of real saliva – the viscosity. They do not mimic the elastic component of real saliva that has an important function of helping to retain saliva in the mouth. Another deficiency is that most artificial salivas displace, rather than supplement, the existing natural saliva. Few xerostomic patients are completely dry [5], so it makes sense to formulate an artificial saliva that will enhance the
G. Carpenter Salivary Research, King’s College London Dental Institute, Floor 17, Tower wing, London SE1 9RT, UK e-mail: [email protected] © Springer-Verlag Berlin Heidelberg 2015 G. Carpenter (ed.), Dry Mouth: A Clinical Guide on Causes, Effects and Treatments, DOI 10.1007/978-3-642-55154-3_11
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properties of pre-existing saliva. Most artificial salivas have such low surface tension that it destroys the properties of any existing saliva – even saliva from a normal healthy person. The recent innovation of hydrogels holds promise for new developments in artificial salivas, but a significant change in the benefits of artificial salivas will only come about if they mimic more closely the real saliva. This may require the use of peptides and other bioactives rather than chemical actives and new delivery systems that formulate the product in the mouth (from two or more separate containers) rather than applying a preformulated product to the mouth. In this chapter, the author will review some of the artificial salivas currently prescribed to patients, analyse their components and present some data on their physical properties in comparison to natural saliva and their retention in the mouth. It should be realised that no single artificial saliva will suit all patients, and indeed few studies compare more than two artificial salivas in any one study. Thus the author will refrain from naming the “best” artificial saliva.
Clinica
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