Oral Balance Gel
Place in Therapy
Place in Therapy
Oral Balance Gel is a salivary substitute with biologically active enzymes aimed at simulating saliva activities lost in xerostomia.<1> Review of primary and secondary sources show that it can be beneficial to patients with xerostomia due to radiation therapy and Sjorgen's syndrome.<2,3,4> An exploratory study by Aliko et al in 2012 showed that it can potentially improve dry mouth symptoms in patients with Sjorgen's syndrome.<2> Patients showed a 26.1 point improvement in a dry-mouth questionnaire for pre and post treatment. Other studies have shown significant improvements in dry mouth in patients who went through radiation therapy, but lacked a placebo control group.<3,4> One study have shown improvements in mouth microflora<3> while one did not<4>. Most studies have shown no improvement in salivary flow rates.<3,4,5>
A meta-analysis of salivary substitutes in 2009 showed that it does show potential in improving xerostomia symptoms.<5> The effects are more pronounced and retention times are better for patients with severe dry mouth.<5> However, a Cochrane analysis showed no significant difference between salivary substitutes and placebo.<6> Despite conflicting evidence, all showed very minimal side effects; most involve nausea, dry mouth, altered taste.<2,3,4,5,6> All studies to date lacked size and proper control groups.<5,6>
Most studies were done for patients who underwent radiation therapy or Sjorgen's syndrome with conflicting results. Given the minimal side effects and the premise of saliva substitution, Oral Balance gel could be tried on patients with xerostomia. It is an appropriate adjunct or monotherapy. Patients with moderate to severe xerostomia may benefit more due to the improved retention time (1hr).<1,5> The retention time improves to 3 hours at night time.<1>
References:
Oral Balance Gel is a salivary substitute with biologically active enzymes aimed at simulating saliva activities lost in xerostomia.<1> Review of primary and secondary sources show that it can be beneficial to patients with xerostomia due to radiation therapy and Sjorgen's syndrome.<2,3,4> An exploratory study by Aliko et al in 2012 showed that it can potentially improve dry mouth symptoms in patients with Sjorgen's syndrome.<2> Patients showed a 26.1 point improvement in a dry-mouth questionnaire for pre and post treatment. Other studies have shown significant improvements in dry mouth in patients who went through radiation therapy, but lacked a placebo control group.<3,4> One study have shown improvements in mouth microflora<3> while one did not<4>. Most studies have shown no improvement in salivary flow rates.<3,4,5>
A meta-analysis of salivary substitutes in 2009 showed that it does show potential in improving xerostomia symptoms.<5> The effects are more pronounced and retention times are better for patients with severe dry mouth.<5> However, a Cochrane analysis showed no significant difference between salivary substitutes and placebo.<6> Despite conflicting evidence, all showed very minimal side effects; most involve nausea, dry mouth, altered taste.<2,3,4,5,6> All studies to date lacked size and proper control groups.<5,6>
Most studies were done for patients who underwent radiation therapy or Sjorgen's syndrome with conflicting results. Given the minimal side effects and the premise of saliva substitution, Oral Balance gel could be tried on patients with xerostomia. It is an appropriate adjunct or monotherapy. Patients with moderate to severe xerostomia may benefit more due to the improved retention time (1hr).<1,5> The retention time improves to 3 hours at night time.<1>
References:
- Kyritsis V. Chapter 95: Dry Mouth. In Repchinsky C ed. Patient Self-Care. 2nd ed. Ottawa, ON: Canadian Pharmacists Association; 2010: 910-917.
- Aliko A, Alushi A, Tafaj A, Isufi R. Evaluation of the clinical efficacy of Biotene Oral Balance in patients with secondary Sjogren's syndrome: a pilot study. Rheumatologi Int. 2012;32:2877-281
- McMillana AS, Tsang CSP, Wong MCM, Kam AYL. Efficacy of a novel lubricating system in the management of radiotherapy-related xerostomia. Oral Oncology. 2006; 42: 842-848
- Epstein JB, Emerton S, Le ND, Stevenson-Moore P. A double-blind crossover trial of Oral Balance gel and biotene toothpaste versus placebo in patients with xerostomia following radiation therapy. Oral Oncology. 1999;35:132-137
- Hahnel S, Behr M, Handel G, Burgers R. Saliva substitutes for the treatment of radiation-induced xerostomia – a review. Support Care Cancer. 2009; 17:1331-1343
- Furness S, Worthington HV, Bryan G, Birchenough S, McMillan R. Interventions for the management of dry mouth: topical therapies (Review). The Cochrane Collaboration. 2011; 12.