Comparison between three different saliva substitutes in patients with hyposalivation

Clin Oral Investig. 2015 Apr;19(3):753-7. doi: 10.1007/s00784-015-1405-8. Epub 2015 Jan 25.


Objective: The aim of the present study was to compare the efficiency of oral spray based on thermal spring water (Buccotherm®) versus commercial saliva substitute (Xeros®) and marshmallow root on the quality of life in patients with hyposalivation.

Materials and methods: A total of 60 patients with unstimulated salivary flow rate <0.2 ml/min were randomized into three groups. In the first group, 30 patients were using Buccotherm®; in the second group, 15 patients were using Xeros®; and in the third group, 15 patients were using marshmallow root. Therapy lasted for 2 weeks; everyday, patients used one of the products four times a day. Quality of life was measured by the Croatian version of Oral Health Impact Profile 14 questionnaire, and visual analog scale was used to determine the intensity of dry mouth before and after therapy. Statistical analysis was performed by Wilcoxon signed-rank test and Kruskal-Wallis test. Standardized effect size was calculated for OHIP following treatment.

Results: Buccotherm® has shown the biggest effect on quality of life in patients with hyposalivation. Intensity of dry mouth was lower after the applied therapy whatever substitute patients used.

Conclusions: We recommend the use of all three saliva substitutes for decreasing the intensity of dry mouth symptoms as well as improvement in the quality of life.

Clinical relevance: Although all tested agents showed beneficial effect in alleviating hyposalivation symptoms, it seems that Buccotherm® was superior to Xeros® and marshmallow root.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Althaea*
  • Betaine
  • Cellulose / analogs & derivatives
  • Drug Combinations
  • Female
  • Humans
  • Male
  • Middle Aged
  • Plant Extracts / pharmacology*
  • Quality of Life
  • Saliva, Artificial / pharmacology*
  • Secretory Rate
  • Sodium Fluoride
  • Surveys and Questionnaires
  • Treatment Outcome
  • Xerostomia / drug therapy*


  • Drug Combinations
  • Plant Extracts
  • Saliva, Artificial
  • Xeros mouthwash
  • Betaine
  • Sodium Fluoride
  • Cellulose