Amifostine may relieve symptoms of salivary gland dysfunction in head and neck cancer patients


Problems with saliva production and salivary glands are a significant and mostly permanent side effect for people after radiotherapy treatment to the head and neck. When this occurs the condition is known as dry mouth or xerostomia. Dry mouth is not measurable and is a subjective or personal expression of how the mouth feels. It can have other causes and is a consequence of the production of less saliva or by the consistency of saliva. The rate of flow of saliva in an individual’s mouth however can be measured. People who have dry mouth have a reduced quality of life. They can experience issues with taste and general discomfort, difficulties chewing, swallowing and speaking as well as tooth decay, thrush and other infections of the mouth. A wide range of drugs that work in different ways have been used to try and prevent problems with salivary glands caused by radiotherapy. Unfortunately there is currently not enough evidence to show which drugs or which type of drugs are most effective. Continue reading

New publications from the Cochrane Oral Health Group

CCUIssue 8 of the Cochrane Library for 2013 has been published, and features two new reviews and one new protocol from the Cochrane Oral Health Group.

Follow the links for more information!

New review
Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia
by Zongdao Shi, Huixu Xie, Ping Wang, Qi Zhang, Yan Wu, E Chen, Linda Ng, Helen V Worthington, Ian Needleman, Susan Furness

Ventilator associated pneumonia is a potentially serious complication in patients who are already critically ill. This new systematic review looks at whether keeping the mouth and teeth clean and preventing the build up of plaque on the teeth helps to reduce the risks. 35 randomized controlled trials were included, involving 5,374 participants. The review found that chlorhexidine mouthrinses or gels reduces the risk of ventilator-associated pneumonia by 40% but there was not enough research information available to provide evidence of the effects of other mouth care rinses such as water, saline or triclosan.

New review
Interventions for the management of dry mouth: non-pharmacological interventions
by Susan Furness, Gemma Bryan, Roddy McMillan, Helen V Worthington

This new review looks at non-drug treatments used to stimulate saliva production for the relief of dry mouth. Nine clinical trials were included in the review, and they covered treatments including acupuncture, electrostimulation and powered toothbrushes. 366 people participated in the trials. The review found that the evidence was generally of poor quality.

New protocol
Hypnosis for alleviation of anxiety in adults undergoing dental treatment
by Catherine Potter, Paul Coulthard, Richard Brown, Tanya Walsh

This is a protocol for a new Cochrane Oral Health Group review, which will consider the effects of hypnosis (with or without conscious sedation) in reducing anxiety in dental treatment.

Other highlights of the Cochrane Library, Issue 8, 2013 include:

Three new editorials:

Highlighted reviews:

Cochrane Library, Issue 2, 2012 has been published!

Issue 2 of the Cochrane Library for 2012 has been released, and features 1 new review, 1 review update and 2 new protocols from the Cochrane Oral Health Group.

New Review: Interventions for replacing missing teeth: partially absent dentition
by Elliot Abt, Alan B Carr, Helen V Worthington

The aim of this review is to assess the effects of different prostheses for the treatment of partially absent dentition in terms of the following outcomes: long-term success, function, morbidity and patient satisfaction. Twenty one trials were included, and the review compares the options available to those patients presenting with some missing teeth.

Review Update: Interventions for replacing missing teeth: management of soft tissues for dental implants
by Marco Esposito, Hassan Maghaireh, Maria Gabriella Grusovin, Ioannis Ziounas, Helen V Worthington

The search for this review has been updated, but the conclusions are unchanged. The focus of this review is the management of soft tissues around dental implants. Dental implants are usually placed by elevating a soft tissue flap, but in some instances, they can also be placed without flap elevation to reduce postoperative discomfort. The review looks at the different techniques involved.

New Protocol: Interventions for the management of dry mouth: non-pharmacological interventions
by Gemma Bryan, Susan Furness, Sarah Birchenough, Roddy McMillan, Helen V Worthington

This new protocol will complement the existing review: Interventions for the management of dry mouth: topical therapies. It will look at non-drug therapies for the treatment of xerostomia, a common complaint which can cause a dry, sticky mouth, difficulty in chewing food, a decrease in taste sensation and irritation with dentures. The interventions investigated will include electrostimulation, lasers and acupuncture.

New Protocol: Metal-free materials for fixed prosthodontic restorations
by Carlo E Poggio, Carlo Ercoli, Carlo Monaco, Marco Esposito

This review will consider the effects of metal-free materials for prosthodontic restorations compared to metal-ceramic or other conventional all-metal materials. It will look at all types of metal-free materials for fixed prosthodontic treatment. Studies comparing metal-free systems (single crowns, fixed dental prostheses (FDPs), complete arch prostheses) among themselves and to other conventional prosthodontic restorations will be considered. Studies comparing metal-free prosthodontic components connected to implants (abutments, crowns, FDPs, complete arch prostheses) to all metal (gold, titanium, semiprecious, etc) components will also be included.

This month’s editorial focuses on the Cochrane Strategic Review, follow the link to read Editor-in-Chief David Tovey’s vision for the future of Cochrane, and how you can contribute to it.

Other highlights include Stem Cell Treatment for Myocardial Infarction and Cold Water Immersion for Preventing and Treating Muscle Soreness.

New publications by the Cochrane Oral Health Group in Issue 12 of the Cochrane Library for 2011

Issue 12 of the Cochrane Library for 2011 has been published – the final edition of the year. It was a bumper month for the Cochrane Oral Health Group. We published three brand new reviews:

Flossing for the management of periodontal diseases and dental caries in adults by Dario Sambunjak, Jason W. Nickerson, Tina Poklepovic, Trevor M Johnson, Pauline Imai, Peter Tugwell, Helen V Worthington

The review included 12 trials with a total of 1083 participants. It found that overall there is weak, unreliable evidence to suggest that flossing plus toothbrushing is associated with a small reduction in plaque after 1 or 3 months. However, the trials were generally of poor quality and conclusions are therefore unreliable.

Fluoride supplements (tablets, drops, lozenges or chewing gums) for preventing dental caries in children by Stéphanie Tubert-Jeannin, Candy Auclair, Emmanuel Amsallem, Paul Tramini, Laurent Gerbaud,
Christiane Ruffieux, Andreas G Schulte, Martin J Koch, Myriam Rège-Walther, Amid Ismail

11 studies were included in this review, involving 7,196 children. The review found that no conclusion could be reached about the effectiveness of  supplemental fluoride treatments in preventing tooth decay in young children with deciduous teeth.

Interventions for the management of dry mouth: topical therapies by Susan Furness, Helen V Worthington, Gemma Bryan, Sarah Birchenough, Roddy McMillan

36 trials were included, with 1597 participants. The review found that there is no strong evidence that any one topical therapy is effective for relieving the symptoms of dry mouth. It did find some differences between treatments: for example, oxygenated glycerol triester spray used as a saliva substitute was more effective than a water based electrolyte spray. Chewing gum and mouthcare systems are also evaluated in this review.

Other highlights of the Cochrane Library, Issue 12 for 2011:

This is the last issue of the Cochrane Library for 2011! The next publication date is 18 January 2012. Merry Christmas and a happy new year to all our authors, referees and contributors. Let’s make 2012 a successful year for the Oral Health Group.