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J Opioid Manag. 2017 Sep/Oct;13(5):335-340. doi: 10.5055/jom.2017.0402.

The effect of toothpicks containing flavoring and flavoring plus jambu extract (spilanthol) to promote salivation in patients -diagnosed with opioid-induced dry mouth (xerostomia).

Author information

1
Primary Investigator, Integrative Pain Center of Arizona, Tucson, Arizona.
2
Co-Investigator, Integrative Pain Center of Arizona, Tucson, Arizona.
3
Vanguard Global Associates LLC, Tucson, Arizona.
4
Research Coordinator, Integrative Pain Center of Arizona, Tucson, Arizona.

Abstract

OBJECTIVE:

To determine if the use of toothpicks infused with flavoring and flavoring plus the food additive spilanthol (Xerosticks™) improve saliva flow in people with opioid-induced dry mouth.

DESIGN:

Time series, nonrandomized, double-blind within-subject design.

SETTING:

Private practice/academic multidisciplinary pain and palliative care clinic.

PARTICIPANTS:

Ten subjects with opioid-induced dry mouth were recruited, and all finished the study.

METHODS:

Salivary flow and pH were measured consecutively at baseline, following use of a mango-flavored toothpick, and again after use of a mango-flavored toothpick infused with spilanthol. Salivary flow rates and saliva pH were compared between flavored and baseline, between flavored + spilanthol and baseline, and between the flavored and flavored + spilanthol. Mouthfeel of each toothpick was assessed using the Bluestone Mouthfeel Questionnaire.

OUTCOMES:

The primary measure was salivary flow, and the secondary measures were salivary pH and mouthfeel.

RESULTS:

Saliva flow increased 440 percent over baseline with use of a flavored toothpick and 628 percent over baseline with similarly flavored toothpicks infused with spilanthol, and these differences are significant (p = 0.00002). Saliva pH increased with both toothpicks (p = 0.04). The addition of spilanthol produced a greater increase in salivary flow (p = 0.05) compared to control toothpicks with flavoring alone. Furthermore, addition of spilanthol improved the "mouthfeel" of the toothpick (p = 0.00001).

CONCLUSIONS:

Toothpicks infused with either flavoring or flavoring plus spilanthol are likely to be an effective remedy for opioid-induced dry mouth. Addition of spilanthol may improve effectiveness over flavoring alone and may be better ac-cepted because spilanthol appears to improve mouthfeel.

PMID:
29199399
DOI:
10.5055/jom.2017.0402
[Indexed for MEDLINE]

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