Sialogogues

May 24, 2020

  

Sialogogues are a class of agents that can be pharmacological or non-pharmacological with their main function being increasing the stimulation of saliva. They are also known as ptysmagogue or ptsylagogue. These agents are particularly useful in patients of dry mouth that is a manifestation of diseases like xerostomia and Sjorgen's syndrome. Apart from dry mouth, these agents are also used in patients suffering fungal infections of the mouth. The range of advantages that saliva has to offer include prevention of dental caries, improving salivary gland function, neutralizing the acids present in the oral cavity and preventing demineralization of enamel to name a few.

Sialogogues work by acting on certain receptors on the body whose function is spread throughout the body. The receptors involved here are called muscarinic. They stimulate the exocrine glands of our body. Salivary glands and sweat glands are examples of exocrine glands. Hence, the action of sialogogues is to enhance the action of these salivary glands. Some of the best sialogogues are as follows:

Pilocarpine

Pilocarpine is a FDA approved drug for the treatment of xerostomia. This drug is also useful in treating glaucoma where it is administered through eye drops. However, for treatment of dry mouth, pilocarpine is given orally. 5 mg of this drug is given thrice a day as an initial dose. The maintenance dose involves 15-30 mg per day. This drug has proven to be effective in cases of salivary gland dysfunction.

Cevimeline

Cevimeline is another FDA approved drug for the treatment of hyposalivation. The recommended dosage is 30 mg, 3 times a day. People with eye infections like iritis or uveitis are contradicted for this medication. Even though the action of this drug is more specific than Pilocarpine, it also has may side effects. These include nausea, vomiting, diarrhoea, excessive sweating, hot flashes and blurry vision.

Bethanechol

Primarily, this drug is used for urinary retention. However, it is also known to increase the secretion of saliva, thereby helping in the treatment of dry mouth. Patients suffering from asthma, heart disease, peptic ulcers and hyperthyroidism should not take this drug. Its odse ranges between 10 to 50 mg and it is given 4 times a day. The advantage of this drug over cevilemine is that it does not cause excessive sweating.

Anethole-trithione

This is a drug that is listed in the U.S. National Cancer Institute. Its main function is treat dry mouth. This drug is marketed in very limited countries. The drug has shown its potential as an inhibitor of carcinogenesis. In the treatment of salivary disorders, it is given thrice a day at a dosage of 25 mg.

The above mentioned drugs are all pharmacological drugs. Each of them has to be taken under a healthcare professional's guidance. Even though they all have the same goal of increasing salivary stimulation, each drug has its own properties and is prescribed to the patient based on his condition and severity of the dryness of the mouth. Besides, generalized contraindications of these drugs include asthma, systemic diseases involving tremors, heart diseases and epilepsy. Any individual who takes these drugs should be aware of their side effects that involves flushing, frequent urination, dehydration and gastrointestinal problems.

There is another class of sialogogues that are non-pharmacological in mature. These are essentially taken after consulting a naturopathist. Echinacea herb and Pyrethrin extracts are the most effective herbs for the treatment of dry mouth. Furthermore, spices and ferments like ginger, tamarind, cayenne, pickle, vinegar and pomegranate molasses also have sialogogue action.

In home remedies, eating citrus fruits like grapes, lemon, lime and orange can trigger the release of more saliva. Other fruits like mangoes, peaches, strawberries and pineapples can also help in improving salivary stimulation.

Another widely used agent for stimulating the flow of saliva is chewing gum. When a person chews a gum, there is a certain pressure exerted on the ligament that binds the tooth to the socket. This is the periodontal ligament. Upon its compression, a fluid known as gingival crevicular fluid is released which helps in countering dry mouth. Since these chewing gums also have a taste, receptors on the tongue also get activated which in turn leads to the release of saliva. In order to cure a problem involving dry mouth, the above mentioned remedies must be taken under proper supervision.

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