Artificial Saliva – Relieving Dry Mouth and Alleviating Oral Inflammation

Artificial saliva is a substitute used to relieve the symptoms of dry mouth (xerostomia) caused by certain conditions where natural saliva production is deficient or absent. It is also helpful in alleviating oral inflammation (mucositis) resulting from chemotherapy or radiotherapy treatments for cancer.

Available in various forms such as sprays, gels, solutions, and lozenges, artificial saliva is composed of proteins, electrolytes, water, and other substances that moisten and lubricate the oral cavity. It forms a mucous coating on the oral mucous membrane (mucosa). While it provides temporary relief for dry mouth symptoms, it does not treat the underlying condition. Some artificial saliva preparations even contain xylitol, a sugar alcohol that stimulates saliva production.

Side Effects and Warnings

• Do not use artificial saliva if you have hypersensitivity to any of its components.
• Certain formulations (such as Numoisyn lozenge) containing fructose should be avoided if you have fructose intolerance.
• Exercise caution if you are on a sodium-restricted diet, as some artificial saliva products may contain a significant amount of sodium. Caphosol, for example, contains 75 mg of sodium per 30 mL dose.
• Artificial saliva is considered safe for pregnant or breastfeeding women, but it is always advisable to check with a physician before using any over-the-counter product.

Common side effects of artificial saliva include taste perversion (dysgeusia), swallowing difficulties (dysphagia), minor gastrointestinal problems, and speech disturbance.

Contact your doctor immediately if you experience any of the following symptoms or serious side effects:

• Severe heart symptoms like fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms such as blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

If you experience serious side effects or adverse reactions while using this drug, consult your doctor for medical advice. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Dosages of Artificial Saliva

Oral Spray

• Oasis: Contains water, glycerin, sorbitol, poloxamer 338, PEG-60, hydrogenated castor oil, copovidone, sodium benzoate, and carboxymethylcellulose. Ethanol-free, sugar-free, with a mild mint flavor.
• Aquoral: Contains oxidized glycerol triesters, silicon dioxide, and aspartame. Delivers 400 sprays with a citrus flavor.
• Mouth Kote: Contains water, xylitol, sorbitol, citric acid, yerba santa, ascorbic acid, sodium benzoate, and sodium saccharin.
• Mol-Stir: Contains water, sodium carboxymethylcellulose, sorbitol, propylparaben, potassium chloride, dibasic sodium phosphate, magnesium chloride, sodium chloride, calcium chloride, and methylparaben.

Oral Solution

• Caphosol: Contains dibasic sodium phosphate, monobasic sodium phosphate, calcium chloride, sodium chloride, and purified water. Packaged in two 15 mL ampuls that provide one 30 mL dose when mixed together.
• Entertainer’s secret: Contains aloe vera gel, sodium carboxymethylcellulose, glycerin, and has a honey-apple flavor.

Lozenge

• SalivaSure: Contains xylitol, citric acid, apple acid, sodium citrate dihydrate, sodium carboxymethylcellulose, dibasic calcium phosphate, silica colloidal, magnesium stearate, and stearic acid.
• Numoisyn: Contains sorbitol, polyethylene glycol, calcium phosphate dibasic, hydrogenated cottonseed oil, silicon dioxide, magnesium stearate, citric acid, malic acid, and sodium citrate.

Liquid Oral

• Numoisyn: Contains Chondrus crispus, potassium sorbate, sorbitol, water, linseed extract, sodium benzoate, dipotassium phosphate, propylparaben, and methylparaben.

Gel

• Biotene Oral Balance: Contains water, sunflower oil, starch, propylene glycol, glycerine, purified milk extract, and xylitol. Sugar-free.

Discs Extended Release

• XyliMelts: Contains 500 mg xylitol. Dye-free, gluten-free, preservative-free, soy-free, and yeast-free.

Powder For Reconstitution

• NeutraSal: Contains chloride, silicon dioxide, bicarbonate, sodium, phosphates, and calcium.

Adult Dosages:

Dry Mouth (Xerostomia)

• Caphosol, NeutraSal: Swish and spit; 2-10 doses per day.
• Oasis spray: 1-2 sprays as needed; not to exceed 60 sprays per day.
• Oasis mouthwash: Rinse mouth with approximately 30 mL every 12 hours as needed; do not swallow.
• Aquoral: 2 sprays orally every 6-8 hours as needed.
• Entertainer’s secret: Spray as needed.
• Mouth Kote spray: Spray 3-5 times; swish for 8-10 seconds and spit or swallow as needed.
• Biotene: Apply a 0.5-inch length onto the tongue and spread evenly; repeat as often as needed.
• Numoisyn liquid: Use 2 mL as needed.
• Numoisyn lozenges: Dissolve 1 lozenge slowly; not to exceed 16 lozenges per day.
• SalivaSure: Dissolve 1 lozenge in the mouth as needed; 1 lozenge per hour recommended.
• XyliMelts: Apply 2 discs before bed, 1 on each side of the mouth in the lower or upper part of the cheek. Use as needed during the day; swallow as it slowly dissolves (the tan, dimpled side adheres to teeth or gums). Before bedtime, use 2 discs, placing one on each side of the mouth.

Pediatric:

• Safety and efficacy have not been established in pediatric patients.
• Overdose of artificial saliva is unlikely to cause any serious symptoms, and side effects should resolve with discontinuation.
• If symptoms persist, contact your doctor or call Poison Control.

Drug Interactions

Inform your doctor about all medications you are currently taking to identify possible drug interactions. Never start, discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Artificial saliva has no listed severe, serious, moderate, or mild interactions with other drugs.

The above drug interactions listed are not exhaustive. For more information, visit the RxList Drug Interaction Checker.

Always inform your doctor, pharmacist, or healthcare provider about all prescription and over-the-counter medications you use. Keep a list of the information and dosage for each medication.

Additional Information

• Artificial saliva is likely safe for most adults.
• Check labels before choosing an artificial saliva product, as they contain different ingredients.
• Make sure to use over-the-counter artificial saliva exactly as directed.
• Store artificial saliva safely out of reach of children.

Summary

Artificial saliva is a substitute used for relieving the symptoms of dry mouth (xerostomia) caused by certain conditions, as well as alleviating oral inflammation (mucositis) resulting from cancer treatments. Common side effects include taste perversion (dysgeusia), swallowing difficulties (dysphagia), minor gastrointestinal problems, and speech disturbance. Artificial saliva has no listed drug interactions. Consult your doctor if pregnant or breastfeeding.