Efficacy of biotene oral balance system and xerostom salivary system on salivary properties, salivary biomarkers (beta- defensin, mucin-7) and caries susceptibility in patients with irradiation induced xerostomia: a single blinded randomized controlled trial

Head and neck carcinoma (HNC) is the sixth most common cancer worldwide,accounting for 2.8% of all malignancies. Approximately 6,30,000 patients arediagnosed each year with an annual death rate of 3,50,000. Radiotherapy (RT) plays a pivotal role in the curative treatment in themajority of patients of head and neck cancer either as a single modality or inconjunction with surgery. Despite the beneficial aspects of radiotherapy inlocoregional tumor control, the damage inflicted to normal tissues surroundingthe tumor such as salivary glands remains a significant problem. Salivary glands are remarkably sensitive to radiation, a phenomenon attributed to disruption ofthe plasma membrane on secretory salivary acinar cells and apoptosis.Radiotherapy induced salivary gland dysfunctionresults in hyposalivation (reduction in salivary flow rate), xerostomia (i.e., thesensation of oral dryness), mucositis, oral infections, difficulty withmastication, dysphagia and loss of taste. As a consequence of the adverse effects directlyrelated to salivary gland hypofunction, the quality of life following radiationtherapy for the head and neck cancer patients may severely deteriorate,characterized by restriction of daily activities, a poorer general health,social disabilities and malnutrition. Effective management of dry mouth symptoms may improve nutritionalstatus of patients and reduce the disease burden on these patients as wellthereby enhancing their overall well being.  A new concept & generation of dry mouth care system have beenmarketed as salivary stimulants. These product formulations not only mimic theessential salivary peroxidase system, but also introduce other naturallyoccurring salivary components to help supplement the mouth’s naturalantibacterial and immune mechanism.These are marketed as systemcomprising salivary stimulating gels, antibacterial toothpaste and alcohol freefluoride mouthwash.