Exploratory Study on Effect of Whitening Agent With Emulsion Gel in Xerostomic Population

Aims:

• Primary aim: To see a reduction in the self-reported subjective perception of dryness in the oral cavity.
• Secondary aims: To measure self-reported sensitivity of the teeth,. self-reported perception of teeth whiteness, and objective measurement of improvement of saliva production.

Background and Rationale:

Xerostomia, is a subjective sensation of dryness of the mouth, which may have a significant effect in a persons quality of life. The sensation of dryness of the mouth may be caused by autoimmune diseases which attack the saliva producing glands irreversibly e.g., salivary glands, or the sensation of dryness could be caused by therapeutic radiation, which can destroy the salivary glands at the genetic level and impede their functions. Additionally, there are more than 700 medications including antihypertensives, anti-anxiety agents, psychiatric remedies, and antihistamines that can effect neural transmission. Neural transmission is when the neuro transmission is hindered reversibly leading to the salivary hypofunction that results in dry mouth. It is estimated that 12-47% of the elderly and 10-19.3% in their early 30's suffer from dry mouth (Thomson et al 2005)(Guggenheimer et al 2003). In a study, it was found that the prevalence of xerostomia was 10.0% (with no apparent gender difference) among 32-year-olds and was significantly higher among those taking antidepressants (odds ratio =4.7) (Murray et al 2006). At risk groups may present much higher (60+%) rates of xerostomia. A systemic literature review suggests a prevalence of 27 -32% of the medicated population suffer from xerostomia as a side effect (Guggenheimer et al 2003).

Saliva, the bulk fluid of the oral cavity is very important in maintaining the functions and balance in the oral cavity including candidiasis and enamel erosion prevention. In past studies, residual mucosal fluid levels were seen to vary in different oral cavity sites from an average of 70-100 μm (Collins et al 1987)(Pramanik et al 2010). In addition, the vault of the hard palate has much less mucosal fluid thickness than the floor of the mouth. Over the moisture layer is the lipid layer and reduction or loss of this moisture layer can contribute to the subjective perception of the dryness in the mouth. An addition of the lipid layer will also increase lubrication in the oral cavity.