Abstract
Xerostomia can predispose dentate subjects to caries, which may be rampant and difficult to manage. In addition to the subjective complaints, the patient with salivary gland dysfunction is susceptible to increased oral pain, frequent infections, and difficulties in speaking, chewing, and swallowing. Management of xerostomia is difficult. Artificial replacement saliva and several drugs have been developed, but they are not wholly satisfactory to the patients. The purpose of this study was to evaluate the effect of parasympathomimetic drugs on the salivary flow rate.
The four representative parasympathomimetic drugs were Pilocarpini Hydrochloridum, Bethanecholi Chloridum, Ambemonium Chloridum, and Neostigmini Bromidum. Unstimulated whole saliva samples were collected immediately before drug administration and then at 20-minute intervals for 3 hours. Subjects, six healthy male volunteers, took nothing by mouth for 2 hours before the experiment and did not eat until after the third hour of sampling. Parotid saliva was collected with a Carlson-Crittenden cup.
An increase in whole and parotid salivary flow were seen within 30 minutes following pilocarpine administration. This reached a maximum at 40 minutes and rapidly declined thereafter. The salivary flow approached baseline values within 3 hours. As for three other drugs, almost the same patterns were found, but there were some variations in time for attaining maximal flow rates. Maximal flow was at least 4 times greater following pilocarpine taking than the other drugs. In conclusion, pilocarpine was considered to be the most effective drug for increasing salivary flow.
