195 Preferences of Sjögren’s syndrome patients for saliva substitutes Table 5: Sjögren’s syndrome patients’ opinion regarding the preferred method of administration. Data are presented as percentages. Method of administration Percentage Mouth spray 45.5 Mouth gel 23.6 Oral rinse 23.6 Tablet 7.3 DISCUSSION The present study was designed to explore criteria for new saliva substitutes according to the preferences of Sjögren’s syndrome patients. The most ideal saliva substitute has thin-watery consistency in spray form, with a neutral flavour and providing a prolonged alleviation of dry mouth. Besides, it preferably should not contain artificial sweeteners or alcohol, and should not have a bitter taste and not cause discoloration of the teeth. Most of the respondents of the present study were female (98%) with average age of 55.7 ± 12.0 years and with severe dry-mouth complaints, as indicated by the high average XI score (47.0 ± 43.0–51.0). This overrepresentation is in line with the female to male ratio of Sjögren’s syndrome, which ranged between 20:1 and 9:1 [17]. The average age and the severity of oral dryness in the current study are also comparable with other studies that included Sjögren’s syndrome patients with dry-mouth complaints [7, 18]. The average age in these previous studies varied between 61.7 ± 14.0 and 64 ± 10 years. As for the severity of xerostomia, the mean XI scores in these previous studies were between 44.0 ± 37.0–49.8 and 45.0 ± 38.0–48.5 [7, 18]. In summary, this suggests that the respondents in the current study form a good representation of Sjögren’s syndrome patients in the Dutch population. Several systematic reviews have reported that the effectiveness of currently available saliva substitutes for the relief of dry mouth seems to be limited [4, 6, 19]. For this reason, in the present study the Sjögren’s syndrome patients indicated that prolonged alleviation of dry mouth is the most essential function of saliva substitutes. Unfortunately, most of the available saliva substitutes now provide only a temporary relief [9]; as the lubrication time of a typical saliva substitute, such as Dentaid Xeros, is around 0.5 min [9]. However, recently a promising new supercharged polypeptide-based salivary lubrication enhancer has been reported which could prolong the lubrication time up to 21 ± 7.3 min [9]. 9
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