Soft Laser, Chewing Gum, and Citric Acid Effects on Salivation

Saliva is a complex biological fluid which maintains homeostasis of the oral cavity and keeps oral mucosa healthy. Reduced salivary flow has deleterious effects on oral health. It increases the risk of dental diseases like dental caries and periodontitis, and oral infections such as candidiasis. In healthy adults, average secretion of unstimulated saliva is 0,3-0,5 ml/ min, and for stimulated saliva 1,0-1,5 ml/min. Hyposalivation or xerostomia is defined as a decreased salivation with salivary flow rate lower than 0.1 ml/min for unstimulated and 0.5 ml/min for stimulated saliva. Etiology may vary: salivary gland disorders, side effects of numerous medications, systemic diseases, radiotherapy and chemotherapy, depression, alcohol consumption, drug abuse.

Aim of this research was to determine which intervention (laser, chewing gum or citric acid)  results in the greatest increase of salivation in tested groups.  

Method:

Research included 60 patients with diagnosis of hyposalivation, who were divided in 3 groups. Salivary flow rate was measured before and after intervention in every group. In first group we intervened with soft laser, chewing gum in the second group and citric acid in the third group.   

Result:

Quantum of salivation increased significantly in all experimental groups after intervention: laser (p<0.001), chewing gum (p<0.001) and citric acid (p<0.001), with effect sizes of 38.9%, 38.8% and 38.5%, respectively.

The quantum of salivation was significantly higher in the group that had been administered citric acid in comparison to the group that had been treated with laser, but not in comparison to the group that used chewing gum (p=0.002). Differences between the group with chewing gum and the group treated with laser were not statistically significant.

Conclusion:

The increase in salivary flow rate in patients with hyposalivation was greatest in patients treated with citric acid. However, all three interventions may be recommended and useful in everyday practice.