➤ Topical mucosal lubricants/saliva substitutes (agents directed at
ameliorating xerostomia and other salivary gland hypofunction-related
symptoms) may be offered to improve xerostomia induced by non-
surgical cancer therapies. (Strong recommendation; EB-I)
➤ Gustatory and masticatory salivary reflex stimulation by sugar-free
lozenges, acidic (non-erosive and sugar-free special preparation if
dentate patients) candies, or sugar-free, non-acidic chewing gum
may be offered to produce transitory increased saliva flow rate and
transitory relief from xerostomia by stimulating residual capacity of
salivary gland tissue. (Moderate recommendation; EB-I)
➤ Oral pilocarpine, and cevimeline where available, may be offered
post-radiation therapy in patients with head and neck cancer for
transitory improvement of xerostomia and salivary gland hypofunction
by stimulating residual capacity of salivary gland tissue. However,
improvement of salivary gland hypofunction may be limited. (Strong
recommendation; EB-H)
➤ Acupuncture may be offered post-radiation therapy in head and
neck cancer patients for improvement of xerostomia. (Weak
recommendation; EB-L)
➤ Transcutaneous electrostimulation or acupuncture-like transcutaneous
electrostimulation of the salivary glands may be offered post-radiation
therapy in head and neck cancer patients for improvement of salivary
gland hypofunction and xerostomia. (Weak recommendation; EB-L)
➤ Evidence remains insufficient for a recommendation for or against the
use of the following interventions for improvement of salivary gland
hypofunction and xerostomia: Extract of ginger and mesenchymal stem
cell therapy. (N-Ins)
Management
