Review of lozenges and sweets for dry mouth symtoms
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7 Best DRY MOUTH lozenges for saliva production

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The definition of dry mouth (medical term: xerostomia) is self-explanatory. Dry mouth may be experienced by anyone as one of the most common causes is dehydration. Many drugs can cause dry mouth. This side effect is sometimes associated with the whole class of medicines rather than a particular drug, making dry mouth management even more critical, as there may be little room for changing the medication. Saliva production is primarily driven by mechanical and gustatory (taste) stimulation (Dodds et al., 2015), making lozenges and sweets an appropriate choice in the management of dry mouth. In today’s post, I will review the best dry mouth lozenges for saliva production. I will mainly include the most popular and best-rated lozenges, which can be purchased on Amazon.co.uk. I will also list products which can be may be available to buy from the pharmacy.

Summary:

  • Causes of dry mouth
  • List of common drugs that cause dry mouth
  • Dry mouth – recommended treatment
  • Do I need a prescription for dry mouth lozenges? 
  • Best dry mouth lozenges
  • Where to buy dry mouth lozenges from?
  • Alternatives products to manage dry mouth

Causes of dry mouth

One of the most common reasons for dry mouth is dehydration. Other common reasons for dry mouth include:

  • Taking certain drugs (see the next paragraph)
  • Treatment, for example, chemotherapy and radiotherapy
  • Underlying conditions, for example, diabetes or Sjögren’s syndrome
  • Smoking
  • Drinking

List of common drugs that cause dry mouth

Dry mouth can be associated with taking a single drug or a whole class of drugs, for example, an antidepressant. Individuals who take two or more drugs, which cause dry mouth may be at higher risk of developing dry mouth symptoms. 

Common drugs that can cause dry mouth include (non-exhaustive list):

  • Antidepressants (for example, tricyclic antidepressants)
  • Antihistamines (for example, cetirizine and other over the counter antihistamines)
  • Anticholinergic drugs (for example, hyoscine), including Parkinson’s Disease medications
  • Decongestants (for example, pseudoephedrine)
  • Diuretics (high blood pressure medication) and ACE inhibitors such as ramipril (high blood pressure)
  • Painkillers (for instance, co-codamol, codeine and other opioids)

Dry mouth – recommended treatment

Simple measures to increase saliva flow are at the centre of dry mouth management. Saliva production and the management of dry mouth may include:  

  • Drinking water frequently and avoiding the dehydration
  • Sucking on the ice cubs or ice lollies
  • Use of saliva stimulating products such as sugar-free chewing gums, pastilles and lozenges.

Patients should avoid using glycerin and lemon juice, which dehydrate the mouth and cause exhaustion of salivary secretions (NICE, 2018).

The National Institute for Health and Care Excellence (NICE) recommends using topical saliva stimulants or topical artificial saliva substitutes if, above, simple measures fail to control dry mouth symptoms.

Do I need a prescription for dry mouth lozenges?

All dry mouth lozenges can be purchased over the counter from pharmacies, supermarkets (ordinary lozenges) and online. 

Specific brands of dry mouth lozenges are only available from behind a pharmacy counter, in the dispensary, where drugs and medicines and other items are stock as a part of dispensing stock. Saliva stimulants and other topical artificial saliva products usually do not contain active ingredients, and thus there are no restrictions on their supply (ibid).

Lozenges are occasionally prescribed in the community to manage symptoms of dry mouth. Generally, sweets and other products for the management of dry mouth are nowadays less commonly prescribed due to their availability over the counter without a prescription.

Saliva producing lozenges

1. ACT dry mouth lozenges (sugar-free)

ACT Dry Mouth Lozenges are one of the most popular and most reviewed product on Amazon.co.uk. ACT Dry mouth lozenges are sugar-free and contain xylitol as a sugar substitute. Topical dry mouth products containing xylitol are safe and effective in relieving the symptoms of dry mouth (Ship et al., 2007).

2. The Breath Co Dry Mouth lozenges

The Breath Co Dry Mouth lozenges are another popular and positively reviewed product on Amazon.co.uk. Apart from ‘natural’ ingredients, The Breath Co contain zinc. Product description advices that zinc is added to help with mouth dryness and bad breath.

Zinc is incorporated in many oral products to control the plaque and possibly to reduce enamel demineralisation and modify remineralisation (Lynch, 2011). The addition of zinc in oral products has shown to reduce the growth of some bacteria (Almoudi et al., 2018). There is some evidence which confirms that zinc-containing oral rinse increases salivary secretions (Kim et al., 2019). 

The Breath Co Dry Mouth lozenges
99 Reviews
The Breath Co Dry Mouth lozenges Mandarin Mint 100 Pieces
  • A NOTE ON ZINC: These lozenges are designed to help with mouth dryness and halitosis. Each lozenge is supplemented with 3mg of zinc for this specific purpose. Any use outside of this indication is at the user’s discretion. We do not claim or suggest any additional benefit.
  • SOOTHES DRY MOUTH SYMPTOMS INSTANTLY: The proprietary blend of natural flavours and healthy ingredients acts quickly to relieve symptoms associated with dry mouth. It also helps to relieve symptoms associated with Sjögren’s Syndrome.
  • ENHANCE SALIVA PRODUCTION: The Breath Co Dry Mouth Lozenges increase and enhance the natural production of saliva, which reduces the symptoms that can cause dry mouth.

3. Salivix dry mouth relief pastilles

Salivix pastilles are occasionally prescribed in the community as Artificial Saliva Pastilles. Salivix pastilles are sugar-free and do not contain any active ingredients. Salivix pastilles are used to manage dry mouth symptoms when they happen. Salivix is one of few brands included in NICE’s guide on the management of dry mouth, hence GPs occasionally prescribe or recommend them to patients.

Sale
Salivix dry mouth lozenges
154 Reviews
Salivix dry mouth pastilles 50 pack
  • Can be used for any dry mouth condition
  • Helps if other medication causes dry mouth
  • Stimulates your own saliva production

4. Salivix Plus lozenges

Salivix Plus pastilles contain fluoride additionally as an active ingredient. Fluoride is used to strengthen enamel (teeth), which offers additional benefit from the use.

Sale
Salivix Plus Dry Mouth sweets
77 Reviews

5. A.S Saliva Orthana Lozenges

Are AS Saliva Orthana best dry mouth lozenges?

A.S Saliva Orthana Lozenges are also on the list of products recommended in NICE’s guide in the management of dry mouth symptoms.

A.S Saliva Orthana Lozenges can be used for long-term relief of dry mouth, often to control the symptoms overnight. Two ingredients that mimic the saliva are mucin and xylitol.

Mucin has similar flow properties as saliva when a lubricating layer is formed (Łysik et al., 2019). Additionally, mucin has good mucoadhesive properties – an attractive force between the mucus membrane and lubricating layer. 

Xylitol is a type of sweetener which increases the production of saliva. 

Where to buy A.S Saliva Orthana Lozenges from?

At present A.S Saliva Orthana Lozenges are not available on Amazon.co.uk. Alternatively, it is possible to order A.S Saliva Orthana Oral Moisturising Saliva Substitute.

It is unlikely that a pharmacy keeps A.S Saliva Orthana Lozenges in stock. It is possible to ask a pharmacy team to order products on an individual basis from the leading pharmaceutical suppliers for the same or next day delivery. To ease the process, you may provide the pharmacy with the following PIP code: 014-014.

6. OraCoat XyliMelts for dry mouth

XyliMelts Mint-Free are strictly not lozenges, but they are worth mentioning due to the interesting form. XyliMelts come in the form of discs, which are placed between the gum and the cheek. XyliMelts stimulate saliva production, moisturise and creates coating for many hours; thus, they are suitable for use overnight. XyliMelts can also be used to manage dry mouth during the day.

7. HAp+ Saliva producing lozenges

HAp+ Dry Mouth Drops are sugar and lactose-free vegan lozenges, which come in a range of different flavours. It is stated in the actual description of the product that HAp+ Dry Mouth Drops increase the production of saliva ‘20 times‘ and that it is three times more effective than chewing gum.

There is some research supporting the effectiveness of HAp+ lozenges; however, it is not produced independently but by the scientist who developed Hap+.

HAp+ Dry Mouth Drops for dry mouth
131 Reviews
HAp+ Dry Mouth Drops - 16 Strawberry & Rhubarb Flavoured Lozenges - Mouth Watering, Vegan, and Sugar Free - Maintains Healthy Teeth - Blister Pack - New Packaging (Strawberry & Rhubarb)
  • Powerful Saliva Stimulant with Calcium - effective relief for dry mouth symptoms
  • Stimulates 20x the unstimulated saliva
  • 3x times as effective as chewing gum

Alternatives to dry mouth sweets for saliva production

Other popular types of products which can be used to manage dry mouth include:

  • chewing gums
  • dry mouth sprays
  • moisturising gels and
  • mouthwashes.

These will be subject to a separate review. Top picks for dry mouth alternatives to lozenges:

Biotene Dry Mouth Moisturising Gel – saliva replacement
1,738 Reviews
Biotene, Dry Mouth Moisturising Gel, Other, 50 g
  • Saliva replacement gel
  • Clinically tested to provide up to four hours dry mouth relief
  • Biotene contains a mouth-moisturising system to help relieve oral dryness

Biotene Mouth Spray – dry mouth spray
79 Reviews

Conclusion

There is no single evidence to suggest that one of the products listed in this post is the best for the management of dry mouth. ACT saliva stimulating lozenges have the best and overall highest number of reviews on Amazon.co.uk Stimulation of saliva can be achieved by using various lozenges, sweets and products. The best approach to managing dry mouth with lozenges would be trying different product to see which one works and tastes the best. For example, the use of more than two products, such as lozenges and mouth gels or chewings gums, is a reasonable approach.

References

Almoudi MM, Hussein AS, Abu Hassan MI, Mohamad Zain N (2018). A systematic review on antibacterial activity of zinc against Streptococcus mutans. Saudi Dent J. 2018;30(4):283-291. doi:10.1016/j.sdentj.2018.06.003 Available at: https://dx.doi.org/10.1016%2Fj.sdentj.2018.06.003 Accessed on 10/03/2021

Dodds, M., Roland, S., Edgar, M. et al. Saliva A review of its role in maintaining oral health and preventing dental disease. BDJ Team 2, 15123 (2015). Available at:  https://doi.org/10.1038/bdjteam.2015.123 Accessed on 11/03/2021

Kim, YJ., Jo, Y., Lee, YH. et al. Zn2+ stimulates salivary secretions via metabotropic zinc receptor ZnR/GPR39 in human salivary gland cells. Sci Rep 9, 17648 (2019). https://doi.org/10.1038/s41598-019-54173-3 Available at: https://doi.org/10.1038/s41598-019-54173-3 Accessed on 10/03/2029

Łysik D, Niemirowicz-Laskowska K, Bucki R, Tokajuk G, Mystkowska J. Artificial Saliva: Challenges and Future Perspectives for the Treatment of Xerostomia. Int J Mol Sci. 2019;20(13):3199. Published 2019 Jun 29. doi:10.3390/ijms20133199 Available at:  https://dx.doi.org/10.3390%2Fijms20133199 Accessed on 09/03/2020

Lynch RJ. Zinc in the mouth, its interactions with dental enamel and possible effects on caries; a review of the literature. Int Dent J. 2011 Aug;61 Suppl 3:46-54. doi: 10.1111/j.1875-595X.2011.00049.x. PMID: 21762155. Available at: https://doi.org/10.1111/j.1875-595x.2011.00049.x Accessed on 10/03/2021

 NICE (2018). Scenario: Dry mouth. Available at: https://cks.nice.org.uk/topics/palliative-care-oral/management/dry-mouth/ Accessed on 09/03/2021

Ship JA, McCutcheon JA, Spivakovsky S, Kerr AR (2007). Safety and effectiveness of topical dry mouth products containing olive oil, betaine, and xylitol in reducing xerostomia for polypharmacy-induced dry mouth. J Oral Rehabil. 2007 Oct;34(10):724-32. doi: 10.1111/j.1365-2842.2006.01718.x. PMID: 17824884. Available at: https://doi.org/10.1111/j.1365-2842.2006.01718.x Accessed on 09/03/2021

 

 

I am a community pharmacist working in UK. I blog about drugs, health and pharmacy.

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