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.
- 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
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).
- ACT Dry Mouth Soothing Mint Lozenge with Xylitol, 36 Count
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).
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.
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.
5. A.S Saliva Orthana 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+.
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
These will be subject to a separate review. Top picks for dry mouth alternatives to lozenges:
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.
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