Efficacy of gel-based artificial saliva on Candida colonization and saliva properties in xerostomic post-radiotherapy head and neck cancer patients: a randomized controlled trial

Objective To evaluate the efficacy of an edible artificial saliva gel, oral moisturizing jelly (OMJ), and a topical commercial gel (GC dry mouth gel) onCandidacolonization and saliva properties. Materials and methods This study was a secondary analysis of a single-blinded randomized controlled trial conducted in xerostomic post-radiotherapy head and neck cancer patients.Candidacolonization, stimulated salivary flow rate (SSFR), saliva pH, and buffering capacity (BC) were measured at 0, 1, and 2 months after each intervention.Candidacolonization was quantified by colony counts and species identified byCandidaChromagar, polymerase chain reaction, and API 20C AUX system. Statistical significance level was 0.05. Results A total of 56 participants in OMJ (N = 30) and GC (N = 26) groups completed the study. OMJ significantly increased saliva pH (p = 0.042) and BC (p = 0.013) after 1-month use, while GC only improved saliva pH (p = 0.027). Both interventions tended to increase SSFR but only GC had a significant increase at 2 months (p = 0.015). GC and OMJ significantly decreased the number ofCandidaspecies at 1 and 2 months, respectively. Both groups tended to reduceCandidacounts but not significant. Conclusions Both OMJ and GC saliva gels could improve saliva pH and decrease the number ofCandidaspecies. OMJ is superior to GC in its buffering capacity, while GC may better improve salivary flow rate. Long-term and large-scale study is warranted to test the efficacy of artificial saliva in oral health improvement. Trial registration number NCT03035825. Date of registration: 25th January 2017.

Automated summary

The study found that both oral moisturizing jelly (OMJ) and dry mouth gel (GC) can improve saliva pH and reduce the number of Candida species. OMJ is superior to GC in buffering capacity, while GC may be more effective in improving salivary flow rate.