Food Colloids and Bioprocessing Group, School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, UK.
School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, UK.
J Texture Stud. 2021 Apr;52(2):141-156. doi: 10.1111/jtxs.12575. Epub 2020 Dec 15.
The aim of this review is to assess the objective and subjective diagnosis, as well as symptomatic topical treatment of dry mouth conditions with a clear focus on textural perspective. We critically examine both the current practices as well as outline emerging possibilities in dry mouth diagnosis and treatment, including a patent scan for saliva substitutes. For diagnosis, salivary flow rates and patient-completed questionnaires have proven to be useful tools in clinical practice. To date, objective measurements of changes in mechanical properties of saliva via rheological, adsorption, and tribological measurements and biochemical properties of saliva such as assessing protein, mucins (MUC5B) are seldom incorporated into clinical diagnostics; these robust diagnostic tools have been largely restricted to application in non-clinical settings. As for symptomatic treatments of dry mouth, four key agents including lubricating, thickening, adhesive, and moisturizing agents have been identified covering the overall landscape of commercial saliva substitutes. Although thickening agents such as modified celluloses, polysaccharide gum, polyethylene glycol, and so forth are most commonly employed saliva substitutes, they offer short-lived relief from dry mouth and generally do not provide boundary lubrication properties of real human saliva. Innovative technologies such as self-assembly, emulsion, liposomes, and microgels are emerging as novel saliva substitutes hold promise for alternative approaches for efficient moistening and lubrication of the oral mucosa. Their adoption into clinical practice will depend on their efficacies, duration of relief, and ease of application by the practitioners and patient compliance.
本文旨在从质构学角度评估口干症的客观和主观诊断以及对症的局部治疗方法。我们批判性地审视了当前的实践方法，并概述了口干症诊断和治疗方面的新进展，包括对唾液替代品的专利扫描。对于诊断，唾液流量和患者完成的问卷调查已被证明是临床实践中的有用工具。迄今为止，通过流变学、吸附和摩擦学测量以及唾液生化特性（如评估蛋白质、粘蛋白（MUC5B））来客观测量唾液机械性能的变化很少被纳入临床诊断中；这些强大的诊断工具在很大程度上仅限于非临床环境中的应用。至于口干症的对症治疗，已经确定了包括润滑剂、增稠剂、黏附剂和保湿剂在内的四种关键药物，涵盖了商业唾液替代品的整体领域。虽然增稠剂（如改性纤维素、多糖胶、聚乙二醇等）是最常用的唾液替代品，但它们只能暂时缓解口干，通常不提供真正人类唾液的边界润滑性能。自组装、乳液、脂质体和微凝胶等创新技术作为新型唾液替代品正在出现，为口腔黏膜的高效湿润和润滑提供了替代方法。它们能否被采用到临床实践中，将取决于它们的疗效、缓解持续时间以及临床医生和患者的易用性和顺应性。
