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Salivary substitutes in xerostomia: Insights into composition, lubrication mechanisms, and clinical utility – A narrative review.

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Title: Salivary substitutes in xerostomia: Insights into composition, lubrication mechanisms, and clinical utility – A narrative review.
Authors: Srishta, R. R. (AUTHOR), Sekar, Sneha (AUTHOR), Krishnaprakash, G. (AUTHOR), Siluvai, Sibyl (AUTHOR), Indumathi, K. P. (AUTHOR)
Source: Journal of Oral Research & Review. Jul-Dec2026, Vol. 18 Issue 2, p254-262. 9p.
Subjects: Artificial saliva, Lubrication & lubricants, Xerostomia, Oral mucosa, Treatment effectiveness, Mixtures
Abstract: Xerostomia is a widespread oral disorder characterized by reduced salivary secretion and altered salivary composition, leading to impaired oral comfort, mastication, speech, and quality of life. It often occurs after head-and-neck radiotherapy, systemic diseases, and long-term medication use. This narrative review objectively assesses the composition, physicochemical properties, lubrication mechanisms, and clinical effectiveness of salivary substitutes for the treatment of xerostomia. A narrative literature search was performed using the databases PubMed, Scopus, and Google Scholar to identify relevant clinical trials, experimental studies, and peer-reviewed papers published up to January 2026. Salivary substitutes vary widely in viscosity, osmolality, and active ingredients, including polymers based on cellulose, mucins, glycerol, hyaluronic acid, and enzyme-containing systems. Their modes of action encompass hydrodynamic lubrication, boundary lubrication, mucosal adhesion, and modification of the salivary conditioning film. Clinical evidence suggests that salivary substitutes provide consistent short-term symptomatic relief in patients with radiation-induced xerostomia and medication-related dry mouth. For denture wearers, improved wetness and lubrication of denture base materials help to improve the retention of the denture, its comfort, and oral function. Most currently available formulations offer only short-term symptomatic relief and do not fully mimic the complex biological composition and functions of natural saliva. Salivary substitutes remain an essential part of the treatment of xerostomia, but future research should focus on biomimetic formulations that provide sustained lubrication, improved retention, and biological properties. To support personalized, etiology-specific treatment strategies, well-designed clinical trials integrating objective tribological measurements with patient-reported outcomes are required. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Oral Research & Review is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Salivary substitutes in xerostomia: Insights into composition, lubrication mechanisms, and clinical utility – A narrative review.
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Oral+Research+%26+Review%22">Journal of Oral Research & Review</searchLink>. Jul-Dec2026, Vol. 18 Issue 2, p254-262. 9p.
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  Data: <searchLink fieldCode="DE" term="%22Artificial+saliva%22">Artificial saliva</searchLink><br /><searchLink fieldCode="DE" term="%22Lubrication+%26+lubricants%22">Lubrication & lubricants</searchLink><br /><searchLink fieldCode="DE" term="%22Xerostomia%22">Xerostomia</searchLink><br /><searchLink fieldCode="DE" term="%22Oral+mucosa%22">Oral mucosa</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Mixtures%22">Mixtures</searchLink>
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  Data: Xerostomia is a widespread oral disorder characterized by reduced salivary secretion and altered salivary composition, leading to impaired oral comfort, mastication, speech, and quality of life. It often occurs after head-and-neck radiotherapy, systemic diseases, and long-term medication use. This narrative review objectively assesses the composition, physicochemical properties, lubrication mechanisms, and clinical effectiveness of salivary substitutes for the treatment of xerostomia. A narrative literature search was performed using the databases PubMed, Scopus, and Google Scholar to identify relevant clinical trials, experimental studies, and peer-reviewed papers published up to January 2026. Salivary substitutes vary widely in viscosity, osmolality, and active ingredients, including polymers based on cellulose, mucins, glycerol, hyaluronic acid, and enzyme-containing systems. Their modes of action encompass hydrodynamic lubrication, boundary lubrication, mucosal adhesion, and modification of the salivary conditioning film. Clinical evidence suggests that salivary substitutes provide consistent short-term symptomatic relief in patients with radiation-induced xerostomia and medication-related dry mouth. For denture wearers, improved wetness and lubrication of denture base materials help to improve the retention of the denture, its comfort, and oral function. Most currently available formulations offer only short-term symptomatic relief and do not fully mimic the complex biological composition and functions of natural saliva. Salivary substitutes remain an essential part of the treatment of xerostomia, but future research should focus on biomimetic formulations that provide sustained lubrication, improved retention, and biological properties. To support personalized, etiology-specific treatment strategies, well-designed clinical trials integrating objective tribological measurements with patient-reported outcomes are required. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Journal of Oral Research & Review is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.4103/jorr.jorr_81_26
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        Text: English
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      – SubjectFull: Artificial saliva
        Type: general
      – SubjectFull: Lubrication & lubricants
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      – SubjectFull: Xerostomia
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      – SubjectFull: Oral mucosa
        Type: general
      – SubjectFull: Treatment effectiveness
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      – SubjectFull: Mixtures
        Type: general
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      – TitleFull: Salivary substitutes in xerostomia: Insights into composition, lubrication mechanisms, and clinical utility – A narrative review.
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            NameFull: Srishta, R. R.
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              Text: Jul-Dec2026
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              Y: 2026
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