Malic Acid in Treatment of Xerostomia

Efficacy of Malic Acid Spray in Treatment of Xerostomia in Type II Diabetic Patients

Background: xerostomia is a subjective sensation of dry mouth resulting from quantitative and /or qualitative changes of saliva. Patients receiving drugs like antihypertensives and antidepressants or patients receiving chemotherapy or radiotherapy for treatment of head and neck cancers may suffer from xerostomia. It also can be experienced in patients with systemic diseases like diabetes mellitus, systemic lupus erythematosus, sjogren's syndrome and rheumatoid arthritis. Malic acid spray with concentration of 1% has grabbed the attention over the last few years as an effective treatment for xerostomia.

Study objective: To evaluate the effect of 1% malic acid spray in treatment of xerostomia in type 2 diabetic patients.

This randomized controlled clinical trial included 52 patients with type 2 diabetes mellitus suffering from xerostomia, divided equally into two groups. Group-I was managed by topical spray containing 1% malic. Group- II was managed by a placebo spray. Both groups received the treatment for 2 weeks. Dry mouth questionnaire scores (DMQ) and unstimulated salivary flow rate was collected before and after treatment.

Inclusion Criteria:

• Patients with type 2 diabetes mellitus suffering from xerostomia.
• Patients aged between 35 and 50 years old.
• Glycated hemoglobin less than 7% (28) .
• Duration of diabetes mellitus not less than 4 years and not more than 8 years.

Exclusion Criteria:

• Patients receiving any drugs that cause hyposalivation like anti-hypertensive drugs.
• Patients with any systemic disease reported to produce hyposalivation (sjogren's syndrome, hepatitis c, rheumatoid arthritis and lupus erythematosus) (8).
• Patients receiving chemo-therapy and radio-therapy.
• Mouth breathers.