Current approaches to the selection of oral hygiene products for patients with periodontitis and xerostomia

Relevance. Xerostomia is a pathological condition that accelerates biofilm formation, promotes the growth of pathogenic microflora, and slows periodontal tissue regeneration. Various oral hygiene products have been proposed for the prevention and management of xerostomia, including toothpaste formulated with Mucosa Protection Pro System (MPPS) technology, which helps maintain mucosal hydration, gently stimulate salivary flow, and reduce pathogenic bacterial adhesion. Objective: To comparatively evaluate the clinical efficacy of incorporating MPPS-based oral hygiene products into an individualized oral hygiene protocol for patients with xerostomia associated with periodontitis.

Materials and methods. A total of 143 patients aged 35–72 years with periodontitis were evaluated using questionnaires, clinical and anamnestic assessment, and salivary flow measurement according to the method of M. Pozharitskaya. Oral hygiene status was assessed using the OHI-S and PHP indices at baseline and at 1 and 3 months. In the second stage, the efficacy of comprehensive therapy was evaluated in patients with periodontitis and xerostomia who were randomly assigned either to the main group, whose oral hygiene regimen included MPPS-based toothpaste, or to the control group. Statistical analysis was performed using IBM SPSS Statistics 20. Quantitative variables are presented as mean ± standard error of the mean (M ± m). The significance of betweengroup differences was assessed according to data distribution: Student’s t test was used for normally distributed variables, whereas the Mann–Whitney U test was applied otherwise. Differences were considered statistically significant at p < 0.05.

Results. Signs of xerostomia were identified by sialometry in 61 of the 143 patients examined. The mean unstimulated whole salivary flow rate was 0.170 ± 0.011 mL/min. In patients with chronic generalized periodontitis and xerostomia, follow-up assessment showed that inclusion of MPPS-based oral hygiene products in the individualized oral hygiene regimen was associated with improved oral hygiene status and increased salivary flow. In the main group, by month 3 the mean whole salivary flow rate had reached normal values, increasing from 0.210 ± 0.008 mL/min at baseline to 0.360 ± 0.009 mL/min, whereas in the control group it remained unchanged at 0.210 ± 0.008 mL/min.

Conclusion. Xerostomia in patients with periodontitis is a clinically significant condition requiring targeted management. Comprehensive periodontal therapy combined with measures aimed at correcting xerostomia and individualized selection of oral hygiene products contributes to stabilization of the periodontal condition and improvement in patients’ quality of life.

1. Chirkova K.E., Leshcheva E.A., Orekhova L.Yu., Vecherkina Zh.V., Kuchumova E.D., Savelyeva I.V. The problem of xerostomia in modern dentistry and features of its clinical manifestations. Sistemnyj analiz i upravlenie v biomedicinskih sistemah. 2024;23(2):83-89 (In Russ.). https://doi.org/10.36622/1682-6523.2024.23.2.012

2. Morozova S.V., Mejtel' I.Yu. Xerostomia: reasons and methods of correction. Meditsinskiy sovet = Medical Council (In Russ.). https://doi.org/10.21518/2079-701X-2016-18-124-127

3. Arakelyan M.G. Tambovceva N.V., Arzukanyan A.V. The main causes and clinical manifestations of xerostomia. Russian Journal of Dentistry. 2016;20(2):74-78 (In Russ.). http://dx.doi.org/10.18821/1728-2802

4. Tarasova Y.G., Dmitrakova N.R., Zlobina O.A., Subbotina A.V. Prevalence and risk factors of xerostomia at the dentist-therapist’s appointment. The Dental Institute. 2023;(1):(98):67-69 (In Russ.). Available from: https://www.elibrary.ru/item.asp?id=50522421

5. Gileva O.S., Smirnova E.N., Pozdnyakova A.A., Libik T.V. Hallmarks of diagnosis and treatment of xerostomia syndrome in patients with periodontal and oral mucosal diseases and diabetes mellitus type 2. Russian Medical Inquiry. 2016;20:1340–1345 (In Russ.). Available from: https://www.rmj.ru/articles/endokrinologiya/Osobennosti_diagnostiki_i_lecheniya_kserostomicheskogo_sindroma_pri_zabolevaniyah_parodonta_i_slizistoy_obolochki_polosti_rta_u_pacientov_s_saharnym_diabetom_2-go_tipa/

6. Elovikova T.M., Sablina S.N., Grigoriev S.S., Mandra Y.V., Karaseva V.V., Zhegalina N.M., et al. Clinical evaluation of xerostomia manifestations in women with chronic periodontitis and reduced bone mineral density. Actual Problems in Dentistry. 2024;20(3):61-66 (In Russ.). http://dx.doi.org/10.18481/2077-7566-2024-20-3-61-66

7. Tanasiewicz M, Hildebrandt T, Obersztyn I. Xerostomia of Various Etiologies: A Review of the Literature. Advances in Clinical and Experimental Medicine. 2016;25(1):199-206. http://dx.doi.org/10.17219/acem/29375.

8. Izrailov A.M., Antonova I.N. Modern approaches to the diagnosis of xerostomia. Parodontologiya. 2023;28(3):235-246 (In Russ.). https://doi.org/10.33925/1683-3759-2023-797.

9. Jalaawi W, Selmi J, Bouguezzi A, Farhan H. Prevalence of Xerostomia and Associated Risks Factors Among Medically Compromised Persons. J Nat Sc Biol Med. 2024;15(1):15-27. https://doi.org/10.4103/jnsbm.JNSBM_15_1_2

10. Kuletskaya K., Tikhomirova E.A., Slazhneva E.S., Atrushkevich V.G. Xerostomia in patients with diabetes mellitus (pilot study). Pediatric dentistry and dental prophylaxis. 2022;22(4):282-290 (In Russ.). https://doi.org/10.33925/1683-3031-2022-22-4-282-290

11. Molania T, Salehi M, Ehsani H, Moosazadeh M, Niksolat F, Rezaei A, et al. Comparison of periodontal indices, DMFT, xerostomia, hyposalivation and oral health-related quality of life in Sjögren's syndrome patients versus healthy individuals: A case-control study. Dent Med Probl. 2023;60(1):99-107. https://doi.org/10.17219/dmp/146771.

12. Makeeva I.M., Volkov A.G., Arakelian M.G., Makarenko N.V. Factors aggravating symptoms of xerostomia. Stomatology. 2017;96(1):25 27 (In Russ.). https://doi.org/10.17116/stomat201796125-27

13. Orlova S.E., Ivanova V.A., Degtev I.A., Arykova L.K., Borisov V.V., Yershov K.A. Sialometry as a method for diagnosing xerostomia and evaluating secretory function (review article). Journal of New Medical Technologies. 2021;15(4):52-57 (In Russ.). https://doi.org/10.24412/2075-4094-2021-4-1-9

14. Babayiğit O, Ögütcen Ö, Özkan Şen D, Taştan Eroğlu Z, Uçan Yarkaç F. The relationship between xerostomia and periodontal status in patients with cardiovascular diseases and type 2 diabetes. Int Dent Res. 2024; 14(S1):21-27. https://doi.org/10.5577/indentres.556

15. Sabirova A.I., Karshina O.O., Sabirov I.S. Cardiovascular profile drugs and the state of periodontal tissues. Meditsinskiy sovet = Medical Council. 2024;(16):317- 324 (In Russ.). https://doi.org/10.21518/ms2024-369

16. Мakhovaya E.S., Ilyicheva V.M., Suleymanova M.F., Miklyaev S.V. Oral health status in individuals with poly-tobacco use. Parodontologiya. 2025;30(3):311- 320 (In Russ.) doi.org/10.33925/1683-3759-2025-104059-2025-1040