sialogogue

A sialogogue, or sialagogue, is a substance that stimulates the production and flow of saliva. The term combines the Latin word for saliva with a Greek root meaning to lead or stimulate. Sialogogues can be pharmacologic agents that act on the salivary glands or non-pharmacologic stimuli that trigger salivation, such as sour tastes or mastication.

Pharmacologic sialogogues work mainly via the parasympathetic nervous system, often by activating muscarinic acetylcholine receptors on salivary glands, particularly the M3 subtype. They are used to treat xerostomia (dry mouth) in conditions such as Sjögren’s syndrome or after radiotherapy to the head and neck. Non-pharmacologic sialogogues include gustatory stimuli such as sour candies or lemon juice and mechanical stimulation from chewing.

Medical uses and examples: Pharmacologic agents include pilocarpine and cevimeline, which can improve saliva production and patient comfort in dry mouth. Non-pharmacologic methods rely on taste and chewing to provoke salivation. Sialogogues may aid dental hygiene and swallowing, and in some cases digestion, by increasing saliva.

Safety and considerations: Because sialogogues increase cholinergic activity, they can cause sweating, flushing, increased salivation, abdominal cramps, nausea, and diarrhea. They may worsen bronchospasm in asthma or COPD and exacerbate peptic ulcers. Contraindications include uncontrolled asthma, significant bradycardia, or active peptic ulcers; drug interactions with anticholinergic medications or with agents that affect cholinergic signaling should be considered. Typical pharmacologic doses include pilocarpine and cevimeline regimens as prescribed by a clinician.