sialogogues

Sialogogues are substances or stimuli that promote the production of saliva by the salivary glands. They are used to treat dry mouth (xerostomia), improve oral lubrication, and aid swallowing and digestion. Sialogogues can be categorized as gustatory or mechanical stimuli and as pharmacologic agents.

Gustatory and mechanical sialogogues include sour-tasting substances such as lemon juice or citric acid, as well as chewing gum or sour candies that elicit reflex saliva secretion. Physical stimulation from chewing also increases salivary flow.

Pharmacologic sialogogues are medications that activate the parasympathetic pathways to increase saliva. The main drugs are muscarinic receptor agonists, notably pilocarpine and cevimeline. They are prescribed for chronic dry mouth due to Sjögren's syndrome or radiation-induced damage to the salivary glands and are taken orally under medical supervision, with dosing tailored to the patient and condition.

Side effects and safety: Common adverse effects include sweating, flushing, abdominal cramps, nausea, lacrimation, and increased salivation. Pilocarpine can worsen bronchospasm and is contraindicated in patients with uncontrolled asthma or COPD and certain types of glaucoma; cevimeline has similar autonomic effects. Sialogogues may not address all causes of xerostomia and should be part of a broader management approach, including hydration, saliva substitutes, and good oral hygiene.