Hedner_2001_Eur.J.Oral.Sci_109_371

A large number of the population especially the elderly suffers from dry mouth The aim of the present investigation was to stimulate the minor salivary glands by the topical application of the cholinesterase inhibitor physostigmine In eight healthy subjects 100 microl of the substance in the concentration interval 2-8 mg/ml was applied locally to the inside of the lower lip for 1 min In a separate study comprising 12 dry-mouth patients 10 ml of 0.4 1.6 mg/ml physostigmine was administered as a mouth rinse solution for 2 min Secretion from the labial glands assessed using the Periotron method increased in a dose-dependent manner in response to physostigmine in both groups Average peak secretion exceeded baseline by more than 50 throughout the 30 to 45-min observation period from 1.71 to 2.62 microl cm(-2 min(-1 among the healthy subjects and from 1.17 to 1.84 microl cm 2 min among the dry mouth patients No systemic effects were registered as reflected by ECG heart rate or blood pressure It is assumed that intraorally applied physostigmine diffuses through the oral mucosa and acts by preserving acetylcholine released from the cholinergic parasympathetic nerves that innervate the minor salivary glands The topical application of physostigmine to the oral mucosa may therefore be an interesting approach for the treatment of dry mouth