How to: Deliver improved quality of life for patients with xerostomia

May 28, 2020
Joan Otomo-Corgel, D.D.S., MPH, FACD, FICD

Dr. Joan Otomo-Corgel is a graduate of UCLA School of Dentistry (DDS), UCLA School of Public Health (MPH), West Los Angeles VAMC General Practice, and Postdoctoral Periodontics Residencies. She is currently a Clinical Full Professor, UCLA School of Dentistry, Department of Orthodontics, and faculty at the Greater Los Angeles VA Health Care Center Dental Service. Dr. Otomo-Corgel is currently the president of the Los Angeles Dental Society, she also serves on the UCLA School of Dentistry Board of Counselors, the ADA Council on Dental Education and Licensure, the AAP CEOC and VQAC, and is a Director on the Board of the American Academy of Periodontology Foundation. She has been in private practice limited to periodontics and implantology in Los Angeles for over 3 decades.

Dental Products Report, Dental Products Report June 2020, Volume 54, Issue 6

GUM Hydral from Sunstar provides meaningful relief for dry mouth.

It has been reported that a high percentage of patients with xerostomia are not receiving help or are dissatisfied with their current dry mouth remedy.

This case series provides detailed reports on individual patients that summarize dry mouth symptoms and the study participants’ quality of life before and after the use of GUM® Hydral™ from Sunstar Americas, followed by an assessment of the possibility that the product will be a new advanced solution for patients with xerostomia.

In a recent study of seven patients with dry mouth symptoms, researchers examined how using GUM Hydral products from Sunstar affected participants’ quality of life.

GUM Hydral, approved by the Food and Drug Administration for dry mouth relief, contains a unique combination of ingredients that stimulate natural saliva. The products in this line, which also contain sugar-free sweeteners, offer lubrication, hydration, and electrolyte balance and create a protective film over the oral mucosa, providing moisturization with little irritation. Relief options include an anti-cavity toothpaste, an oral spray for on-the-go use, an oral rinse, and an oral gel for nighttime relief.

This article will highlight three of the seven participants in this study, most of whom experienced xerostomia caused by medications and/or medical conditions. Most of the patients received a diagnosis of xerostomia from their primary physician. The average age of the participants was  67-years-old, ranging from 51 to 79-years-old. All had been receiving periodontal maintenance.

The participants were asked to complete a 30-second rinse with 15 mL of the GUM Hydral Rinse up to five times a day for two weeks. They were asked to keep a diary and, after the two weeks, evaluate their quality of life, dry mouth relief, and other benefits.

Next, the participants were asked to place a half-inch length of the GUM Hydral Gel directly on the tongue and then spread it evenly inside the mouth. They were instructed to use the gel as needed for symptom relief, especially once before bedtime. This step was added to the rinsing routine for two weeks, after which participants again evaluated the effects.

All patients were directed to a visual analog scale (VAS) to rank their oral dryness on a 10 cm line, with 0 cm meaning “not dry at all” and 10 cm meaing “no saliva at all, extremly dry.” Participants also received oral exams throughout the study from dental professionals, recording objectcive parameters.

A 63-year-old woman had a medical history of hypothyroidism, cardiovascular issues, and angular cheilitis. Her prescribed medications included Lipitor (atorvastatin) and Synthroid (levothyroxine sodium tablets, USP), both of which, in addition to hypothyroidism, could contribute to xerostomia. The patient had previously used Biotene for dry mouth relief.

She used the GUM Hydral Rinse an average of three times a day and the gel once per day. This case successfully demonstrated symptom relief in subjective and objective evaluations.

  • Subjective: VAS improved from 8 to 7 after two weeks of using GUM Hydral Rinse and from 7 to 5 after another two weeks of using the rinse and the gel.

  • Objective: Examiners observed the functional improvement in oral mucosa throughout the duration of use. Prior to use, the oral mucosa was grade 2, with areas that were dry or had discoloration or coating. Days 14 to 28, the oral mucosa was grade 1, meaning the mucosa was pink and moist.1

The patient’s total score of oral health impact profile (OHIP)-14 decreased from 7 (of 56) to 2 after four weeks of using GUM Hydral products, indicating improved quality of life. She experienced outstanding improvement in painful aching in the mouth and long-lasting relief of several hours with the gel.

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A 69-year-old woman had a medical history of hypertension, thyroid issues, prediabetes, arthritis, depression, and allergies. Her medications included hydrochlorothiazide and aspirin. She had a 10-year history of xerostomia and previously used Biotene to treat dry mouth symptoms.

This participant used the GUM Hydral Rinse and/or the GUM Hydral Gel twice per day. This case also demonstrated symptom relief in subjective and objective evaluations.

  • Subjective: VAS improved from 7 to 0 after two weeks of using the rinse, and the relief was maintained after another two weeks of using the rinse and gel together.

  • Objective: Examiners observed functional improvement in tongue and saliva throughout the duration of use. Before her use of GUM Hydral products, the patient’s tongue was grade 2, with moderate papillae and dry coating. By days 14 to 28, her tongue improved to grade 1, and her saliva, which was grade 2 prior to use, also improved to grade 1.

 A 79-year-old man had a medical history of arthritis and cutaneous squamous cell carcinoma treated by laser. His medications included hydroxyzine, diclofenac, and famotidine. He had a 12-year history with xerostomia, although he stated that he had tried no other products to ease this condition.

This participant used the GUM Hydral Rinse an average of two times per day and the gel once per day. This case demonstrated successful symptom relief in subjective and objective evaluations.

  • Subjective: VAS was improved from 5 to 2.5 after four weeks of using Hydral products.

  • Objective: Examiners observed the functional improvement in lips, tongue and saliva throughout the duration of use. The lips, tongue, and saliva were all grade 2 prior to the use of GUM Hydral products. After two weeks, the lips improved to grade 1, but by day 28, the lips, tongue and saliva had all improved to grade 1.

The total OHIP score for this patient decreased from 11 to 2 after four weeks of using the GUM Hydral products, indicating an improved quality of life. Outstanding improvement was found in diet satisfaction (taste and swallowing) and self-consciousness. The patient also reported better sleep throughout the study period.


Overall, the majority of the patients who used the GUM Hydral Rinse and Gel reported improvement in their mouth moisturization and quality of life.

Most patients reported dry mouth relief after two weeks of using the rinse, and most also reported additional effectiveness after two weeks using the rinse and gel together.

Quality of life was also improved throughout the study period in the majority of patients. Some reported that applying the gel before going to bed reduced their waking up at night. In addition, dental professionals observed improvement in oral functions throughout the use period. The effectiveness was confirmed both objectively and subjectively.
This case report indicates that GUM Hydral products offer a new, effective solution for dry mouth symptoms in patients with xerostomia who are not satisfied with their current remedy.


1. Konradsen H, Trosborg I, Christensen L, Pedersen PU. Evaluation of interrater reliability assessing oral health in acute care settings. Int J Nurs Pract. 2014;20(3):258-264. doi:10.1111/ijn.12140

GUM Hydral Dry Mouth Relief

  • Works like natural saliva to provide relief

  • Gentle mint flavor that moisturizes and soothes

  • The rinse is suitable for daily use and provides relief up to four hours

  • Ideal for nighttime use, the gel moisturizes and lubricates the oral mucosa

Sunstar Americas, Inc.
800-528-8537  |

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