Year 2014,
Volume: 31 Issue: 1, 54 - 60, 25.02.2014
İsmail Akkaş
,
Orçun Toptaş
Fatih Özan
Abstract
Saliva is an important body fluid that helps in digestion of food and facilitation of speech and swallowing, and protects the oral tissues by its antimicrobial and lubricating properties. Subjective oral dryness, or xerostomia, is usually associated with a decreased salivary flow rate (hyposalivation) or psychological factors. The common causes of reduction in salivary flow rates are dehydration, medications, head and neck radiotherapy, and specific diseases. The patient with xerostomia who has salivary gland hypofunction is at risk for many oral complications and it is critical to institute appropriate symptomatic treatment and preventive measures. This paper has reviewed evaluation methods of xerostomia and practical and contemporary measures for management of the patients with dry mouth.
References
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- Fox PC. Differentiation of dry mouth etiology. Adv Dent Res 1996;10:13-6.
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- Dawes C. Physiological factors affecting salivary flow rate, oral sugar clearance, and the sensation of dry mouth in man. J Dent Res 1987;66 Spec No:648-53.
- Percival RS, Challacombe SJ, Marsh PD. Flow rates of resting whole and stimulated parotid saliva in relation to age and gender. J Dent Res 1994;73:1416-20.
- Mercadante S, Calderone L, Villari P, Serretta R, Sapio M, Casuccio A, et al. The use of pilocarpine in opioid-induced xerostomia. Palliat Med 2000;14:529-31.
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- Su N, Marek CL, Ching V, Grushka M. Caries prevention for patients with dry mouth. J Can Dent Assoc 2011;77:b85.
- Peterson DE. Oral problems in supportive care: no longer an orphan topic? Support Care Cancer 2000;8:347-8.
- Narhi TO. Prevalence of subjective feelings of dry mouth in the elderly. J Dent Res 1994;73:20-5.
- Orellana MF, Lagravère MO, Boychuk DG, Major PW, Flores-Mir C. Prevalence of xerostomia in population-based samples: a systematic review. J Public Health Dent 2006;66:152-8.
- Davies AN, Singer J. A comparison of artificial saliva and pilocarpine in radiation-induced xerostomia. J Laryngol Otol 1994;108:663-5.
- Nagler RM, Gez E, Rubinov R, Laufer D, Ben-Aryeh H, Gaitini D, et al. The effect of low-dose interleukin-2-based immunotherapy on salivary function and composition in patients with metastatic renal cell carcinoma. Arch Oral Biol 2001;46:487-93.
- Schiodt M. HIV-associated salivary gland disease: a review. Oral Surg Oral Med Oral Pathol 1992;73:164-7.
- Chambers MS, Toth BB, Martin JW, Fleming TJ, Lemon JC. Oral and dental management of the cancer patient: prevention and treatment of complications. Support Care Cancer 1995;3:168-75.
- Chambers MS, Garden AS, Kies MS, Martin JW. Radiation-induced xerostomia in patients with head and neck cancer: pathogenesis, impact on quality of life, and management. Head Neck 2004;26:796-807.
- Guggenheimer J, Moore PA. Xerostomia: etiology, recognition and treatment. J Am Dent Assoc 2003;134:61-9.
- Ciancio SG. Medications' impact on oral health. J Am Dent Assoc 2004;135:1440-8.
- Sreebny LM, Schwartz SS. A reference guide to drugs and dry mouth--2nd edition. Gerodontology 1997;14:33-47.
- Abebe W. An overview of herbal supplement utilization with particular emphasis on possible interactions with dental drugs and oral manifestations. J Dent Hyg 2003;77:37-46.
- Epstein JB, Stevenson-Moore P, Scully C. Management of xerostomia. J Can Dent Assoc 1992;58:140-3.
- Epstein JB, van der Meij EH, Lunn R, Stevenson-Moore P. Effects of compliance with fluoride gel application on caries and caries risk in patients after radiation therapy for head and neck cancer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:268-75.
- Leek H, Albertsson M. Pilocarpine treatment of xerostomia in head and neck patients. Micron 2002;33:153-5.
- Reddy SP, Leman CR, Marks JE, Emami B. Parotid-sparing irradiation for cancer of the oral cavity: maintenance of oral nutrition and body weight by preserving parotid function. Am J Clin Oncol 2001;24:341-6.
- Eisbruch A, Kim HM, Terrell JE, Marsh LH, Dawson LA, Ship JA. Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer. Int J Radiat Oncol Biol Phys 2001;50:695-704.
- Berger AM, Kilroy TJ. Oral complications of cancer therapy. Berger AM, Portenoy RK, Weissman DE, eds. Principles and Practice of Supportive Oncology. 1st edn. Philadelphia: Lippincott-Raven Publishers; 1998. p. 223-36.
- von Bültzingslöwen I, Sollecito TP, Fox PC, Daniels T, Jonsson R, Lockhart PB, et al. Salivary dysfunction associated with systemic diseases: systematic review and clinical management recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103 Suppl:S57 e1-15.
- Kassan SS, Moutsopoulos HM. Clinical manifestations and early diagnosis of Sjögren syndrome. Arch Intern Med 2004;164:1275-84.
- Hattori T, Wang PL. Calcium antagonists cause dry mouth by inhibiting resting saliva secretion. Life Sci 2007;81:683-90.
- Ogawa Y, Kuwana M. Dry eye as a major complication associated with chronic graft-versus-host disease after hematopoietic stem cell transplantation. Cornea 2003;22(7 Suppl):S19-27.
- Ogawa Y, Kuwana M, Yamazaki K, Mashima Y, Okamoto S, Tsubota K, et al. Dry eye associated with chronic graft-versus-host disease. Adv Exp Med Biol 2002;506(Pt B):1041-5.
- Davis PB. Pathophysiology of cystic fibrosis with emphasis on salivary gland involvement. J Dent Res 1987;66 Spec No:667-71.
- Livnat G, Bentur L, Kuzmisnsky E, Nagler RM. Salivary profile and oxidative stress in children and adolescents with cystic fibrosis. J Oral Pathol Med 2010;39:16-21.
- Harvey J, Catoggio L, Gallagher PJ, Maddison PJ. Salivary gland biopsy in sarcoidosis. Sarcoidosis 1989;6:47-50.
- Sagowski C, Ussmüller J. Clinical diagnosis of salivary gland sarcoidosis (Heerfordt syndrome). HNO 2000;48:613-5.
- Vairaktaris E, Vassiliou S, Yapijakis C, Papakosta V, Kavantzas N, Martis C, et al. Salivary gland manifestations of sarcoidosis: report of three cases. J Oral Maxillofac Surg 2005;63:1016-21.
- Ataman M, Sözeri B, Ozçelik T, Gedikoglu G. Tuberculosis of the parotid salivary gland. Auris Nasus Larynx 1992;19:271-3.
- Kim YH, Jeong WJ, Jung KY, Sung MW, Kim KH, Kim CS. Diagnosis of major salivary gland tuberculosis: experience of eight cases and review of the literature. Acta Otolaryngol 2005;125:1318-22.
- Tauro LF, George C, Kamath A, Swethadri G, Gatty R. Primary tuberculosis of submandibular salivary gland. J Glob Infect Dis 2011;3:82-5.
- Jeffers L, Webster-Cyriaque JY. Viruses and salivary gland disease (SGD): lessons from HIV SGD. Adv Dent Res 2011;23:79-83.
- Pinto A, De Rossi SS. Salivary gland disease in pediatric HIV patients: an update. J Dent Child (Chic) 2004;71:33-7.
- Shanti RM, Aziz SR. HIV-associated salivary gland disease. Oral Maxillofac Surg Clin North Am 2009;21:339-43.
- Dodds MW, Johnson DA, Yeh CK. Health benefits of saliva: a review. J Dent 2005;33:223-33.
- Akarslan Z, Can E, Alasya D, Güngör K. Xerostomia semptomları ve tükürük akış hızı arasındaki ilişkinin değerlendirilmesi. GÜ Diş Hek Fak Derg 2003;20:5-8.
- Navazesh M. Methods for collecting saliva. Ann N Y Acad Sci 1993;694:72-7.
- Sreebny L. Saliva--salivary gland hypofunction (SGH). FDI Working Group 10. J Dent Assoc S Afr 1992;47:498-501.
- Erlichman M. Patient selection criteria for electrostimulation of salivary production in the treatment of xerostomia secondary to Sjögren's syndrome. Health Technol Assess Rep 1990:1-7.
- Porter R. The Merck Manual. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2004.
- Baur DA, Heston TF, Helman JI. Nuclear medicine in oral and maxillofacial diagnosis: a review for the practicing dental professional. J Contemp Dent Pract 2004;5:94-104.
- Thoeny HC. Imaging of salivary gland tumours. Cancer Imaging 2007;7:52-62.
- Fox PC. Xerostomia: recognition and management. Dent Assist 2008;77:18, 20, 44-8.
- Tazegül S, Bodrumlu E, Erten H, Erten D, Kasap R. Kalsiyum fosfat içerikli çikletlerin tükürük kalsiyum ve fosfat konsantrasyonları ile tükürük pH ve akış hızına etkileri. GÜ Diş Hek Fak Derg 2004;21:1-5.
- Braga FP, Sugaya NN, Hirota SK, Weinfeld I, Magalhaes MH, Migliari DA. The effect of acupuncture on salivary flow rates in patients with radiation-induced xerostomia. Minerva Stomatol 2008;57:343-8.
- Cummins MJ, Papas A, Kammer GM, Fox PC. Treatment of primary Sjögren's syndrome with low-dose human interferon alfa administered by the oromucosal route: combined phase III results. Arthritis Rheum 2003;49:585-93.
- Ship JA, Fox PC, Michalek JE, Cummins MJ, Richards AB. Treatment of primary Sjögren's syndrome with low-dose natural human interferonalpha administered by the oral mucosal route: a phase II clinical trial. IFN Protocol Study Group. J Interferon Cytokine Res 1999;19:943-51.
- Fife RS, Chase WF, Dore RK, Wiesenhutter CW, Lockhart PB, Tindall E, et al. Cevimeline for the treatment of xerostomia in patients with Sjögren syndrome: a randomized trial. Arch Intern Med 2002;162:1293-300.
- Petrone D, Condemi JJ, Fife R, Gluck O, Cohen S, Dalgin P. A double-blind, randomized, placebo-controlled study of cevimeline in Sjögren's syndrome patients with xerostomia and keratoconjunctivitis sicca. Arthritis Rheum 2002;46:748-54.
- Vivino FB, Al-Hashimi I, Khan Z, LeVeque FG, Salisbury PL 3rd, Tran-Johnson TK, et al. Pilocarpine tablets for the treatment of dry mouth and dry eye symptoms in patients with Sjögren syndrome: a randomized, placebo-controlled, fixed-dose, multicenter trial. P92-01 Study Group. Arch Intern Med 1999;159:174-81.
- Nin T, Umemoto M, Negoro A, Miuchi S, Sakagami M. Nizatidine enhances salivary secretion in patients with dry mouth. Auris Nasus Larynx 2008;35:224-9.
- Ogawa T, Takada K, Sato Y, Chiba H. The influence of causes of hyposalivation on clinical outcome of nizatidine in patients with dry mouth. Asian Journal of Oral and Maxillofacial Surgery 2010;22:68-73.
- Ueki S, Seiki M, Yoneta T, Aita H, Chaki K, Hori Y, et al. Gastroprokinetic activity of nizatidine, a new H2-receptor antagonist, and its possible mechanism of action in dogs and rats. J Pharmacol Exp Ther 1993;264:152-7.
- Adachi K, Furuta K, Katsube T, Fujisawa T, Azumi T, Fujishiro H, et al. Nizatidine and cisapride increase salivary secretion in rats. Dig Dis Sci 2004;49:399-403.
- Adachi K, Ono M, Kawamura A, Yuki M, Fujishiro H, Kinoshita Y. Nizatidine and cisapride enhance salivary secretion in humans. Aliment Pharmacol Ther 2002;16:297-301.
Year 2014,
Volume: 31 Issue: 1, 54 - 60, 25.02.2014
İsmail Akkaş
,
Orçun Toptaş
Fatih Özan
Abstract
Tükürük, sindirim, konuşma ve yutma işlemlerinin kolaylaştırılması ve antimikrobiyal ve kayganlaştırıcı etkisi ile oral dokuların korunmasında görev alan önemli bir vücut sıvısıdır. Subjektif ağız kuruluğu veya kserostomi genellikle azalmış tükürük akımı ve daha nadir olarak da psikolojik faktörler ile alakalıdır. Tükürük akımının azalmasına neden olan başlıca sebepler dehidratasyon, bazı ilaçlar, baş ve boyun bölgesine uygulanan radyoterapi ve Sjögren sendromu gibi bazı özel sistemik hastalıklardır. Tükürük bezi hipofonksiyonuna sahip hastalar birçok oral patoloji yönünden risk altındadırlar ve uygun semptomatik ve önleyici yaklaşımlar ile tedavi edilmeleri önemlidir. Bu makalede ağız kuruluğunun değerlendirilmesi, semptomların giderilmesi ve önlenmesi güncel literatürler eşliğinde anlatılmaktadır.
References
- Myers N, Ferris R. Salivary Gland Disorders. 1st edn. New York: Springer; 2007.
- Fox PC. Differentiation of dry mouth etiology. Adv Dent Res 1996;10:13-6.
- Chambers MS. Sjögren's syndrome. ORL Head Neck Nurs 2004;22:22-30.
- Dawes C. Physiological factors affecting salivary flow rate, oral sugar clearance, and the sensation of dry mouth in man. J Dent Res 1987;66 Spec No:648-53.
- Percival RS, Challacombe SJ, Marsh PD. Flow rates of resting whole and stimulated parotid saliva in relation to age and gender. J Dent Res 1994;73:1416-20.
- Mercadante S, Calderone L, Villari P, Serretta R, Sapio M, Casuccio A, et al. The use of pilocarpine in opioid-induced xerostomia. Palliat Med 2000;14:529-31.
- Nederfors T. Xerostomia and hyposalivation. Adv Dent Res 2000;14:48-56.
- Su N, Marek CL, Ching V, Grushka M. Caries prevention for patients with dry mouth. J Can Dent Assoc 2011;77:b85.
- Peterson DE. Oral problems in supportive care: no longer an orphan topic? Support Care Cancer 2000;8:347-8.
- Narhi TO. Prevalence of subjective feelings of dry mouth in the elderly. J Dent Res 1994;73:20-5.
- Orellana MF, Lagravère MO, Boychuk DG, Major PW, Flores-Mir C. Prevalence of xerostomia in population-based samples: a systematic review. J Public Health Dent 2006;66:152-8.
- Davies AN, Singer J. A comparison of artificial saliva and pilocarpine in radiation-induced xerostomia. J Laryngol Otol 1994;108:663-5.
- Nagler RM, Gez E, Rubinov R, Laufer D, Ben-Aryeh H, Gaitini D, et al. The effect of low-dose interleukin-2-based immunotherapy on salivary function and composition in patients with metastatic renal cell carcinoma. Arch Oral Biol 2001;46:487-93.
- Schiodt M. HIV-associated salivary gland disease: a review. Oral Surg Oral Med Oral Pathol 1992;73:164-7.
- Chambers MS, Toth BB, Martin JW, Fleming TJ, Lemon JC. Oral and dental management of the cancer patient: prevention and treatment of complications. Support Care Cancer 1995;3:168-75.
- Chambers MS, Garden AS, Kies MS, Martin JW. Radiation-induced xerostomia in patients with head and neck cancer: pathogenesis, impact on quality of life, and management. Head Neck 2004;26:796-807.
- Guggenheimer J, Moore PA. Xerostomia: etiology, recognition and treatment. J Am Dent Assoc 2003;134:61-9.
- Ciancio SG. Medications' impact on oral health. J Am Dent Assoc 2004;135:1440-8.
- Sreebny LM, Schwartz SS. A reference guide to drugs and dry mouth--2nd edition. Gerodontology 1997;14:33-47.
- Abebe W. An overview of herbal supplement utilization with particular emphasis on possible interactions with dental drugs and oral manifestations. J Dent Hyg 2003;77:37-46.
- Epstein JB, Stevenson-Moore P, Scully C. Management of xerostomia. J Can Dent Assoc 1992;58:140-3.
- Epstein JB, van der Meij EH, Lunn R, Stevenson-Moore P. Effects of compliance with fluoride gel application on caries and caries risk in patients after radiation therapy for head and neck cancer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:268-75.
- Leek H, Albertsson M. Pilocarpine treatment of xerostomia in head and neck patients. Micron 2002;33:153-5.
- Reddy SP, Leman CR, Marks JE, Emami B. Parotid-sparing irradiation for cancer of the oral cavity: maintenance of oral nutrition and body weight by preserving parotid function. Am J Clin Oncol 2001;24:341-6.
- Eisbruch A, Kim HM, Terrell JE, Marsh LH, Dawson LA, Ship JA. Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer. Int J Radiat Oncol Biol Phys 2001;50:695-704.
- Berger AM, Kilroy TJ. Oral complications of cancer therapy. Berger AM, Portenoy RK, Weissman DE, eds. Principles and Practice of Supportive Oncology. 1st edn. Philadelphia: Lippincott-Raven Publishers; 1998. p. 223-36.
- von Bültzingslöwen I, Sollecito TP, Fox PC, Daniels T, Jonsson R, Lockhart PB, et al. Salivary dysfunction associated with systemic diseases: systematic review and clinical management recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103 Suppl:S57 e1-15.
- Kassan SS, Moutsopoulos HM. Clinical manifestations and early diagnosis of Sjögren syndrome. Arch Intern Med 2004;164:1275-84.
- Hattori T, Wang PL. Calcium antagonists cause dry mouth by inhibiting resting saliva secretion. Life Sci 2007;81:683-90.
- Ogawa Y, Kuwana M. Dry eye as a major complication associated with chronic graft-versus-host disease after hematopoietic stem cell transplantation. Cornea 2003;22(7 Suppl):S19-27.
- Ogawa Y, Kuwana M, Yamazaki K, Mashima Y, Okamoto S, Tsubota K, et al. Dry eye associated with chronic graft-versus-host disease. Adv Exp Med Biol 2002;506(Pt B):1041-5.
- Davis PB. Pathophysiology of cystic fibrosis with emphasis on salivary gland involvement. J Dent Res 1987;66 Spec No:667-71.
- Livnat G, Bentur L, Kuzmisnsky E, Nagler RM. Salivary profile and oxidative stress in children and adolescents with cystic fibrosis. J Oral Pathol Med 2010;39:16-21.
- Harvey J, Catoggio L, Gallagher PJ, Maddison PJ. Salivary gland biopsy in sarcoidosis. Sarcoidosis 1989;6:47-50.
- Sagowski C, Ussmüller J. Clinical diagnosis of salivary gland sarcoidosis (Heerfordt syndrome). HNO 2000;48:613-5.
- Vairaktaris E, Vassiliou S, Yapijakis C, Papakosta V, Kavantzas N, Martis C, et al. Salivary gland manifestations of sarcoidosis: report of three cases. J Oral Maxillofac Surg 2005;63:1016-21.
- Ataman M, Sözeri B, Ozçelik T, Gedikoglu G. Tuberculosis of the parotid salivary gland. Auris Nasus Larynx 1992;19:271-3.
- Kim YH, Jeong WJ, Jung KY, Sung MW, Kim KH, Kim CS. Diagnosis of major salivary gland tuberculosis: experience of eight cases and review of the literature. Acta Otolaryngol 2005;125:1318-22.
- Tauro LF, George C, Kamath A, Swethadri G, Gatty R. Primary tuberculosis of submandibular salivary gland. J Glob Infect Dis 2011;3:82-5.
- Jeffers L, Webster-Cyriaque JY. Viruses and salivary gland disease (SGD): lessons from HIV SGD. Adv Dent Res 2011;23:79-83.
- Pinto A, De Rossi SS. Salivary gland disease in pediatric HIV patients: an update. J Dent Child (Chic) 2004;71:33-7.
- Shanti RM, Aziz SR. HIV-associated salivary gland disease. Oral Maxillofac Surg Clin North Am 2009;21:339-43.
- Dodds MW, Johnson DA, Yeh CK. Health benefits of saliva: a review. J Dent 2005;33:223-33.
- Akarslan Z, Can E, Alasya D, Güngör K. Xerostomia semptomları ve tükürük akış hızı arasındaki ilişkinin değerlendirilmesi. GÜ Diş Hek Fak Derg 2003;20:5-8.
- Navazesh M. Methods for collecting saliva. Ann N Y Acad Sci 1993;694:72-7.
- Sreebny L. Saliva--salivary gland hypofunction (SGH). FDI Working Group 10. J Dent Assoc S Afr 1992;47:498-501.
- Erlichman M. Patient selection criteria for electrostimulation of salivary production in the treatment of xerostomia secondary to Sjögren's syndrome. Health Technol Assess Rep 1990:1-7.
- Porter R. The Merck Manual. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2004.
- Baur DA, Heston TF, Helman JI. Nuclear medicine in oral and maxillofacial diagnosis: a review for the practicing dental professional. J Contemp Dent Pract 2004;5:94-104.
- Thoeny HC. Imaging of salivary gland tumours. Cancer Imaging 2007;7:52-62.
- Fox PC. Xerostomia: recognition and management. Dent Assist 2008;77:18, 20, 44-8.
- Tazegül S, Bodrumlu E, Erten H, Erten D, Kasap R. Kalsiyum fosfat içerikli çikletlerin tükürük kalsiyum ve fosfat konsantrasyonları ile tükürük pH ve akış hızına etkileri. GÜ Diş Hek Fak Derg 2004;21:1-5.
- Braga FP, Sugaya NN, Hirota SK, Weinfeld I, Magalhaes MH, Migliari DA. The effect of acupuncture on salivary flow rates in patients with radiation-induced xerostomia. Minerva Stomatol 2008;57:343-8.
- Cummins MJ, Papas A, Kammer GM, Fox PC. Treatment of primary Sjögren's syndrome with low-dose human interferon alfa administered by the oromucosal route: combined phase III results. Arthritis Rheum 2003;49:585-93.
- Ship JA, Fox PC, Michalek JE, Cummins MJ, Richards AB. Treatment of primary Sjögren's syndrome with low-dose natural human interferonalpha administered by the oral mucosal route: a phase II clinical trial. IFN Protocol Study Group. J Interferon Cytokine Res 1999;19:943-51.
- Fife RS, Chase WF, Dore RK, Wiesenhutter CW, Lockhart PB, Tindall E, et al. Cevimeline for the treatment of xerostomia in patients with Sjögren syndrome: a randomized trial. Arch Intern Med 2002;162:1293-300.
- Petrone D, Condemi JJ, Fife R, Gluck O, Cohen S, Dalgin P. A double-blind, randomized, placebo-controlled study of cevimeline in Sjögren's syndrome patients with xerostomia and keratoconjunctivitis sicca. Arthritis Rheum 2002;46:748-54.
- Vivino FB, Al-Hashimi I, Khan Z, LeVeque FG, Salisbury PL 3rd, Tran-Johnson TK, et al. Pilocarpine tablets for the treatment of dry mouth and dry eye symptoms in patients with Sjögren syndrome: a randomized, placebo-controlled, fixed-dose, multicenter trial. P92-01 Study Group. Arch Intern Med 1999;159:174-81.
- Nin T, Umemoto M, Negoro A, Miuchi S, Sakagami M. Nizatidine enhances salivary secretion in patients with dry mouth. Auris Nasus Larynx 2008;35:224-9.
- Ogawa T, Takada K, Sato Y, Chiba H. The influence of causes of hyposalivation on clinical outcome of nizatidine in patients with dry mouth. Asian Journal of Oral and Maxillofacial Surgery 2010;22:68-73.
- Ueki S, Seiki M, Yoneta T, Aita H, Chaki K, Hori Y, et al. Gastroprokinetic activity of nizatidine, a new H2-receptor antagonist, and its possible mechanism of action in dogs and rats. J Pharmacol Exp Ther 1993;264:152-7.
- Adachi K, Furuta K, Katsube T, Fujisawa T, Azumi T, Fujishiro H, et al. Nizatidine and cisapride increase salivary secretion in rats. Dig Dis Sci 2004;49:399-403.
- Adachi K, Ono M, Kawamura A, Yuki M, Fujishiro H, Kinoshita Y. Nizatidine and cisapride enhance salivary secretion in humans. Aliment Pharmacol Ther 2002;16:297-301.