Thursday, November 29, 2012

Does Acupuncture Relieve Dry Mouth Symptoms?

Acupuncture chart from Hua Shou (fl. 1340s, Ming Dynasty) found on Wikipedia. 

Recently, a reader asked this question: Does the oral dryness (xerostoma) associated with Sjogren's syndrome respond to acupuncture?

I didn't know the answer to that. But it's an excellent question. I found a few studies on the topic. The first was a a study on SS and acupuncture conducted by M. Blom, T. Lundeberg, I. Dawidson and B. Angmar-Mansson Department of Cariology. School of Dentistry, Stockholm, Sweden and summarized:
"In conclusion, the results of this study show that manual or low frequency- electroacupuncture causes an increase in the peripheral vascular flux, which may be one important factor in the relief of xerostomia. Further studies to examine the effect of acupuncture and the role of VIP in xerostomia are in progress."
My understanding of their phrase "peripheral vascular flux" refers to an increase in blood flow to the saliva gland causing increased function of the gland.


This  JAMA Network article: Prognostic Value of the Pilocarpine Test to Identify Patients Who May Obtain Long-term Relief From Xerostomia by Acupuncture Treatment, found here, went on to quantify which patients would more likely be good candidates for acupuncture based on gland stimulation with pilocarpine:
 "...our results show that the pilocarpine test is a good prognostic tool for easily predicting if acupuncture treatment may be successful in patients with xerostomia. A randomized trial within prognostic subgroups must be done if acupuncture is to be scientifically evaluated for effectiveness....... Although the physiologic mechanisms of acupuncture are only partly understood, acupuncture is known to affect the parasympathetic and sympathetic nervous system via input in group III and IV afferent fibers. A positive pilocarpine test result not only identifies possible residual salivary gland function but implies that the patient may respond to acupuncture. Acupuncture has also been found to have trophic effects on the salivary gland through the action of locally released neuropeptides acting as growth factors, which would suggest that the improvement seen over time in these patients is the result of actual increase in gland function. The course of treatment in this study was designed with the knowledge that 24 acupuncture treatments have been found to provide long-term improvement in salivary secretion."(Bolding mine.) 
In other words, the authors of this study are making the assumption that for acupuncture to be effective in increasing salivary flow from the saliva glands, there must be some demonstrable functioning gland tissue remaining. If a patient is not receiving results from taking the saliva-stimulant drugs such as pilocarpine, then acupuncture would probably not be a useful tool for that person.

VERY interesting.

A study completed in 2011 by the University of Texas MD Anderson Cancer Center looked at prevention of xerostoma caused by radiation therapy:
"There have been a number of small studies examining the benefits of acupuncture after xerostomia develops, but no one previously examined if it could prevent xerostomia," said Cohen, who is also the study's principal investigator. "We found incorporating acupuncture alongside radiotherapy diminished the incidence and severity of this side effect."
Well, now.

If you respond to pilocarpine or civemiline medications for dry mouth but are uncomfortable with their side effects or do not wish to take these drugs for other reasons, you may want to consider talking to your doctor about the use of acupuncture in your treatment plan.

Have you tried acupuncture for relief of dry mouth or other symptoms of autoimmune disease?


Christine said...

I have used acupuncture regularly and have had some success in relief from dry mouth. What typically happens as during the treatment I literally feel the saliva explode from my salivary glands. It doesn't happen at every single treatment but often enough that it is not a coincidence.

Unfortunately though, I do not find that effect to be long lasting menaing that the effect does not last more than a few hours after the treatment. It does feel good while it lasts though!

Andrea said...

My 17-year old daughter (who has lupus) and I (who have Sjogren's, RA and possibly lupus)both have acupuncture every 2 weeks to provide relief from joint pain, fatigue and skin rashes. Acupuncture is the single most effective treatment that we have found for these symptoms. We have an excellent acupuncturist, which I am sure makes a big difference.

I think acupuncture is the only thing that successfully got my daughter through her final school exams last month.

We haven't tried acupuncture specifically for dry mouth, but I must say that all symptoms do improve after treatments because she is treating the whole immune system.

I would highly recommend acupuncture to anyone with AI disease who is looking for symptom relief without side effects. It's worth doing your homework and finding a therapist who has an excellent reputation and experience in AI diseases.

Unknown said...

I started acupuncture but put it on hold to try electrical stim therapy. I think it definitely helps. And I will also try acupuncture again though as regardless I think it is good for the soul. Take care-

Marisa said...

Thank you for the very interesting post. I haven't tried acupuncture yet, but I will soon. I did experience a rush of saliva, as Christine described, during a massage.

A little off topic, but I found that when I started drinking high-quality loose tea from Teavana my dry mouth symptoms improved significantly. I went from needing to chew gum frequently to not having to chew it at all. And I hate gum.

Erik Denmon said...

You’re right, the question is interesting. Though, if you’d so some research, you’d find out that this is not a foreign subject. Acupuncture has long been proven to ease dry mouth, particularly those caused by radiotherapy for head and neck cancers. It is actually one of the few effective treatments for it. However, there are also short-term solutions available, like using a mouthwash.

Julia Oleinik said...

Hi Erik, actually I DID do a bit of research -- you'll note a link to the 2011 study by University of Texas Cancer Center in my post regarding the use of acupuncture and xerostoma related to radiation therapy.

The issue here for most sjoggies, however, is that the studies cited earlier in my post point out that for acupuncture to stimulate increased saliva, the patient needs to have a significant amount of functioning saliva gland tissue; Many sjoggies with severe dry mouth do not have enough healthy tissue to respond to civemilient, OR acupuncture.

Javier Parrales said...

From the studies, it seems that acupuncture works well as a support treatment rather than the main solution for the problem. Still, it would be worth trying out, especially if you’re undergoing radiotherapy so as to lessen the side effects of such treatment.

Unknown said...

very effective article about dry mouth.It will very helpful to prevent dry moth problem.Thanks!
dry mouth symptoms

Eliaz Beth said...

Though, if you’d so some research, you’d find out that this is not a foreign subject.

Unknown said...

A decrease in saliva puts patients at risk for cavities, gum disease, and discomfort, since foods that are consumed adhere to the teeth longer. Dry mouth can be caused by medications such as antihistamines, antidepressants, and diuretics and can often be treated by the dentist.