Supersaturated Calcium phosphate rinses are well studied and have been proven effective in treating dry mouth, xerostomia, and mucositis. Below is just a sampling of the available literature.
Saini reports on the results of SalivaMAX in a xerostomic population (n = 38) with high levels of S. mutans. Compared against a control using standard customary treatment, the SalivaMAX group (customary treatment plus SalivaMAX 4x/day) had a statistical (p<0.05) and marked improvement in oral hygiene scores and other measured outcomes.
Brock et al. describes the use of SalivaMAX, a supersaturated calcium phosphate rinse, by head and neck patients receiving 70Gy of fractionated IMRT chemoradiation as compared to the standard of care, a salt/soda rinse. The SalivaMAX group demonstrated a significant reduction in the peak level of mucositis along with a delay in the onset of mucositis during treatment as compared to the control. More specifically, using assessments based on the WHO Oral Mucositis Scale 90% of SalivaMAX patients were eating solid foods with many not even experiencing ulcerations. While in the control group, 40% of the patients were on a liquid diet.
This study provided a review of thirty studies and found that the majority (24) reported that a supersaturated calcium phosphate rinse was efficacious at reducing the mucositis grade and/or duration as well as the mucositic pain associated with the condition.
Quinn et al. Efficacy of a supersaturated calcium phosphate oral rinse for the prevention and treatment of oral mucositis in patients receiving high-dose cancer therapy: a review of current data. Eur J Cancer Care. 22:564-579;2013.
Markiewicz evaluated supersaturated calcium phosphate rinse compared to the standard of care, topical mouth solutions, in patients undergoing high dose chemotherapy. The supersaturated calcium phosphate group showed statistically significant improvements over the control group in:
• need for total parenteral nutrition
• duration of analgesics
• peak mouth pain
• mucositis duration
• oral toxicity severity (WHO scale)
Markiewicz et al. Treating oral mucositis with a supersaturated calcium phosphate rinse: comparison with control in patients undergoing allogeneic hematopoietic stem cell transplantation. Support Care Cancer. 20:2223-2229;2012.
This study evaluated patients that received at least 4500cGy to the oral cavity using supersaturated calcium phosphate rinse compared to standard supportive care. The supersaturated calcium phosphate group showed marked improvements over the control group in:
- PEG tube application
- In-patient hospitalization
- Incremental costs of treatment for oral mucositis (savings of $1,700 - $7,000 per person)
This is a first published study to determine the efficacy of a supersaturated calcium phosphate oral rinse on patients with solid tumors (breast cancer) in response to chemotherapy-induced mucositis. Although this was a single sided study, the short time to elimination of mucositis was noteworthy: resolution of Grade 3 mucositis was an average of 4 days and Grade 2, 3.5 days.
This study by Taylor evaluated the cost benefit of using a supersaturated calcium phosphate rinse for treating oral mucositis in patients undergoing conditioning therapy for bone marrow transplantation (high dose chemo) and head and neck cancer (chemo and radiation therapy). The net savings of using a supersaturated calcium phosphate rinse over the standard of care were $5,582 and ranging $475 - $6,695, respectively, for each patient in addition to the positive clinical outcomes.
This study by Papas evaluated supersaturated calcium phosphate rinse compared to the standard of care, a fluoride rinse, in patients undergoing high dose chemotherapy. The supersaturated calcium phosphate group showed statistically significant improvements over the control group in:
- oral mucositis duration
- peak level of oral mucositis
- peak level of pain
- days of pain
- total morphine
This study evaluated supersaturated calcium phosphate rinse compared to standard of care in patients receiving high dose chemotherapy. In all clinical outcomes with patients treated with BEAM chemotherapy, the supersaturated calcium phosphate group scored markedly better in terms of:
- Incidence of oral mucositis
- mean number of days with oral mucositis
- parenteral nutrition
- opioid use
Wasko-Grabowska et al. Efficiency of Supersaturated Calcium Phosphate Mouth Rinse Treatment in Patients Receiving High-Dose Melphalan or BEAM Prior to Autologous Blood Stem Cell Transplantation. Trans Proc. 43:3111-3113;2011.
This peer reviewed paper by Levin offers a general approach to the etiology, diagnosis and management of xerostomia.
- draws a distinction between organic and non-organic components of saliva
- highlights that most xerostomia in a general dental setting is caused by medications
- identifies supersaturated calcium phosphate rinse as one of the most powerful adjuncts in the care of xerostomia