Xerostomia is a common problem among adults, its incidence ranging from 10-29% of general

population and treating them has always been a clinical challenge for a Prosthodontist.

Salivary gland secretion is regulated by autonomic

nervous system and is regulated by three component

reflex archAfferent receptors and nerves carry impulses induced from sialogogicgustation and mastication

Central connection and processing nucleus ( Salivary nucleus in medulla oblongata)

Efferent reflex arm containing parasympathetic and sympathetic nerve bundles

Neuro-electrical stimulator are miniature intra oral device, they increase the salivation by means of stimulating the salivary reflex arch

Generations of salivary

pacemakersHow it works??

First Generation: Salitron

Manufactured by Biosonic USA

• Consists of mouth piece(MP) and

external module both connected

by cord.

• MP was held between the dorsal

side of tongue and palate

• Signals generated by this

stimulated the nerve and

resulted in increased salivary

secretion

• But was cumbersome in size and

high cost decreased its

popularity

Self- contained electronic splint:

Saliwell GenNarino

• The miniature electrode, battery

and the circuit is embedded with

a thermoplastic splint.

• Electrode is located close to the

third molar area to enable

stimulation of lingual nerve.

• Splint can be customized for

each patient and the electrode

can be controlled via remote

control

• This device is similar to a night

guard splint.

• It is small and easy to handle,

but needs to be replaced when

its battery runs out.

Miniature electrode supported by

a dental implant:Saliwell Crown• It is fixed avoids the

disadvantages of removable

type.

• Dimension of the electrode is

similar to a molar tooth and can

be adapted to a commercially

available dental implant.

• In addition to electrical stimulus

it also contains wetness detector

which detects the oral moisture

and regulates its electrical

impulse automatically.

• Implant is placed in lower third

molar region to assure close

proximity to lingual nerve and to

avoid interference with normal

oral functions.

Future trends: Currently research is going on in field of genetics and tissue

engineering to create more secreting cells in the gland. However, studies have

so far been conducted with rodents, human investigation is yet to be explored

Conclusion: Xerostomia has multiple causes but all of them, regardless of their etiology affect

the normal quality of living. Neuro electrical stimulation offers a new non pharmacological method of

treatment which overtakes the relevant role in therapeutic stimulation salivation for the patients

requiring long term therapy.

References:

Gloria Lafaurie 1, Stefano Fedele 2, Rafael Martín-Granizo López 3, Andy Wolff 4, Frank Strietzel 5, Stephen R. Porter 6, Yrjö T. Konttinen Med Oral Patol Oral Cir Bucal. 2009 Feb 1;14 (2):E76-80.