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New Paste for Severe Oral Stomatitis

Hossam Hamza Mar 05, 2018 Dental Education

Researchers at Hyogo College of Medicine (Japan) assesses the application of an admixture paste containing dexamethasone, gel for oral care and petrolatum to treat the severe stomatitis that associate head and neck cancer and radiotherapy. The paste works to promote eating, chewing and swallowing which are usually painful and difficult in case of inflamed oral tissues. It is basically designed for patients using oral appliances such as dentures and splints.

It contains steroid ointment to provide pain relief, oral gel to lubricate the soft tissues and Vaseline to safely modify the viscosity of the paste. This research group named their paste (Dexi/Moist/Vase) admixture; and each of these components has its own active ingredient. Dexi has Plastibase which gives heat stability for the mix; Moist has sodium polyacrylate (superabsorbent polymer) possesses hydrophilic and hydrophobic features so it controls the absorption of the mix by the tissues. It is important that this admixture does not become fully absorbed by tissues and to be partially retentive on the mucous membrane to give some wettability to the tissues. This retention is tested on six-hour intervals which is the average time between meals. Sodium polyacrylate acts as a superabsorbent polymer which forms a gel-like structure incorporating large numbers of water molecules to promote wettability. Vaseline has oil and fat components that aid in the formation of gelatinous structure, increasing the viscosity and water retention and giving high adhesive properties to the mixture.

Dexi/Moist/Vase is still in laboratory testing but soon can be prescribed typically as commercial denture adhesives; the oral appliances need to have few drops of the paste every 6 hours. As the paste possesses strong adhesion properties, it can be used as a denture adhesive itself. The solubility, stability and breakdown of this mix were tested against artificial saliva; and the results were encouraging. The paste is believed to have long-term steroid efficacy as well as good local retention inside the oral cavity.

The paste was tested on a small number of patients: subjective pain was improved or unchanged; infection rate was low as the mixture also contained Refrecare H® that exerts antimicrobial action against Candida and prevents biofilm formation; severe stomatitis of the mouth and pharynx has improved and mastication, swallowing and salivary secretion were enhanced. That is to say, this invention helped in improving and maintaining quality of life for the subject patients.

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