Managing Dry Mouth in Sjögren’s Syndrome: A Breakthrough with Malic Acid/Fluoride (Sour Apple) Rinse
Dry mouth, or xerostomia, is a common and debilitating symptom affecting individuals’ quality of life by causing discomfort, pain, and even difficulty eating.
“Overall, the observed prevalence of xerostomia was 24% among females and 18% among males. While xerostomia was more commonly observed in women than men, this association was only clear after age 50.”
Saliva is essential for oral health, helping to moisten the mouth, break down food, and cleanse teeth by neutralizing plaque acids. A lack of saliva makes foods taste different, complicates eating dry foods, impacts speech, and contributes to bad breath. Dry mouth, often more pronounced at night, increases the risk of tooth decay and gum disease. It may stem from medical conditions like Sjogren’s syndrome, aging, certain medications (including those for heart and blood pressure). Women are statistically more likely to experience chronic dry mouth than men.
Malic Acid for Dry Mouth: What’s the Research Saying?
Recent studies highlight the potential of 1% malic acid sprays in managing symptoms of dry mouth, showing an increase in salivary flow rates after two weeks of application. Research points to malic acid as a possible aid for those experiencing dry mouth, with implications for improving saliva production and potentially enhancing oral health-related quality of life.
“Dry mouth symptoms improved after 1% malic acid application. After 2 weeks of 1% malic acid application, unstimulated and stimulated salivary flows rates increased significantly.”
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How It Works:
Malic acid stimulates saliva production, helping to naturally hydrate the mouth. Fluoride provides dental protection, an essential aspect of care for patients with chronic dry mouth who are prone to cavities. Our formula is a pre-measured powder added to 5–10 ml of water, creating a convenient rinse to be used three times daily.
At Health Dimensions Clinical Pharmacy (HDRx), we have developed a customized Malic Acid/Fluoride (Sour Apple) Rinse to help patients manage dry mouth. Our formulation consists of 100 mg of malic acid in a pH-adjusted mixture, enhanced with fluoride for dental protection and a pleasant sour apple flavor. This rinse is designed specifically for patients with Sjögren’s syndrome or other conditions leading to persistent dry mouth.
We ship Malic Acid/Fluoride (Sour Apple) Rinse to multiple states with a prescription.
We are licensed to ship prescriptions to Michigan as well as FL, IL, IN, MN, OH, and WI.
Sjögren’s Syndrome Patient Real-Life Case Study: HDRx’s Real Results
An HDRx patient, Marsha, faced these Sjögren’s syndrome challenges — her mouth was painfully dry, leading to weight loss as she couldn’t eat. Traditional remedies like Biotene, ice chips, and constant hydration weren’t providing the relief she needed.
“I have Rheumatoid Arthritis and Sjögren’s. Sjögren’s dries your mouth and eyes. It also causes pain in your mouth and tongue. Had trouble eating. Lost weight. Dentist gave me a script for oral rinse. Definitely was a game changer for me. I can eat again.
My mouth is better even my lips are better. They were chapped all the time, now they’re not thanks to the rinse. The food I ate burned my mouth now it doesn’t thanks to the rinse. I can eat anything and I’ve gained my weight back and I’m healthy again. The rinse that you guys make for me is Malic acid and fluoride, sour apple flavor, which has kicked in my salivary glands. Thanks again I’m so appreciative and my husband as well for giving me my life back.”
She then started using our compounded Malic Acid/Fluoride (Sour Apple) Rinse three times daily — no eating or drinking for 60 minutes post-application. Within weeks, her mouth pain subsided, and she was able to eat without discomfort, marking significant improvement. Her ability to maintain weight and enjoy meals again has been life-changing. After the first month, she reduced the usage to twice daily and continues to experience great relief.
Medical Practitioners
Do you want to easily prescribe compounded Malic Acid/Fluoride Rinse with HDRx?Why Malic Acid/Fluoride Rinse? Who Prescribes Dry Mouth Medications?
Dentists, ENT specialists, and rheumatologists who encounter patients with Sjögren’s or similar conditions can find this compounded medication particularly useful in offering more targeted options. Unlike traditional solutions, this rinse offers targeted stimulation of saliva production, with its potential showcased through patient experiences like Marsha’s.
HDRx is committed to working closely with healthcare providers across multiple specialties to deliver custom medications for patients who need more than conventional therapies. We proudly offer shipping to multiple states and welcome consultations to discuss the potential of our compounded formulas for dry mouth management.
For more information, contact us today or schedule a consultation to learn more about how our Sour Apple Malic Acid/Fluoride rinse may improve you or your patients’ quality of life.
References
Billings RJ, Proskin HM, Moss ME. Xerostomia and associated factors in a community-dwelling adult population. Community Dent Oral Epidemiol. 1996 Oct;24(5):312-6. doi: 10.1111/j.1600-0528.1996.tb00868.x. PMID: 8954216.
Gómez‐Moreno, G., Aguilar‐Salvatierra, A., Guardia, J., Uribe‐Marioni, A., Cabrera‐Ayala, M., Delgado‐Ruiz, R. A., & Calvo‐Guirado, J. L. (2013). The efficacy of a topical sialogogue spray containing 1% malic acid in patients with antidepressant‐induced dry mouth: A double‐blind, randomized clinical trial. Depression and anxiety, 30(2), 137–142.
Liu, G., Qiu, X., Tan, X., Miao, R., Tian, W., & Jing, W. (2023). Efficacy of a 1% malic acid spray for xerostomia treatment: a systematic review and meta‐analysis. Oral Diseases, 29(3), 862–872.
Niklander, S., Fuentes, F., Sanchez, D., Araya, V., Chiappini, G., Martinez, R., & Marshall, M. (2018). Impact of 1% malic acid spray on the oral health-related quality of life of patients with xerostomia. Journal of oral science, 60(2), 278–284.
See, L., Mohammadi, M., Han, P. P., Mulligan, R., & Enciso, R. (2019). Efficacy of saliva substitutes and stimulants in the treatment of dry mouth. Special Care in Dentistry, 39(3), 287–297.
