How do you manage dry mouth after head and neck RT?

I think it is important to very clearly explain to the patient that xerostomia is common and even should be expected, even in the era of highly conformal treatment plans. If a patient is highly motivated to preserve saliva, pilocarpine can be used concurrently with radiation where it has been shown to have a prophylactic effect in a meta-analysis (PubMed ID: 26867879).

For patients who are not taking pilocarpine, I generally wait about 6 months to assess their saliva recovery and their degree of bother with the current level of xerostomia. Many patients with significant degrees of xerostomia are able to make lifestyle adjustments and demonstrate little bother, while others with less severe cases are significantly bothered. For these patient...

The product “Caphosol” should be part of your program for management of treatment induced caries. /Sid Sobel, M.D., FACR