A sialogogue (also spelled sialagogue, ptysmagogue or ptyalagogue) is a

substance Substance may refer to: * Matter, anything that has mass and takes up space Chemistry * Chemical substance, a material with a definite chemical composition * Drug, a chemical agent affecting an organism Arts, entertainment, and media Music * ' ...

, especially a

medication Medication (also called medicament, medicine, pharmaceutical drug, medicinal product, medicinal drug or simply drug) is a drug used to medical diagnosis, diagnose, cure, treat, or preventive medicine, prevent disease. Drug therapy (pharmaco ...

, that increases the flow rate of

saliva Saliva (commonly referred as spit or drool) is an extracellular fluid produced and secreted by salivary glands in the mouth. In humans, saliva is around 99% water, plus electrolytes, mucus, white blood cells, epithelial cells (from which ...

. The definition focuses on substances that promote production or secretion of saliva (proximal causation) rather than any food that is mouthwatering (distal causation that triggers proximal causation). Sialogogues can be used in the treatment of

xerostomia Xerostomia, also known as dry mouth, is a subjective complaint of dryness in the mouth, which may be associated with a change in the composition of saliva, reduced salivary flow, or have no identifiable cause. This symptom is very common and is o ...

(the subjective feeling of having a dry mouth), to stimulate any functioning

salivary gland The salivary glands in many vertebrates including mammals are exocrine glands that produce saliva through a system of ducts. Humans have three paired major salivary glands ( parotid, submandibular, and sublingual), as well as hundreds of min ...

tissue to produce more saliva. Saliva has a bactericidal effect, so when low levels of it are secreted, the risk of

caries Tooth decay, also known as caries,The word 'caries' is a mass noun, and is not a plural of 'carie'.'' is the breakdown of teeth due to acids produced by bacteria. The resulting cavities may be a number of different colors, from yellow to black ...

increases. Not only this, but fungal infections such as oral candidosis also can be a consequence of low salivary flow rates. The

buffer Buffer may refer to: Science * Buffer gas, an inert or nonflammable gas * Buffer solution, a solution used to prevent changes in pH * Lysis buffer, in cell biology * Metal ion buffer * Mineral redox buffer, in geology Technology and engineeri ...

effect of saliva is also important, neutralising acids that cause tooth enamel demineralisation.

Usage in dentistry

The following are used in dentistry to treat xerostomia: *Parasympathomimetic drugs act on parasympathetic

muscarinic receptors Muscarinic acetylcholine receptors (mAChRs) are acetylcholine receptors that form G protein-coupled receptor complexes in the cell membranes of certain neurons and other cells. They play several roles, including acting as the main end-recep ...

to induce an increased saliva flow. The M3 receptor has been identified as the principal target to increase salivary flow rates.Melvin JE, Yule D, Shuttleworth T, Begenisich T. REGULATION OF FLUID AND ELECTROLYTE SECRETION IN SALIVARY GLAND ACINAR CELLS. Annual Review of Physiology. 2005 Mar 17;67(1):445–69.

Pilocarpine Pilocarpine, sold under the brand name Pilopine HS among others, is a lactone alkaloid originally extracted from plants of the Pilocarpus genus. It is used as a medication to reduce pressure inside the eye and treat dry mouth. As an eye drop ...

is an example; the maximum dose of this drug is 30 mg/day. Contraindications include many lung conditions, such as asthma, cardiac problems, epilepsy and Parkinson's disease; side effects include flushing, increased urination, increase perspiration, and GI disturbances. *Chewing gum induces stimulated saliva secretion of the minor salivary glands in the oral cavity. During mastication (chewing), the resultant compression forces acting on the

periodontal ligament The periodontal ligament, commonly abbreviated as the PDL, are a group of specialized connective tissue fibers that essentially attach a tooth to the alveolar bone within which they sit. It inserts into root cementum on one side and onto alveo ...

cause the stimulated release of gingival crevicular fluid. Further salivation can be also achieved by the stimulation of taste receptors (parasympathetic fibers from the

chorda tympani Chorda tympani is a branch of the facial nerve that carries gustatory (taste) sensory innervation from the front of the tongue and parasympathetic ( secretomotor) innervation to the submandibular and sublingual salivary glands. Chorda tymp ...

and the

lingual nerve The lingual nerve carries sensory innervation from the anterior two-thirds of the tongue. It contains fibres from both the mandibular division of the trigeminal nerve (CN V) and from the facial nerve (CN VII). The fibres from the trigeminal nerve ...

are involved). *Malic and ascorbic acid are effective sialogogues, but are not ideal as they cause demineralisation of

tooth enamel Tooth enamel is one of the four major Tissue (biology), tissues that make up the tooth in humans and many animals, including some species of fish. It makes up the normally visible part of the tooth, covering the Crown (tooth), crown. The other ...

Historical source from plants

A tincture is prepared from the root of the pyrethrium (

pyrethrum ''Pyrethrum'' was a genus of several Old World plants now classified in either '' Chrysanthemum'' or '' Tanacetum'' which are cultivated as ornamentals for their showy flower heads. Pyrethrum continues to be used as a common name for plants form ...

) or pellitory (a number of plants in the ''

Chrysanthemum Chrysanthemums ( ), sometimes called mums or chrysanths, are flowering plants in the Asteraceae family. They are native to East Asia and northeastern Europe. Most species originate from East Asia, and the center of diversity is in China. Co ...

'' family). It is found growing in Levant and parts of Limerick and Clare in

Ireland Ireland (, ; ; Ulster Scots dialect, Ulster-Scots: ) is an island in the North Atlantic Ocean, in Northwestern Europe. Geopolitically, the island is divided between the Republic of Ireland (officially Names of the Irish state, named Irelan ...

. The root powder was used as flavouring in tooth powders in the past.Jude, "Medicinal and Perfumery Plants and Herbs of Ireland", MH Gill and son, (1933) pp.36

Herbs with sialogogue action

* Bloodroot (''

Sanguinaria ''Sanguinaria canadensis'', bloodroot, is a perennial, herbaceous flowering plant native to eastern North America. It is the only species in the genus ''Sanguinaria'', included in the poppy family Papaveraceae, and is most closely related to ' ...

canadensis'') * Blue flag ('' Iris versicolor'') * Cayenne pepper (''

Capsicum ''Capsicum'' () is a genus of flowering plants in the Solanum, nightshade family Solanaceae, native to the Americas, cultivated worldwide for their edible fruit, which are generally known as "peppers" or "capsicum". Chili peppers grow on five s ...

annuum'') * Centaury ('' Centaurium erythraea'') *Chilcoatl / Azteca gold root ('' Heliopsis longipes'') * Great yellow gentian ('' Gentiana lutea'') * Jambu (''

Acmella ''Acmella'' is a genus of plants in the family Asteraceae, described as a genus in 1807. It is native to the Americas and has been introduced species, introduced to Asia, Africa, the Pacific islands, and Australia. One familiar species is ''Acm ...

oleracea'') *

Ginger Ginger (''Zingiber officinale'') is a flowering plant whose rhizome, ginger root or ginger, is widely used as a spice and a folk medicine. It is an herbaceous perennial that grows annual pseudostems (false stems made of the rolled bases of l ...

('' Zingiber officinale'') * Northern prickly-ash (''

Zanthoxylum ''Zanthoxylum'' is a genus of about 250 species of deciduous and evergreen trees, shrubs and climbers in the Family (biology), family Rutaceae that are native to warm temperate and Subtropics, subtropical areas worldwide. It is the type gen ...

americanum'') * Senega (''

Polygala ''Polygala'' is a large genus of flowering plants belonging to the family Polygalaceae. They are commonly known as milkworts or snakeroots. The genus is distributed widely throughout much of the world Hypersalivation Hypersalivation or hypersialosis is the excessive production of saliva. It has also been defined as increased amount of saliva in the mouth, which may also be caused by decreased clearance of saliva.Medscape > HypersalivationBy Erica Brownfield. P ...

References

{{reflist Drugs Dentistry Otorhinolaryngology