Efficacy of adhesive discs for nocturnal xerostomia after head and neck radiotherapy: a randomized crossover trial

OBJECTIVES: Radiotherapy for head and neck cancer (HNC) frequently results in irreversible salivary gland damage and persistent xerostomia. This study aimed to assess the efficacy of a topical mucoadhesive disc containing xylitol in comparison to water with respect to (i) subjective symptom burden of nocturnal dry mouth and (ii) objective salivary flow parameters in post-radiotherapy HNC patients. MATERIALS AND METHODS: In a randomized, single-blind, crossover-controlled clinical trial, 33 patients with radiotherapy-induced xerostomia received either adhesive discs (XyliMelts) or water across two treatment phases, separated by a washout period of 7 days. Subjective outcomes were assessed using a 100 mm visual analogue scale (VAS) and the Shahdad symptom relief questionnaire. Objective measures included unstimulated and stimulated salivary flow rates. Within-group pre-post comparisons were analyzed using paired t-tests or Wilcoxon signed-rank tests; between-group differences were assessed using independent t-tests or Mann-Whitney U tests (p < 0.05). RESULTS: Adhesive discs use was associated with significantly greater subjective symptom relief (76% vs. 24%; p < 0.001), improved sleep continuity (67% vs. 9%; p < 0.001), and higher willingness to continue product use (70% vs. 30%; p = 0.044). Perceived oral moisture, comfort, and flavor ratings were also higher with adhesive discs. No changes were observed in salivary flow parameters. Tolerability was high, with minimal adverse events reported. CONCLUSIONS: Topical, symptom-oriented interventions may provide meaningful relief for patients suffering from post-radiotherapy xerostomia, especially when regenerative treatment options are limited. Further clinical trials are warranted to confirm these findings in larger populations and to evaluate long-term efficacy and safety. CLINICAL RELEVANCE: Mucoadhesive xylitol discs appear to be well tolerated and are perceived as beneficial by patients experiencing xerostomia following HNC therapy.