Lee Ann Brady, DMD's Dental Blog

  • Home
  • About Dr. Lee Ann Brady
  • Dental Practice
  • Categories
    • Dental Materials
    • Esthetic Dentistry
    • Occlusion/TMD
    • Practice of Dentistry
    • Preventive Dentistry
    • Restorative Dentistry
    • Restorative Techniques
    • Treatment Planning
    • Videos
    • A-Z Topic List
  • Speaker’s Packet Request
  • Contact
You are here: Home / Dental Materials / Pilocarpine Lollipop for Severe Dry Mouth

Pilocarpine Lollipop for Severe Dry Mouth

By Lee Ann Brady on 10.22.14Category: Dental Materials, Preventive Dentistry

Recently I have been having my patients with severe dry mouth utilize a prescription that relieves their symptoms and restores some of the balance to the oral cavity that saliva provides. Pilocarpine is a cholinergic medication and is commonly given to patients with severe dry mouth. Many patients have dry mouth that is not significantly helped with topical solutions like Biotene or AOvantage, or they have to use these products so often that it becomes a challenge. Recently our GCAmerica rep came in for a lunch and learn and mentioned using Pilocarpine in a lollipop for this group of patients. I was intrigued enough to do the research. Compounding pharmacies can fabricate a lollipop that contains pilocarpine in either a 5mg or 2mg dose, they also can add Xyltiol as a caries preventive and flavoring agents.

Patients are instructed to suck on the lollipop for 3-20 seconds as needed up to 5 times per day. The length of time they use the lollipop and number of times per day is easy for them to discern based on the feeling of saliva in their mouths. The medication increases salivary flow for about 3-5 hours. The pharmacy dispenses the lollipop in a plastic pill holder with a hole in the lid that supports the stick and allows the pop to be used over and over again until it is gone while being kept clean. Pilocarpine can also be given as a pill and is available in 5 and 10mg formulations, but I was amazed at how much more patients like the lollipop then having to swallow a pill. When I did my research I was amazed at the variety of instructions I came across, from 3-30 seconds in the mouth, and 3 times per day to every 2 hours and even use as needed.

I am fortunate enough to have a compounding pharmacy right down the street so I called and spoke to the lead pharmacist.  He explained that unlike a pill the dose will be variable with the lollipop, however it will take a lower dose to get the same oral effect versus a systemic application, and this accounts for the variable instructions. The most common side effect will be too much salivary flow and the patient will use this to reduce the length of time the pop is in their mouths or the number of uses per day. Pilocarpine can also cause increased sweating, but the pharmacist explained this should be uncommon at the does of the lollipops. He also shared that although it is available in many flavors, Root Beer seems to cover the flavor of the Pilocarpine the best, and he strongly recommends the formula with Xylitol.

It has been great to have one more thing to offer our patients to help them be comfortable and keep their mouths healthy.

Related

Share

Comments

  1. Paul Barton says

    October 22, 2014 at 2:39 PM

    Thanks Lee I will try this. I think my hygienists will love it as well.

    Reply
  2. dan says

    October 23, 2014 at 4:40 PM

    Is there a pharmacy that you can recommend? I have not worked with a compounding pharmacy in my area.

    Reply
    • Lee Ann Brady says

      October 24, 2014 at 4:57 AM

      I use a local compounding pharmacy called Potter’s House Apothecary, however if you do not have one locally use a mail order compounding pharmacy. Two examples are Steven’s Pharmacy and Apex Compounding Pharmacy, both have great websites where you can submit prescriptions.

      Reply
  3. steve spivack says

    October 23, 2014 at 11:21 PM

    Seems like a great idea. I have too many patents with severe dry mouth. root caries are a huge problem. Any concerns with getting too much of the pilocarpine?

    Reply
    • Lee Ann Brady says

      October 24, 2014 at 4:58 AM

      Steve,

      It’s hard to get too much with the lollipop. The first sign a patient needs to cut back is excessive salivation, and then they can do fewer seconds or fewer times per day. The next most common sign of too much is excessive sweating, and again I tell my patients to look for this and cut back accordingly. I use this when the dry mouth is severe, the current treatments are ineffective, and when caries is still an ongoing issue.

      Reply
  4. Ashley Griffon says

    April 11, 2017 at 9:18 AM

    Does the 2mg or 5mg dose mean that is the total amount in the whole lollipop or that is how much they should get each time they suck the lollipop?

    Reply
  5. Melinda Ferrari says

    May 20, 2018 at 6:00 PM

    I need this when I am going to have surgery and after prep I am left to wait fo up to 30 minutes. They don’t let me have any water and I am in severe pain. Is there a place near Pacifica, CA where I could buy these? Must I have a prescription? I need help!

    Reply
  6. Matthew R. Maley, DDS says

    August 28, 2020 at 8:52 AM

    We are interested in ordering these for our patients. Do I contact one of the compounding pharmacies mentioned above?

    Reply
    • Lee Ann Brady says

      August 28, 2020 at 8:59 AM

      Work with a local compounding pharmacy

      Reply
  7. Bam66 says

    January 30, 2021 at 11:55 AM

    This works so much better than Biotene and the others. I have tried them all. And price is better!!!!! Go for it!!!

    Reply

Leave a Comment Cancel

Search

Recent Posts

  • Retraction Paste Technique Sensitivity
  • The Next Generation of Glass Ionomer Cements
  • A Fantastic New Temporary Cement
  • Tissue Blanching When Seating An Implant Restoration
  • Is It Time To Get An Intra-oral Impression Scanner?
  • Does Your Team Order The Dental Materials You Want?

Recent Comments

  • Joe on Stick Bite: Why and How
  • Joan Johnson on Post & Core’s Coming Loose?
  • Rosemary on Ugh, The Margins Are Open!
  • Sakshi on Removing An e.max Restoration
  • Jeremy Montrose on Ugh, The Margins Are Open!
  • John on Signs & Symptoms of a Restricted Envelope of Function

Policies

Terms of Use

Privacy Policy

Cancellations and Refunds

Security Seal

© 2020 Lee Ann Brady LLC, All Rights Reserved Site by CSL