Difficulties in dental prescribing of saliva substitutes for xerostomia

The value of salivary substitutes for many elderly patients is indicated by a simple web search which found 2,470 references, with references to prescribing across the globe. To contain the public expense, prescribing medicaments within the National Health Service in England is limited to approved lists. The only salivary substitute currently prescribable by dentists has not been produced for 18 months. It is argued that: the prescription of this symptomatic therapy should be based on potential benefit for the xerostomic patient and not, as now, primarily on the pathological aetiology of the oral dryness. Secondly, that the professional caring for that oral problem--the dentist, is best placed to manage the prescribing as part of the overall management of the patient, independent of any reference to the patients physician that may be appropriate as part of the overall management of the patient.