WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your Also contains: sorbitol liquid (non-crystallising) acacia, peppermint oil, simethicone antifoam, vegetable oil, carnuba wax, water. The BNSSG Joint Formulary Group have considered that the most appropriate clinician to prescribe high fluoride toothpaste such as Duraphat should be dentists. doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect: Do not take these pastilles if you are allergic to any of the ingredients.Not recommended for children under 3 years. Consult your doctor or pharmacist if you are pregnant or breatfeeding. Product Specification

Keeping your nasal passages moist will help relieve dry mouth. Your doctor or dentist may be able to recommend some options. Salivix pastilles are tutti-frutti flavoured and stimulate natural saliva production. The product can be used for stimulation of saliva production in patients suffering from dry mouth when saliva secretion is impaired and potentially functioning gland tissue is still present. Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review. A short course of soluble betamethasone (one 500microgram tablet to be dissolved in 10-20mls water and rinsed around the mouth up to four times per day - not to be swallowed) may be prescribed for patients with severe recurrent aphthous ulcers that have not responded to first line options. Some fiber laxatives work by drawing water into your intestines, and they can do the same for your mouth. Ask your doctor or therapist for good brands to try. Mix some up, swish it around your mouth and spit it out. (Do not swallow it, or it could cause diarrhea.)

Water

Oral hygiene Chlorhexidine 0.2% mouthwash (TLS Green) Chlorhexidine 1% dental gel (TLS Green) Hydrogen peroxide mouthwash 6% (TLS Green)

Active ingredients: Benzalkonium chloride solution 1.11 mg, tinct. Benzoin co. 8.06 mg per pastille. Salivix Spray is a saliva stimulant rather than a saliva substitute. In mild to moderate dry mouth, natural saliva stimulation should be treatment of choice. Using a humidifier once or twice a day, especially in your sleeping area at night, can help a lot. Cool or warm mist both work; use what you prefer. There are different kinds of humidifiers, including small, personal models, some with face masks and others that just direct steam in the air near you. MHRA DSU Hydrocortisone muco-adhesive buccal tablets: should not be used off-label for adrenal insufficiency in children due to serious risks Dec 2018

Keep a spray bottle with water nearby and spray inside your mouth when needed to keep it wet. Adding a few drops of aloe or glycerin to the water can make it last longer or extend the moisturizing effects. Conditions for which over the counter items should not routinely be prescribed in primary care: Guidance for CCGs The Oral Balance Gel enzyme-protein system is clinically proven to provide long-lasting freshness to a dry mouth. At the same time, the bio-active enzymes in Biotène Oral Balance Gel can strengthen your saliva’s natural antibacterial properties, limiting the microbes that cause bad breath and protecting the teeth and oral tissues. GWH only: Restricted for use in patients undergoing autologous stem cell transplant only. Consultant haematologist prescription only.

Oral ulceration and inflammation Corticosteroids Hydrocortisone 2.5mg muco-adhesive buccal tablets (TLS Green) Betamethasone soluble tablets (TLS Green) Alcohol can further dry out your mouth. Most kids’ mouthwashes are alcohol-free, and many brands have an alcohol-free option. Acid Reflux Heartburn is a burning feeling in the chest caused by stomach acid travelling up towards the throat (acid reflux). If it keeps happening, it’s called gastro-oesophageal reflux disease (GORD).

What is Salivix Spray used for?

Note: Lozenges and sprays have not been considered for formulary inclusion. The BNF states: ‘There is no convincing evidence that antiseptic lozenges and sprays have a beneficial action and they sometimes irritate and cause sore tongue and sore lips. Some of these preparations also contain local anaesthetics, which relieve pain but may cause sensitisation.’ For patients undergoing bone marrow transplant treatment and haematology patients on multiple drug regimens that include high dose methotrexate MHRA DSU Sept 2017 Miconazole (Daktarin): over-the-counter oral gel contraindicated in patients taking warfarin Glycerin (also called glycerol) is an inexpensive, flavorless and nontoxic ingredient you can find at cake decorating stores and online. It is a humectant, which means it attracts and retains moisture. Put a few drops of glycerin in water, swish it around in your mouth and spit it out. Or, make an oral spray: Use four drops of glycerin in a small spray bottle of water (4 ounces) and use as needed — you don’t have to spit it out. (Note: Do not put drops directly on tongue or in mouth. You must dilute them in water.) In use from Oct 2020) Used where a decision has been made by the BSW APC not to routinely commission this preparation for its licensed indications. Do not prescribe.

See SPS link below to understand safety risks associated with betamethasone soluble tablets used as mouthwash (off-label use). Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; See Guide for Primary Care on the use of off-label topical steroids for inflammatory oral conditions within the Oral Medicine Department Non-steroidal anti-inflammatory drugs Benzydamine 0.15% oral rinse/spray (Difflam ®) (TLS Green) tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue,

Acne Acne is a common skin condition that affects most people at some point. It causes spots, oily skin and sometimes skin that’s hot or painful to touch. Acne most commonly develops on the face. If small amounts of Caphosol or NeutraSal are swallowed accidentally, no adverse effects are anticipated. A dry mouth occurs when your mouth does not produce enough saliva to stay moist. It is a common concern, yet it is often not reported or properly managed.BiotèneMoisturising Gel helps provide protection against dry mouth. It moisturises oral tissue to give long lasting relief.It comes in a small tube for discreet application. Portable and easy to use, Biotène Moisturising Gel has a gentle feel that refreshes and moisturises. It helps provide moisturisation for people with a dry mouth. RED - Hospital only – to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.