Counteract the Causes and Damaging Effects of Dry Mouth Syndrome
with Targeted Stem Cell-based Injections in Saliva Glands
Dry mouth syndrome comes with a variety of undesirable conditions. As a consequence of insufficient wetting, impairment of oral functions such as speech, chewing, and swallowing, as well as a reduced lubrication of consumed foods is possible. Additionally, the oral mucosa can regularly be affected by ulceration, frictional trauma, while the mouth in general can be prone to excessive microbial overgrowth, leading to dental erosion, caries and oral candidiasis.
Systemic disease such as high blood pressure and diabetes, and their management through medication can cause dry mouth symptoms. There are also autoimmune causes, like Lupus, Sjögrens, sarcoidosis or chronic eczema. Besides these factors, a wide range of other diseases can result in dry mouth symptoms.
Besides the numerous medical therapies which can significantly decrease salivary gland function, the most severe cases are due to radiation therapy or chemotherapy in Head and neck cancer patients. The incidence of Head and Neck Cancer is globally increasing, with approx. 300.000 of newly diagnosed cases every year. Radiation therapy as one of the most important treatments in Head and Neck Cancer significantly affects healthy tissue which surrounds the tumor, which usually includes the salivary glands. The decline of gland function leading to dry mouth is called “xerostomia”, and often leads to the oral symptoms described above, which has a severe negative impact on quality of life of the patients.
Dry Mouth Syndrome - Diagnostics - Treatment - Stem Cells - Medication
On this page, we inform you about Dry Mouth Syndrome giving an overview on important aspects of causes, treatment options, precision diagnostics that reveals the cause of pain as well as our stem cell-based therapies that we offer in Offenbach (near Frankfurt am Main) Germany.
Jump directly to the following topics:
- Conventional therapies
- ANOVA therapies for Dry Mouth
- Expectations and limits
- Diagnostics of inflammatory sites
- The ANOVA difference: targeted treatment
- You want a second opinion
- Workflow of the treatment process
- FAQ- frequently-asked questions
- Sources and Literature
Our stem cell treatments are experimental, but we only treat patients for whom we believe the risk/benefit ratio indicates treatment based on the state of the art, i.e., medical, scientific evidence.
Please understand that we therefore do not treat patients for whom the following points apply:
- Active cancer in the last two years
- Not yet of legal age
- Existing pregnancy or lactation period
- Unable to breathe on own, ventilator
- Difficulty breathing in supine position
- Dysphagia (extreme difficulty swallowing)
- Psychiatric disorder
- Active infectious disease (hepatitis A, B, C, HIV, syphilis, or other)
Existing Conventional Therapies for Dry Mouth Syndrome
Medication, Lubricants and Time
Currently available treatments aim at improving salivary gland function, but all of them are symptomatic treatments. This means that those strategies merely stimulate the function of the remaining salivary gland tissue, or they provide limited improvement in lubrication. Some of them include sialagogues, saliva stimulants (such as sugar-free chewing gum and candy with weak acidity), and the application of saliva substitutes and oral lubricants. All of these bring short-term ease, but none of them regenerate the tissue for a long-term effect.
Usually, symptoms decrease with time and after 2-3 years, saliva productions slowly increases.
Stem Cell Treatments for Dry Mouth Syndrome - DMS at
ANOVA Institute for Regenerative Medicine - Offenbach, Germany
BMC, Secretome/Exosomes, PRP
ANOVA Institute for Regenerative Medicine is now offering stem cell treatment for patients with Dry Mouth syndrome. Get in touch with our medical professionals today to find out more about your treatment options.
Potency Hypothesis of Stem Cell Therapies
Stem cells possess the potential to communicate with the immune cells that elicit inflammation and by natural, so far not understood mechanisms may inhibit the immune-over-reaction that blocks regeneration. Furthermore, stem cells have the ability to stimulate regeneration of tissue thereby fasten the tissue recovery. The aim of a stem cell treatment for DMS is to reduce residual inflammation and to stimulate and fasten regeneration in radiation-damaged saliva glands.
MSEC - Mesenchymal Stem Cell Secretome - Exosomes - Autologous
As Dry Mouth Syndrome arises from severe damage to salivary glands, we usually treat patients with MSEC (secretome, exosomes, EVs) of mesenchymal stem cells (MSC, AD-MSC, adipose-derived, fat-derived stem cells) which we harvest from the patients belly in a mini-liposuction (very brief and limited liposuction) under slight sedation. Worldwide, ANOVA is the first stem cell clinic to acquire legal permission form the responsible governmental authorities and therefore, offers high quality, safe and legally-controlled autologous (own) exosome-containing secretome.
The main advantage of MSEC is that in contrast to live stem cells which would loose their therapeutic potency, can be frozen without loss of exosomes. This enables us to produce 10-20 injection doses from one liposuction which can then be administered over a longer treatment period. This is especially advantageous for continuous stimulation of saliva gland regeneration in DMS. The MSEC can be injected directly into the damaged glands.
What a Secretome/Exosome is and how they compare is explained on our overview page.
BMC - Bone Marrow Concentrate - Autologous
Autologous (self) BMC are the second stem cell therapy that we use for treatment of dry mouth syndrome. However, BMC is a one-injection per bone marrow donation treatment.
In severe cases, we initiate treatment with localized BMC injection followed by localized MSEC injections. BMC contains autologous meaning patients own, adult stem cells (hematopoietic and mesenchymal stem cells in natural composition) which we isolate and concentrate from your pelvis crest in a short process under slight sedation.
These stem cells are supposed to inhibit the residual inflammation and stimulate the regeneration of saliva glands.
More information about this type of stem cell therapy is summarized on our page an BMC.
PRP - Platelet-Rich Plasma - Autologous
PRP - platelet-rich plasma is usually not used in the treatment of Dry Mouth Syndrome.
It is a comparatively inexpensive, blood-derived stimulant for wound healing and repair.
More on PRP (as a combination therapy) is summarized on our PRP overview page.
How does the ANOVA Therapy differ?
Diagnostics – We Look for the Cause of your Pain
Prof. Dr. Dr. Dr. M. K. Stehling, the founder of ANOVA IRM and the Vitus Prostate Center , is a radiologist (MD) and holds a PhD in physics. For this reason, the ANOVA Institute for Regenerative Medicine, in cooperation with the Prof. Stehling Institute for Diagnostic Imaging located in the same building, has the capability to use special precision diagnostics such as arthro-MRI and non-radioactive contrast MRIs.
Compared to many conventional MRIs, these methods are often able to localize the pain-causing inflammation in your joints and tissues. This enables us to determine individually how patients should be treated and where the stem cells should be applied.
Furthermore, in consultation with you and if advisable, we supplement our patient-specific diagnostics with specific blood tests on hormones, inflammation parameters and other factors that are important in your case, or recommend further examinations such as a preventive MRI spinal scan.
How Does the ANOVA Therapy Differ?
We Implant the Stem Cells Precisely Where They are Needed
Based on our specific diagnostics using arthro-MRI and non-radioactive contrast medium MRIs, we can, in contrast to many other clinics, deliver the stem cells with image support, e.g. using CT, precisely to the affected area. This means we can inject into and at glands to specifically and quickly trigger an effect where regeneration is to be induced. All interventions are performed under supervision and care of our anesthesiologist and are pain free.
A purely intravenous administration, as many other clinics do, is only performed for the secretome (exosomes) if it is needed to centrally modulate immune reactions.
Of course, we will thoroughly advise you in the early process and the on-site consultation in advance on all steps and discuss alternatives and expectations.
Are you Interested but Uncertain? Book a Counseling Appointment!
Our patient care managers are happy to inform you about what information we need upfront (MRI, CT, X-ray), how to transfer large data files and schedule a counseling appointment with our physicians for you. Our patient care managers are happy to inform you about what information we need upfront, how to transfer large data files and schedule a counseling appointment with our physicians for you. Please use our contact form to support a fast processing of your case and request.
You are also always welcome to send us an e-mail about your case. The counseling appointment may also take place per telephone or video chat if you live outside Germany. For more intense counseling or additional diagnostic evaluations you may also book an on-site appointment. We can perform needed MRI on the same day. All services rendered by our patient care team are free of charge and we inform you about all physician appointment charges up-front.
Therapy Workflow for Dry Mouth Syndrome
The precise workflow is described in detail on the stem cell- specific pages of BMC, Secretome/Exosomes and PRP (rarely used in DMS cases).
All therapies are divided into phases such as evaluation of the medical history (we analyze your current therapies and medical records), initial counseling and evaluation of potential, patient-individual benefit of a stem cell therapy (indication statement), preliminary examinations, diagnostics, consultation on all therapy options, preparation of an individual treatment plan including cost estimate, harvesting of tissue, production of the stem cell product, quality control of the product and application. There are two special features for osteoarthritis and arthritis patients. If your previous findings have not found the specific causes of your joint pain, we will examine you in advance with a precise and informative arthro-MRI or an MRI with non-radioactive contrast medium, if you wish. In addition, we often apply the stem cells (BMC) intra-articularly (i.e., directly in the joint). This means that we deliver the stem cells to the exact location where your pain originates.
Unfortunately, according to the risk-benefit ratio, we cannot treat children or pregnant women. In addition, other factors can also be exclusion criteria.
How Long Does a Stem Cell Therapy Take?
The initial analyses and counselling can be done without you having to travel to Offenbach (near Frankfurt/Main, Germany). This period can be 2 weeks up to months depending on the availability of patients slots. If you live further away, we will conduct the initial discussions by telephone or video conference. For the actual treatment, you will travel to Offenbach. Then, depending on the therapy, the tissue collection, quality control and treatment type it will take as follows:
BMC- and PRP-Therapy
Each donation and application of BMC and PRP (as combination therapy) on-site period: 2 days (consecutive days).
Preparation and harvest of the fat (mini-liposuction) need once 2 days (consecutive days) in Offenbach, followed by enrichment of the mesenchymal stem cells (Secretome/Exosome) and quality control. Approximately 4 weeks after the isolation, the therapy begins according to the therapy plan determined with you. You will then come to Offenbach am Main (Germany) several times for the application. The shelf life of the secretome (exosomes) is 2 years.
How Much Does Stem Cell Treatment Cost?
Our treatments are always tailored to your specific situation, disease, stage and other factors. The therapies differ in the product used (BMC, secretome or PRP), the frequency of treatment as well as the further examinations and your sedation and anesthesia wishes. A treatment for Dry Mouth Syndrome can cost from a few hundred to several thousand euros. You will receive a cost estimate for all treatments in advance so that you can accurately estimate what a treatment would cost in your individual case.
Does my Health Insurance Cover the Therapy Costs?
Unfortunately, at the moment it is assumed that health insurance companies do not cover the costs of experimental therapies (BMC, secretome, PRP, micro-fracture technique), i.e. you will have to bear the costs entirely yourself.
The Power of Stem Cells Treatment - External Scientific results
Adult stem cells are abundant in almost all tissues. Stem cells have been identified as a resourceful option for the treatment of a wide range of degenerative disorders. Their effectiveness is known to lie in their secreted molecules, as well as in their ability to differentiate into different types of specialized cells. Recent research has shown that mesenchymal stem cells (MSCs), and in particular stem cell secretome Therapy have a number of characteristics which are useful in tissue regeneration, including anti-inflammatory and anti-apoptotic effects. Stem cells can enhance immunological parameters and tissue-regenerating properties. For radiation-induced xerostomia (which is dry mouth due to cancer radiation treatment), stem cells have shown promising results in recent studies 1,2. The results indicate that stem cells improve the amount of saliva by 33% after four weeks and 50% after four months 2. Additionally, stem cells may reduce the amount of scar/fibrous tissue in the gland and the feeling of thirst.2
Please note that stem cell therapy is still an experimental therapy for all medical indications, including dry mouth. Therefore, your attending physician will assess the benefits and risks of stem cell-based therapy for your individual case. If the benefits outweigh the risks, your doctor can suggest the treatment as an option to you.
Frequently Asked Questions: Stem Cell-Based Treatments and Regenerative Therapies for Osteoarthritis
What is Dry Mouth Syndrome?
Dry mouth syndrome (Xerostomia) is the symptom-based name of a condition in which the salivary glands in the mouth are not able or do not produce sufficient saliva to keep the mouth and tongue wet. Dry mouth often arises as a side effect of radiation therapy for cancer or certain medications. In rare cases it seems to be a aging-related issue.
How is Dry Mouth Treated?
The normal treatments follow the following strategies:
- Reduce all substances that can further reduce saliva: alcohol, tobacco, caffeine, mouth washes unless DMS-approved
- Reduce drying from breathing: enhanced breathing through the nose
- Stimulate saliva production: sugar-free chewing gum, sweets
- Passive wetting: frequent zips of water or herbal tee, medical lubricant spays
Sources and Literature
- Xiong, X., Shi, X., & Chen, F. (2014). Human adipose tissue derived stem cells alleviate radiation induced xerostomia. International journal of molecular medicine, 34(3), 749-755.
- Grønhøj, C., Jensen, D. H., Vester-Glowinski, P., Jensen, S. B., Bardow, A., Oliveri, R. S., ... & Jensen, M. (2018). Safety and efficacy of mesenchymal stem cells for radiation-induced xerostomia: a randomized, placebo-controlled phase 1/2 trial (MESRIX). International Journal of Radiation Oncology* Biology* Physics, 101(3), 581-592.