The effect of chewing gum on dry mouth, interdialytic weight gain, and intradialytic symptoms: A prospective, randomized controlled trial

Introduction The major salivary glands can be stimulated by chewing gum to increase saliva flow and decrease xerostomia. The aim of this study was to investigate the effect of chewing gum on dry mouth, interdialytic weight gain, and intradialytic symptoms in hemodialysis (HD) patients. Methods This prospective randomized controlled single-blind study was conducted with patients who had been treated for at least 6 months with sessions 3 days a week for 4 hours at two HD units. Patients were randomly allocated to chewing gum group or the control group. In the chewing gum group, gum was chewed for 10 minutes six times a day, and when the patients felt mouth dryness or were thirsty. In the nonchewing gum group, gum was not chewed. The patients were followed-up for 3 months. A total of three saliva samples were taken before starting treatment at the first, 12th, and 36th HD session. Data were collected with the Visual Analogue Scale (VAS), Hemodialysis Patients Fluid Control Scale, Dialysis Symptom Index, and Hospital Anxiety and Depression Scale at baseline, week 4, week 8, and week 12. Findings The study was completed with a total of 44 patients consisting of 22 patients in the each group. The second and third month VAS values (xerostomia) of the patients in the chewing gum groups were statistically significantly lower than those in the control group (P= 0.014,P < 0.001, respectively). The third month salivary flow rate in the chewing gum group was higher than the values in the control group patients (P < 0.001). Discussion It is anticipated that this study will raise nurses' awareness of dry mouth and encourage future studies on interventions to increase the salivary flow rate to prevent or treat dry mouth.