Medication To Dry Up Saliva?

A DOCS Education member asks:
What is the best anti-cholinergic to use to dry up saliva before starting a large restorative case? This mid-fifties male is healthy and takes no medication.

Thanks!


DOCS Education faculty member, Dr. Jerome Wellbrock, responds:

I would stay with hydroxyzine, up to 100mg. Some patients will have unwanted side effects with other anticholinergic medication (such as those used for motion sickness), which may include symptoms like blurred vision which would otherwise be concerning during a sedation appointment.

Editor’s note:
Hydroxyzine is a very safe medication when dispensed according to DOCS protocols. However, an overdose of a medication with anticholinergic effects can lead to anticholinergic syndrome, which poses a serious risk to patients. Should a patient self-medicate or neglect to include an anticholinergic on a health history, this mnemonic is used by doctors to identify the main symptoms:

  • Blind as a bat (dilated pupils)
  • Red as a beet (vasodilation/flushing)
  • Hot as a hare (hyperthermia)
  • Dry as a bone (dry skin)
  • Mad as a hatter (hallucinations/agitation)
  • Bloated as a toad (disruption in peristalsis)
  • And the heart runs alone (tachycardia)
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