Introduction
xerostomia, CKD, chronic kidney disease, chronic renal failure, pre-cancerous or malignant lesions, uremia, HD, Xerostomia, ESRD, tooth loss, dry mouth, Hyposalivation, dryness
XEROSTOMIA, CHRONIC RENAL FAILURE, UREMIA, PERIODONTITIS, DECREASED SALIVARY FLOW, XEROSTOMIA, DENTAL CARIES, ESRD, HYPOSALIVATION, DRY MOUTH
In the past two to three decades, extensive research has been conducted on the oral and dental health of elderly people. Dental caries, tooth loss, periodontitis, xerostomia, oral pre-cancerous or malignant lesions, and oral health-related quality of life were the oral conditions associated with older patients [For the foreseeable future, an aging population with a high rate of coexisting illnesses is anticipated to exist with a prevalence of 46.3% chronic kidney disease (CKD) [Hemodialysis (HD) has a significant effect on salivary secretion and the biochemical composition of saliva, as patients on HD have decreased salivary flow rates [The subjective sense of oral dryness known as xerostomia is most usually associated with either diminished salivary flow or altered salivary composition. On the other side, Hyposalivation is objectively determined as a reduction in salivary flow rate. Xerostomia is a somewhat common condition, especially in elderly adults, and it can have serious effects on a person's overall health, including oral health [In earlier investigations, a variety of pharmacological and non-pharmacological treatments based on stimulating salivary gland flow were evaluated to treat xerostomia and increase salivary flow in individuals with ESRD. Local stimulation as chewing of gum or citrus solid food or fruits, using various mouthwash formulas, low-level laser therapy, and acupuncture were used in the management of xerostomia, while, systemic stimulation with drugs like, angiotensin-converting enzyme inhibitors, cevimeline, pilocarpine, and angiotensin-receptor antagonists can all be used to mechanically stimulate salivary glands [Overall, it appears that the therapies that are currently accessible do not offer a long-term, complete, or successful management of xerostomia. This has increased the need for additional research into alternative therapies for the treatment of xerostomia [Honey has many therapeutic potentials, and it doesn't cause negative effects like other pharmaceutical treatments [The production of saliva is significantly influenced by nitric oxide (NO), which is a biological messenger and a free radical [Endogenous nitric oxide production in chronic renal failure patients is controversial. It has been suggested that the increase in the NO concentration may improve some pathological changes in uremia patients. The increase in NO in patients on hemodialysis could be due to hemodialysis membrane and/ or lack of renal excretion [To the best of the author’s knowledge, there are no published data regarding the use of Thyme honey oral rinse in the management of xerostomia in geriatric patients with ESRD. So regarding the up mentioned properties of Thyme honey, we hypnotized that using thyme honey oral rinse could improve subjective and objective dry mouth scores by increasing the salivary NO levels.