The value of salivary substitutes for many elderly patients is indicated by a simple web search which
found 2,470 references, with references to prescribing across the globe. To contain the public expense, prescribing medicaments within the National Health Service in England is limited to approved lists. It is argued that: the prescription of this symptomatic therapy should be based on potential benefit for the xerostomic patient and not, as now, primarily on the pathological aetiology of the oral dryness. Secondly, that the professional caring for that oral problem- the dentist, is best placed to manage the prescribing as part of the overall management of the patient, independent of any reference to the patients physician that may be appropriate as part of the overall management of the patient.
The value of salivary substitutes for many elderly patients does not need to be argued in this Journal, but this need is not adequately perceived outside the dental profession. Restriction on prescribing within the public funding of the National Health Service (NHS) in England has produced the anomalous position where prescription by medical practitioners is allowed but not by primary care ‘General Dental Practitioners’. This is obviously of direct importance for patients in England
but a simple web search found 2,470 references to salivary substitutes, with references to rescribing across the globe. It seems this difficulty is not just a parochial issue. This problem is a further example of the need for those specialising in gerodontology to establish relevant bases for ‘patient-centred’ care.
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