The Effects of Pilocarpine Mouthwash on Vocal Quality

Objective: to verify the effects of pilocarpine mouthwash on vocal acoustic parameters and salivation of healthy volunteers. Method: a clinical, randomized, placebo-controlled (saline) trial was conducted with 36 healthy individuals. Salivation was measured before and 15, 30, 45, 60 and 75 minutes after the administration of pilocarpine solutions (1% or 2%) or saline solution control. Blood pressure, heart rate, voice acoustic analysis, and assessment of symptoms resulting from the use of pilocarpine by visual analogue scale were measured before and at 75 minutes after treatment. Results: the increase in salivation was dosed (p = 0.021) and time-dependent. The 2% pilocarpine solution showed a significant difference in the salivation level of the volunteers who received saline at 60 and 75 minutes after the mouthwash (p = 0.001). Vocal evaluation was obtained with 22 individuals. Women did not present significant differences in the vocal acoustic parameters after pilocarpine use, while men presented a significant difference in the fundamental voice frequency after the use of pilocarpine solutions (p = 0.026). In addition, men presented a significant increase in absolute and relative Shimmer and in the amplitude variation coefficient (p = 045, p = 0.034 and p = 0.006, respectively) after the use of 1% pilocarpine. Conclusion: Our results show that topical treatment with pilocarpine via mouthwash increased salivation without significant adverse clinical effects. However, increased salivation caused voice alterations that could be explained by small saliva penetrations in the larynx, causing an incoordination in the vocal fold vibration cycle.

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