Local dentists prepare to launch discreet, wearable hydration for dry mouth

For the past quarter century, excessive dryness has been Jane Middleton’s enemy.

Since being diagnosed with what is now called limited systemic sclerosis – which causes the buildup of scar tissue on internal organs – Middleton has developed numerous autoimmune disorders, resulting in many oral surgeries. Due to complications from the surgeries, she’s lost all her teeth and bone support in her jaw.

Though surgery corrected some of her issues, the chronic dryness of Middleton’s mouth – caused by her condition – remained a perpetual problem. At night, she’d wake up multiple times in discomfort. During the day, she constantly had to sip water.

“I’d wake up in the morning, and my tongue would be so dry that my tongue would be stuck, and I would have to bathe my mouth in water to be able to talk,” says the 69-year-old. “And I’m quite a talker, so that was a real hardship for me.” But all that changed more than two years ago when a team of local doctors suggested she become a beta tester for a new device that wasn’t yet on the market. That device, now called the Voutia System, changed her life.

“It’s a pretty amazing device. I’ve been using it now over two years, and it has made a dramatic improvement in my dry mouth,” says Middleton, a retired educator who now lives near Lake Gaston on the Virginia and North Carolina border. “The device has made life much more comfortable, and I believe it has made it possible for me to be productive overall for a longer period.”

Developed by a Bon Air dentist over the past six years, the Voutia device aims to alleviate the symptoms associated with xerostomia, a condition caused by reduced or absent saliva flow, and acute dry mouth. Those undergoing chemotherapy, the treatment of neck and head cancers, and autoimmune problems may also benefit from using the device.

More than just an irritant, the lack of saliva means a lack of protection, leaving the teeth, mouth, gums and throat more prone to infection and abrasion. Without saliva, a person may become vulnerable to tooth decay, sore throat, gum disease, tooth loss and can have difficulty speaking and swallowing.

The inspiration for the device came nearly two decades ago, when creator Dr. Jeff Cash was diagnosed with stage four testicular cancer that had metastasized to his lungs. After a lymph node dissection and other measures, Cash underwent nine weeks of chemotherapy to combat the cancer. The oral complications and discomfort he experienced would become the impetus for Cash to create the Voutia System.

“It was extremely painful,” says Cash. “Orally, it impeded my ability to eat well, and what I could eat.”

In the two years since his invention was first reported in the Observer, Cash has worked to refine his prototype, created a business and has been cleared by the U.S. Food and Drug Administration to market Voutia as an over-the-counter device. Voutia has also been approved in Canada and Europe.

Though the system has undergone several design changes, the basic concept is the same as before: the device extends a tiny microfiber tube from an earpiece directly to the mouth, carrying water to combat dryness. A larger tube runs down from the earpiece to a small, wearable bag that carries the liquid and dispensary equipment. The system is intended to mimic normal saliva secretion rates.

“It’s a silent epidemic,” says Cash of chronic dry mouth. “It’s just something that people suffer with.”

Where Cash’s earlier prototype could fit inside a camera bag or fanny pack, his current model is slightly bigger than a 3- by 5-inch pack of index cards. He hopes to reduce its size even further.

“It’s been an interesting journey, and we’re finally at the point where we can offer it to the public,” says Dr. Thomas Eschenroeder, an oral surgeon and co-founder of the company who also lives in Bon Air. “In my experience, there is quite a bit of xerostomia. That is a clinical issue, and I’ve never in all my years come across a device like that that can provide relief from this annoying oral condition.” So far, Voutia – which means a “swig” or “sip” in colloquial Greek – has been tested by 20 patients.

“We have had 100 percent positive feedback,” Cash says. “They have received a significant benefit to alleviate their symptoms.”

While the device duplicates the function of normal salivary glands, Cash and Eschenroeder are careful to say that they lay no claim to being able to prevent any conditions, and that at this time they can only claim its use as a tool for moisturizing the mouth. From the initial prototype – which he first tested on himself – Cash has worked to refine his device, eventually partnering with an engineer to reduce its size. Cash adds that the pumping system has been designed to deliver medicinal agents, but studies must first be concluded to prove its safety.

A year ago, Cash submitted a report to the FDA, detailing all the of the device’s electronic and functional capabilities. The FDA ruled that the device shouldn’t pose a risk to consumers, and now, after two years of testing on patients, Cash and Eschenroeder believe Voutia is ready for prime time. Now looking to bring on investors as partners, the oral health professionals say they have a new tool in the treatment of complications resulting from neck and head cancers and autoimmune problems.

While Cash is legally the only current employee, Eschenroeder will become a major shareholder when investors are brought on. To get the word out, Cash plans to use a marketing team to contact and inform general dental practitioners and physicians of the device, as well as engaging the public through mailers, its website and support groups for cancer survivors.

Noting that they’re trying to keep costs down for consumers, Cash and Eschenroeder say they’re trying to price the device in the range of a few thousand dollars; it’s a steal, they say, compared to the $10,000 price tag of the average insulin pump. The men hope to have the device available to the public by early 2019.

While Cash still dreams of getting the device smaller than the current model, it’s already inconspicuous enough to create a few humorous interactions. Middleton says the tube is so unobtrusive people have removed it from her face three times, thinking it was an errant hair.

“It’s not at all noticeable. It’s very discreet,” she says. “This device could make a lot of people enjoy their lives more.” ¦