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Oral sialagogues are commonly recommended, but their optimal timing remains uncertain. This systematic review compares early (&lt;24\u00a0h) versus delayed (&gt;24\u00a0h) sialagogue initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature search was conducted in Embase, PubMed, CINAHL, and Cochrane from inception to January 2026. \u201cEarly\u201d protocols initiated stimulation within 24\u00a0h post-RAI, while \u201cdelayed\u201d protocols initiated after 24\u00a0h. Methodological quality and risk of bias were assessed using Cochrane\u2019s ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions, 2016) tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three observational studies were included, comprising 818 adults with reported mean ages of 43\u201359 years. Interventions consisted primarily of lemon candy or oral vitamin C tablets. Primary outcomes included acute sialadenitis (pain and\/or swelling), taste dysfunction, and xerostomia. Findings regarding acute salivary gland outcomes were inconsistent. Two earlier studies reported higher rates of acute sialadenitis with early stimulation (54.7\u201363.8% vs. 34.4\u201336.8%), taste dysfunction (37.5\u201339.0% vs. 18.8\u201325.6%), and xerostomia (23.8\u201346.9% vs. 11.2\u201329.7%) compared with delayed initiation. In contrast, the most recent propensity score-matched study, which evaluated a composite endpoint of acute salivary gland damage, reported lower event rates with early stimulation (4.78% vs. 15.22%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This review underscores how evidence regarding the optimal timing of sialagogue initiation after RAI remains inconsistent. These heterogeneous findings highlight the need for high-quality randomized controlled trials to establish evidence-based recommendations for sialagogue timing after RAI therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12020-026-04727-z","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:21:33Z","timestamp":1785759693000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early versus delayed oral sialagogues for the prevention of salivary gland dysfunction after radioiodine therapy in differentiated thyroid cancer: a systematic review"],"prefix":"10.1007","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9361-4973","authenticated-orcid":false,"given":"Andressa","family":"Frankowski Dagostin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2778-7164","authenticated-orcid":false,"given":"Novel Yourdhan","family":"Rehandhika","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7544-7771","authenticated-orcid":false,"given":"Ana Luiza","family":"Potiguara de Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3061-9263","authenticated-orcid":false,"given":"Soemiwati","family":"Holland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"4727_CR1","doi-asserted-by":"publisher","first-page":"4981","DOI":"10.1158\/1078-0432.CCR-16-0384","volume":"22","author":"SA Wells","year":"2016","unstructured":"S.A. 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