As a hygienist with Sjogren’s syndrome, I know this frustration firsthand from both the clinician and patient perspectives. My personal and professional experience has shown me that there is no one-size-fits-all approach—what works for one patient may not work at all for another. Finding the ultimate treatment regimen usually involves a process of trial and error with a combination of products.
As clinicians, we’re better positioned to guide patients to an individualized solution when equipped with a working knowledge of the available options and a sense of which products are both safe and effective. Based on the products I have used and found most helpful, I’ve identified nine that provide a range of excellent options.
What it is: A self-adhering disc lozenge that includes xylitol and allows for convenient hydration over extended periods. Xylitol exposure neutralizes PH which has been shown to protect high-risk patients from tooth decay.
How it fits in: Can be used safely at nighttime or anytime during the day for dry mouth relief.
My experience: XyliMelts are great for sleep, but I also like to use them in the daytime on occasion. In addition to providing great relief, the self-adhering disc is convenient and long-lasting: the slow release of xylitol lasts anywhere from 45 minutes to one hour.
Where to purchase: Amazon, in stores, OraCoat.com
AllDay Dry Mouth Spray
What it is: A dry mouth relief spray with 44% xylitol, the highest concentration of any OTC spray. It also contains a hydrogel that adds additional lubrication and relief.
How it fits in: Can be used any time of day. It’s convenient to keep with you at all times, and it can be used several times a day and provides great protection because of the xylitol content.
My experience: This spray provides lasting comfort and has a great taste. The hydrogel is quite good at providing long-lasting lubrication of dry oral tissues.
Where to purchase: Amazon, in participating dental offices, Elevate Oral Care
What it is: Sugar-free soft chews containing arginine bicarbonate and calcium carbonate that help neutralize pH and enhance enamel health.
How it fits in: Patients use them two times a day, morning and night (after brushing).
My experience: BasicBites are great. While they don’t provide immediate symptom relief as some of the other dry mouth therapies do, over an extended time they will protect the enamel. With the combination of arginine and calcium, these are a great choice for our high-risk dry mouth sufferers.
Where to purchase: Amazon, BasicBites
MI Paste One
What it is: MI Paste One is among the newer formulas in the MI Paste line from GC America, which contains Recaldent and fluoride. It’s ideal for sensitivity, decalcification, and remineralization, and in preventing white spot lesions.
How it fits in: Part of a preventive daily regimen for the elevated risk of caries associated with xerostomia.
My experience: I like MI Paste One for the added benefit of protection. As a Sjogren’s patient, I have areas of recession that are high-risk sites because of my severe xerostomia. This may not be a necessary product for all dry mouth sufferers, but it is something I choose to use.
Where to purchase: Amazon, in participating dental offices
What it is: A sugar-free, 100% natural xylitol gum. It’s a great option for patients suffering from dry mouth who want an alternative to a spray or lozenge.
How it fits in: Can be used as needed and is convenient to keep on hand.
My experience: Spry gum has a great flavor and I like to use it for the added xylitol benefit. As with many things, the flavor is only going to last for so long. But overall, this is a handy option for dry mouth sufferers.
Where to purchase: Amazon, Xlear
FluoriMax 5000PPM toothpaste
What it is: 5000 parts per million (PPM) toothpaste to be used for caries prevention. This formula contains 10% xylitol and has the highest fluoride uptake on the market.
How it fits in: Used daily, morning and night, to aid in caries reduction. It’s part of a preventive regimen for xerostomia patients who are at increased risk of decay.
My experience: Has a great flavor and is my personal choice for a 5000ppm toothpaste because of its fluoride uptake and xylitol concentration.
Where to purchase: In participating dental offices, Elevate Oral Care
What it is: A small wearable device designed to provide a continuous stream of water to the oral cavity via a hidden microtube. It directly delivers and replenishes moisture to the oral tissues versus relying on stimulating the patient’s own salivary function.
How it fits in: This device can be worn 24/7, including nighttime and during exercise. It may provide relief for patients who have found other products relying on natural flow stimulation to be insufficient.
My experience: This device has been incredibly beneficial to my personal arsenal of relief therapies. I can wear this device out in public and on work calls without anyone noticing I have it on. The earpiece is comfortable, and the device provides great hydration.
Where to purchase: Voutia
What is it? A powder containing supersaturated calcium phosphate that becomes a rinse when added to water. The powder dissolves into a solution containing a high concentration of electrolytes, similar to natural saliva.
How it fits in? Can be used multiple times a day, depending on the severity of symptoms.
My experience: While SalivaMax is not something I use daily, it is particularly helpful during oral “flares” from my Sjogren’s syndrome. At these times I find that it provides great additional relief of my dry mouth and throat.
Where to purchase: SalivaMax
WaterPik Cordless Ion
What it is: One of the WaterPik family of water flossers. Water flossing is a great adjunctive for patients dealing with dry mouth. While any of the WaterPik line of products are a great choice, I’m highlighting the new cordless Ion because that’s what I most often use.
How it fits in? Most patients with dry mouth struggle with clearing food debris because of the lack of salivary flow. Residual debris puts these already vulnerable patients at an even higher risk. Patients can use this as preventive on a daily basis, if not after each meal.
My experience: My WaterPik has become something I could not get by without. Water flossing is another one of my go-to answers for relief during Sjogren’s oral flares. Even after brushing and flossing, my WaterPik removes debris that I would have otherwise missed.
Where to purchase: Amazon, WaterPik
Brooke Crouch, RDH is a hygienist and dental industry educator with more than a decade of clinical experience in private practice and non-for-profit state and federal health care providers. She lectures on a range of dental and hygiene related topics, with a particular focus and expertise in the area of managing and treating xerostomia. Brooke provides education on xerostomia as a clinician and patient as she is a Sjogren’s sufferer. In addition to being a recognized author and national speaker, she serves as a Preventative Care Consultant for Elevate Oral Care and is the Senior Vice President of the American Mobile & Teledentistry Alliance.