The second common Sjogren’s symptom that most patients experience is dry mouth. Ninety-two percent of Sjogren’s patients report having “dry mouth”, and as you well know, it can take a toll on us. It makes so many aspects of life more difficult — eating, socializing, working, sleeping — and can be expensive over time with products and the advanced dental care we need. First and foremost, you need to make sure you are well-versed in oral care for a Sjogren’s patient. To learn more about caring for your mouth, teeth, and gums, go to the Sjogren’s Foundation site and review the completed Clinical Practice Guidelines. Be sure to print them off and take them to your dentist as well! Following these guidelines strictly will help slow-down the impact of a dry mouth on your teeth (and your pocketbook).
In this section, I am offering up some popular OTC (Over-the-Counter) products and some personal favorites. The sections below are to help guide you to some products that may help you. These are not recommendations for the treatment of a particular issue, but they are things that have worked for me and have been recommended to me. If you have a real concern, a bad case of cracked tongue or thrush, or other issues, please do call a dentist ASAP and take the Clinical Practice Guidelines for Oral Care with you!
Many of us do use a prescription salivary stimulant (Salagen or Evoxac) and those can be helpful. Your doctor or dentist can prescribe these. I would recommend trying Salagen first (if you haven’t already) as it is the least expensive of the two. If Salagen works for you, it would be great to save the money. However, if it doesn’t Evoxac might be the right drug for you. In the long run, extra dental work is more expensive than the cost of the drug.
The Oral Care Kit of products for a Sjogren’s patient with moderate to severe dry mouth contains:
- Dry Mouth Toothpaste with Flouride
- Dry Mouth Rinse
- Good Dental Floss
- Good Toothbrush
- Dry Mouth Gel
- Dry Mouth Lozenges and/or Gum
- Tooth Remineralizing Product
- Sleep Solution for Dry Mouth
Additional products that patients use are prescription flouride toothpaste, a Waterpik, coconut oil for oral pulling and (of course) a humidifier.
In almost all products that you place in your mouth for moistness, you are looking for the main active ingredient to be XYLITOL. This is true in mouthwashes, toothpaste, mints, and gum! Xylitol is a sweet, has the ability to moisten our mouth, and has been proven to help reduce carries.
Let’s move on to specific products!
Daily Oral Care Products
The most important aspect of our dry mouth is the daily care we give to our teeth, gums, and oral tissue. Many of us brush our teeth after every meal (instead of the average morning and bedtime routine of others). Sjogren’s patients early in their journey may not be thinking about the impact of dry mouth on your teeth if things look good right now. That was me; I had no cavities when I was young. My dry mouth became more noticeable in my late thirties and I was caring for my mouth well (flossing, brushing 2x per day with Sonicare, seeing the dentist 2x per year). Then suddenly, the cavities started coming and then REALLY coming! (Read my story about the day I was told I had 14 cavities). So I’ve upped my oral care diligence!
Let’s start with Toothpaste
Dry mouth toothpastes should have at least these two essential ingredients: xylitol and Flouride (unless you have an allergy) to comfort and protect your mouth. They will also have a cleaning agent. They should NOT have the ingredient SLE (sodium lauryl sulfate) which is very rough and drying on a sensitive mouth.
The most recommended product (and dry mouth product line) is Biotene. Biotene Fresh Mint Flouride Toothpaste is a good product and often recommended by dentists. If your drugstore has created their own dry mouth toothpaste, it is likely they copied the active ingredients in Biotene. I know CVS has their own product at a great price. Take a look at the list of ingredients and compare before you purchase to know what you are getting (and not getting).
ACT used to make a dry mouth toothpaste I really liked, but I can’t find it. However, I found something I like better and is my favorite toothpaste! It is SQUIGLE. Weird name but good toothpaste. Squigle Enamel Saver Toothpaste is not only great for Dry Mouth with its high level of xylitol and no SLE, and it is good for tooth enamel as it has no harsh abrasives. It also has Flouride to protect our teeth from carries (or reduce them best as we can). I’m a big fan of this product.
You would think any floss will do…and any floss is better than none! However, I was surprised to learn how different floss can be. I used to use Glide because it was easy to get through my tight teeth. But my dental hygienist turned me on to a product I love and that performs so much better and with great comfort. I use Listerine UltraClean Mint Floss. on Amazon It’s a bit stretchy and clings to any debris. It also has a very mild mint flavor. But as I said at the beginning of the section any floss used daily is better than no flossing!
My favorite oral rinse is ACT Total Care Moisturizing Anticavity with Flouride Dry Mouth Mouthwash. I really like that it has Flouride, does coat my mouth, and the sweet mint is not too cloying. It’s my favorite for a reason!
Biotene Moisturising Oral Rinse is also the most recommended Oral Rinse. It works just fine but is not my favorite. this product has been the market leader for some time, so it may be worth seeing if your local drugstore has their own branded dry mouth rinse because if they do, it is likely this formula they are copying. Just hold up the bottle and compare ingredients. Then choose based on price!
Amazon Brand Solimo Dry Mouth Rinse comes in at a low price of $5.00. The first seven ingredients are the same as Biotene for Dry Mouth (but there are several other ingredients that differ). I prefer ACT for Dry Mouth, but this product does seem to lubricate my mouth. This product is worth a try for the price as ACT is currently $7.88 and Biotene is 9.88 (at the time of writing). It’s worth getting the small savings if you like the product well enough! I found it a little too sweet and cloying, so I will keep with my ACT for Dry Mouth.
I use MI PASTE PLUS for tooth remineralization. There is some support for remineralization products in the Clinical Practice Guidelines and you’ll want to review the information carefully. There is an MI Paste (without the Plus but I (and my dentist) prefer the Plus which has a form of Flouride that helps remineralization. I’m a big believer if making sure my products work as hard for me as possible! I use this product at night and smear it on my teeth. If you wear a mouthguard, you can wear your guard over the MI Paste Plus and it will hold the product in place and work even harder for you! I like that this company makes other flavors like Vanilla, Melon, Strawberry, and Tutti-Frutti. You can purchase this product from your dentist or from a place like DentaMart or Dental Essentials DentaMart may be limited in the flavors they carry, but I have found my dentist is often ordering the mint flavor. So beware if you dislike mint as much as I do! You can request that your dentist special order flavors for you and see if they will go for it. My favorites are vanilla and melon.
Products to Help Dry Mouth Feel Moist
Are you a gum or mint person? Whichever one you are, this is the area we get to break out, go wild, and have a flavor in our mouth OTHER THAN MINT! At this stage of the dry mouth game, I’m pretty sick of mint. The only place I currently have mint is in my toothpaste, my oral rinse, and the slight (but different mint) of my dental floss.
Chewing Gum for Dry Mouth
Personally, I don’t like to chew gum and I never do it in public. However, the act of chewing gum can stimulate saliva, so I chew at my desk, occasionally. As far as gum goes, there are A LOT of options. Most sugar-free gums have xylitol in them, and that’s the magic product for dry mouth. In fact, gum was the earliest product category to widely accept xylitol use because of it’s “burst of juiciness” effect. So pick up the sugar-free gum flavor you like best and make sure it has Xylitol in it. I reach for a new flavor at the store which is much cheaper than the “dry mouth” marketed products. The main product we are really needing is XYLITOL and this is one product that doesn’t cost us extra just because we’re a patient.
Mints for Dry Mouth
I’m a mint person. I’ve tried a lot of mints. I use just one product that meets all of my needs: Spry Mint in Berry Blast flavor on Amazon. Be warned that this link is the biggest size as I go through a lot and this is the best per-unit. This size is hard to find, so I placed it here, but do start with a smaller version to see if you like them. I love this product because it is small enough that it fits in the side of your cheek if you need to speak with someone. Usually, I have one in my mouth and if I have a meeting or a speech, I’ll pop one mint in the side of each cheek to slowly melt and provide some moistness. I also love it for its smooth coating that doesn’t irritate or poke my mouth. The coating also seems to make it last. I also love the berry flavor as it’s mild but still a flavor.
There is nothing worse than trying to discreetly maneuver a large mint to the side of your mouth only to have it pop out onto the floor while attempting the swipe. And for this reason, I don’t like the ACT DryMouth lozenges. They’re just too big. But they work if you want to give them a try. But … they are MINT (ick, unless you love mint).
A current favorite of a lot of patients and dentists are ICE CHIPS. They come in a lot of fun flavors! They also come in a Tin tray and in a resealable pouch on Amazon. This product is pure Xylitol, flavor, cream of tartar, and calcium stearate. So they are good for your mouth. The drawback for me is that they have sharp edges and melt very fast. But I like that two older women created this product and company, got on Shark Tank, and have been very successful! I encourage you to try their product!
OraCoat Xylimelts for Daytime and Sleep
One of my favorite products is Oracoat’s Xylimelts. This is a “darling’ product for many Sjogren’s patients. I can’t go a night without it! These little mints have an adhesive-like backing that sticks to your teeth once moist enough. I use two of these mints every night, one on each side of my cheek, and I rarely ever wake up for a drink of water. The trick to these is to place them on your teeth (I use my upper side teeth) and drink a little water to accelerate moistening the tablets. Once they have some moisture, the sticky back melts enough to adhere. I have never had one come off! they slowly melt and provide enough moisture for me to get a good 8-hours of sleep every night. I get my Xylmelts from Amazon. I prefer the non-flavored (slightly sweet) product and not the mint flavored. And because i use them every night, I get the larger bottle instead of the package.
I also use these when I’m speaking to large groups, or in a more formal work setting. When I’m speaking for an extended period of time, these help me get through without a lot of water sips (if any).
Oil Pulling with Coconut Oil
This is yet another use for coconut oil! Oil pulling is an old technique used for oral care. Just take a spoonful of coconut oil in your mouth and let it melt. Then swish it around for an extended period of time before spitting out. It is a bacteria fighter and it really moistens your mouth! Check out this article on Healthline. My favorite products is Dr. Bronner’s and frankly, I use coconut oil for a lot more than this! I consider coconut oil a very hard-working product for Sjogren’s’s patients! Dr. Bronners is not selling on Amazon right, but I get it at my local grocery store. There is a decent product at Trader Joe’s too, and the individual packets are very handy for multiple uses. There are many products on the market, so look for something you like, but be sure to get the whole, saturated oil (solid when cool). This whole product has more beneficial qualities than fractionated oil.
Products to Help Issues from Dry Mouth
My most common mouth “issue” in addition to dry mouth, is angular cheilitis. That’s the red patches that can crack open at the corners of your mouth. It’s best to start treating these as soon as you see slight redness so it does not advance. Once that happens, the healing process is long and painful. If this is a common issue for you, especially if it is an advanced situation where you have cracked the corners, do go to the dentist or doctor to confirm what it is. Then discuss a treatment plan that is right for you. If it is yeast, ask if placing a bit of Monistat cream is helpful in your situation. Because once you know what triggers this problem for you, and what the issue really is (yeast or something else), then you can have your plan of attack ready to roll at the first sign of redness.
I have had oral yeast go wild in my mouth — called thrush. It is not fun! My tongue got white, bumpy, and eventually cracked in several places. I needed a serious oral yeast medication that wreaked havoc on my gut. Now, I know the early signs and I will start treatment by holding yogurt with a high amount of probiotics in my mouth for a period of time before swallowing. I will do this throughout the day. If it’s a little more advanced, I will take a Monistat insert ovules, cut it in half, and suck on it. Oddly, there is no odd taste! I suck and spit, so I don’t ingest much product. I cleared this approach with my dentist, but you will want to clear it with yours! You should ask your doctor or dentist first as a prescription may be a better choice for you.
Coconut oil pulling also helps!
Oral Care Tools
Sonicare Toothbrush. I love my Sonicare! I think it’s an essential tool for a Sjogren’s patient. There is a lot of research behind the sonic technology being able to remove more tartar and debris from our teeth than a manual toothbrush. There are several Sonicare options, but the most purchased product is this Sonicare. It is important to remember to change the head of the toothbrush every three months. And this is where the extra expense comes in. You can purchase a large bundle of toothbrush heads ar a decent price at Costco, if you’re a member. For these, do know that they are white, so if you purchase a black Sonicare, know that the price deals often come in white (only).
Waterpik Water Flossers are another recommended product for Sjogren’s patients. I don’t have one of these, but I should. Writing this will remind me to purchase one! I understand from people that brush with a Sonicare and floss nightly, that adding the Waterpik helped make a difference in their oral care! I do know my dentist has recommended it to me. The most popular Waterpik is this one, but there are several other models to review if you’re interested.
Recently, I’ve seen an ad for a combo Sonicare and Waterpik product where the toothbrush shoots out water as well as brushes. If anyone has tried this and compared it to a standalone Waterpik, let us know what you think! Although a convenient-sounding tool, sometimes combining technologies only diminishes the effectiveness of each one. So I’ll wait to hear more about this product.
There is trial and error in what products work best for each patient. But once you find the products that work best for you, you’re really dialed in for awhile. I’ll keep this page up to date to the best of my ability for new and favorite products.