Preventive Protocols and Quality Recommendations: Helping Your High-Risk Dry Mouth Patients

by Brooke Crouch, RDH


Is dry mouth a complaint you hear frequently from your patients? Does your mirror ever stick to your patient’s cheek during their dental visit? We can all probably think of those patients – those patients with severe dry mouth. The American Dental Association reports that anywhere from .9-64.8% of patients suffer from dry mouth.1 The true prevalence is hard to define due to the data being subjective. We rely on our patients to report their symptoms to us – which many do not do. It is important to remember that dry mouth makes a patient high risk for dental caries and dental disease due to poor salivary flow and poor saliva quality. Many things are factored into a patient having dry mouth. Some of those factors include age, medications, auto-immune disorders and cancer treatment. It is important that we review medical histories closely and recommend products aimed at relief and prevention of dental disease. When it comes to xerostomia and dry mouth relief, there is no one-size-fits-all approach. It is a lot of trial by error by the patient. And what works for one may not work for another. It is our job, as clinicians, to know the various options out there and to make sure they are safe for our patients. One of the most important factors, other than patient comfort, is keeping a neutral pH for high-risk xerostomia patients. Therefore, recommending products we know are safe is our ultimate responsibility as a dental provider. As a hygienist who also has Sjogren’s Syndrome, I have spent many years researching and trying various products to lower my own risk for dental disease. I share the following products with you as a dental hygienist and one of your highest risk dental patients.



What is it: Self-adhering disc technology that includes xylitol and allows for hydration during sleep because of its adhering technology. These are great for extended periods of time, and because of the xylitol exposure, helps protect high-risk patients.

How does it fit in: Can be used safely at nighttime or anytime during the day for dry mouth relief.

My experience: These are great for nighttime, and I also like to use them throughout the day. They provide great relief and because it’s a disc technology; its slow release of xylitol lasts anywhere from 45 minutes to one hour.

Where to get it: Can be ordered online and on Amazon.

AllDay ®Spray and Allday ® Gel

What is it: A dry mouth product that comes in both a spray and gel delivery method with 44% xylitol, the highest concentration of any OTC spray. Also contains a hydro-gel that adds additional lubrication and relief.

How does it fit in: Can be used any time of day and is convenient to keep with you at all times. Can be used several times a day and great protection because of the xylitol content. These products complement each other and can be used interchangeably.

My experience: This spray and gel provide lasting comfort and have a great, refreshing taste. The hydro-gel allows for the lubrication of dry tissues, and lasts for quite a while.

Where to get it: Order directly from Allday Dry Mouth Relief website, may be dispensed in your dental office, or ordered on Amazon and

FluoriMax 5,000 PPM toothpaste

What is it: 5,000 parts per million (ppm) toothpaste to be used for caries prevention, and this formula contains 10% xylitol and has a higher fluoride uptake than competitors on the market.

How does it fit in: Used morning and night to aid in caries reduction, which is a high concern for our xerostomia suffering patients.
My experience: This toothpaste has a great flavour and is my personal choice for a 5,000 ppm toothpaste because of its fluoride uptake and xylitol concentration.

Where to get it: Prescribed and dispended by your dental provider. Dental providers can purchase from Elevate Oral Care’s website.

Basic Bites

What is it: Sugar-free soft chew containing arginine bicarbonate and calcium carbonate that helps neutralize pH and enhance enamel health.
How does it fit in: These are used two times a day; two chews are used by the patient after brushing morning and night.

My experience: Basic Bites are great. They do not provide immediate relief as many other dry mouth therapies do, but over an extended time they will protect the enamel. And with the combination of arginine and calcium, these are a great choice for our high-risk dry mouth sufferers.

Where to get them: These can be purchased directly from Basic Bites or can be ordered from Amazon.

MI Paste One

What is it: MI Paste one is one of the newest formulas in the MI Paste line from GC America, and contains Recaldent and fluoride. It is ideal for sensitivity, decalcification, remineralization and to prevent white spot lesions.

How does it fit in: For someone like myself, with Sjogren’s Syndrome, I use MI Paste in addition to all other therapies I’ve mentioned. I apply MI Paste on my areas of recession in the evening.

My experience: I like MI Paste One for the added benefit of protection. I have areas of recession and I know these 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 get it: Dental offices may dispense this product or it may be purchased online.

Spry gum

What is it: This is a sugar-free, 100 percent natural xylitol gum. This is a great option for patients suffering from dry mouth who want something other than a spray or lozenge.

How does it fit in: This can be used as needed and is convenient to keep on hand.

My experience: Spry gum has a great flavour and I like to use it for the added xylitol benefit. As with many things, the flavour is only going to last for so long (and remember each person is different). But this is a great product for dry mouth sufferers.

Where can you get it: This can be found in stores and ordered online, as well as on Amazon.

Xlear Nasal Spray

What is it: A xylitol and saline nasal spray that uses a patented xylitol solution that works against bacteria and pulling moisture into the nasal cavity.

How does it fit in: This nasal spray can be used daily to hydrate and protect the nasal cavity. Most dry mouth patients tend to experience dry sinuses at times, particularly Sjogren’s patients.

My experience: I use this daily and find that it’s been a great addition to help my dry nasal passages.

Where to get it: This can be found at various drug stores and some natural food stores, as well as Amazon and directly from Xlear.

SalivaMax by Forward Science

What is it: This is a rinse that contains supersaturated calcium phosphate powder that is dissolved in water and used by the patient. When the powder dissolves in water, the patient is left with a solution containing a high concentration of electrolytes, similar to natural saliva.

How does it fit in: This rinse is used by the patient and can be used multiple times a day, depending on severity of symptoms.

My experience: While SalivaMax is not something I am using on a daily basis, I have used it during an oral “flare” from Sjogren’s syndrome and have found it to provide great relief. This would be ideal for many severe dry mouth sufferers to aid in their discomfort of dry mouth and dry throat.

Where to get it: This is available by prescription only, but Forward Science makes this an easy process. To learn more visit their website.

WaterPik Cordless Ion

What is it: WaterPik makes a variety of water flossers and this is a great additive for patients dealing with dry mouth. Any line of WaterPik products are a great choice; I’m highlighting the new cordless Ion because that’s what I most often use.

How does it fit in: Most patients with dry mouth struggle with clearing food debris because of the lack of salivary flow. Food debris not being cleared from the mouth effectively puts these high-risk patients at an even higher risk. This should be used on a daily basis, if not after each meal.

My experience: My WaterPik has become something I could not get by without. Many times, my Sjogren’s syndrome causes oral flares, and when that happens my WaterPik is one of my go-tos for relief. Even after brushing and flossing, my WaterPik removes debris that I would have left otherwise.

Where to get it: These can be purchased directly from WaterPik or on Amazon.

Excerpts from this article were originally published in RDH magazine.


  1. Xerostomia. American Dental Association. 2021.

About the Author

Brooke Crouch is a registered dental hygienist with over thirteen years of clinical experience, both in private practice and public health. Brooke is a dental hygienist with Sjogren’s Syndrome and has made it her mission to help dry mouth patients across the world. Brooke has provided mobile dentistry in both a school-based and nursing home setting. Brooke is the Professional Education Specialist for Elevate Oral Care and a Senior Executive Consultant with Cellerant Consulting. Brooke is the past Vice-President of the American Mobile and Teledentistry Alliance (AMTA) and is now a founding board member for AMTA. She also serves on the editorial board for RDH Magazine. Brooke enjoys sharing her passion of prevention with her peers and helping dry mouth patients through education.

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