Sjögren’s disease is an autoimmune disorder that frequently causes overwhelming dryness, especially in your mouth, eyes, and respiratory tract. Even your skin, nose, throat, and genital area can be impacted. But the most common complaint is dry mouth, which can lead to a burning sensation, taste changes, and a sticky feeling.

The discomfort associated with dry mouth symptoms isn’t the only risk to contend with when you have this autoimmune disease. You’re also at risk for cavities, periodontal disease (gum disease), and even tooth loss. In fact, people with Sjögren’s typically have, on average, three fewer teeth than other people their age. For this reason, you need to do everything you can to protect your oral health. Here are 10 ways you can keep your mouth healthy and practice good oral care.

1. Drink Plenty of Water

Xerostomia (dry mouth) is one of the most common symptoms of Sjögren’s disease, with 73 percent of people with this condition saying it impacts their quality of life. Dry mouth can also cause a burning sensation and stickiness in your mouth and can negatively impact your oral health.

To help alleviate this dry, sticky feeling and protect your teeth, make sure to stay hydrated by drinking eight 8-ounce glasses of water daily. Dehydration can exacerbate your symptoms and make dry mouth worse, so try to choose water over caffeinated and acidic beverages when you can. You can also sip on water or ice chips throughout the day.

2. Use Saliva Substitutes

When it comes to protecting your oral health, saliva is essential. Not only does saliva help prevent tooth decay, mouth sores, and fungal infections, but it also plays a role in chewing, speaking, and swallowing. Even wearing dentures depends on saliva production. That’s why some healthcare providers suggest using saliva substitutes or artificial saliva.

These over-the-counter products come in a variety of forms, including sprays, gels, and lozenges, and can alleviate dry mouth symptoms. Typically, these products contain minerals, fluoride, preservatives, and flavorings. You may need to experiment with a few different types to determine which one is best for you.

3. Limit Sugar Intake and Choose Drinks Wisely

When your body doesn’t produce saliva as it should, you have an increased risk for dental caries (or cavities). Not having enough saliva can also increase your risk of periodontal disease and tooth loss. In fact, about 30 percent of people with Sjögren’s disease report having cavities, tooth decay, and mouth sores. For this reason, you may want to limit how much sugar you eat and drink. Not only do these foods and drinks speed up tooth decay and lead to cavities, but they can also irritate the soft tissues in your mouth and increase the risk of dehydration, especially if your sugary drinks also contain caffeine.

4. Try Chewing Sugar-Free Gum

Chewing sugar-free gum or sucking on sugar-free hard candies is another way to stimulate your salivary glands. Look for products that contain xylitol. This sugar-free sweetener not only causes your glands to produce more saliva, but it can also reduce cavities and tooth decay. Researchers have found that chewing gum or sucking on candies that contain xylitol four or five times a day for at least five minutes after meals may reduce the bacteria that cause cavities.

5. Choose Products With Fluoride

When you have Sjögren’s disease, you should also use fluoride toothpaste to help prevent cavities. Start by applying a pea-sized amount to your toothbrush and brushing twice per day. Once you’re done brushing, you can spit out the toothpaste, but resist the urge to rinse your mouth out.

You can also talk to your dentist about regular fluoride treatments, such as fluoride varnish, which helps with remineralizing or restoring essential minerals in your tooth enamel. However, there isn’t a lot of evidence that varnish is effective in people with Sjögren’s, so discuss the option with your dentist.

6. Avoid Alcohol-Based Mouthwashes

Mouthwashes that contain alcohol can irritate an already dry and sensitive mouth, and, in some cases, these products can cause even more dryness in your mouth. For this reason, you should select an alcohol-free mouth rinse like Biotene or another similar product. If you already have gingivitis or ulcers in your mouth, your dentist may prescribe Peridex or PerioGard to help kill the bacteria. But these prescription products should only be used for the short term.

7. Maintain a Consistent Dental Routine

One of the best ways to protect your oral health when you have Sjögren’s disease is to develop a consistent oral hygiene routine, especially because your mouth contains more than 700 species of bacteria. Sticking to an oral hygiene routine means brushing your teeth with fluoride toothpaste and using floss daily to clean between your teeth. This routine will help rid your mouth of anything that could cause tooth decay. If you plan to brush after a meal, wait 30 minutes to avoid damaging your tooth enamel, especially if you’ve eaten something acidic. Or, you can simply rinse with water when you finish eating.

8. Use a Humidifier

When the air inside your home is excessively dry and lacking humidity, your dry eyes and mouth get worse. Dry air can also dry out your nasal passages, cause inflammation in your throat and lungs, and irritate the mucous membranes in your mouth. When this happens, you may develop aphthae (canker sores), dry lips, and angular cheilitis (cracks or sores at the corner of your mouth).

Using a humidifier, especially at night, may help alleviate this dryness and keep your mucous membranes moist. The key is keeping your humidifier clean. Try using distilled water and washing it weekly with diluted vinegar. Also, change the water regularly or consider investing in a self-sterilizing unit. These steps will keep you from inhaling bacteria and other germs.

9. Schedule Regular Dental Exams

A well-trained dentist can help you manage Sjögren’s disease as well as alert you to any changes in your condition or your oral health. Not only can they ensure that cavities and periodontal disease are promptly addressed, but they will also examine your salivary glands to look for inflammation and complications, such as lymphoma.

When you have Sjögren’s, you’re at a greater risk for mucosa-associated lymphoid tissue (MALT) non-Hodgkin B-cell lymphoma, which often develops in your salivary glands. About 10 percent of people develop this condition, and a dentist may be the first one to recognize the symptoms and suggest further care. A dentist can also provide you with a fluoride gel as well as remineralizing or mineralizing products designed to safeguard your teeth. Try to schedule a preventive visit every three to four months unless your dentist says twice a year is enough.

10. Work Closely With a Dentist

Most rheumatology professionals recommend you get ongoing dental care when you have Sjögren’s disease. If you don’t have a dentist, ask them to recommend one who is familiar with your condition. Not only will you need regular cleanings and dental care, but you’ll also need a treatment plan that includes fluoride therapy and other preventive measures. Your dentist can also conduct salivary production tests as needed, as well as prescribe salivary stimulants when warranted. Most of the time, dentists prescribe pilocarpine and cevimeline hydrochloride to treat dry mouth. These medications do have some side effects, like nausea, diarrhea, and heart rhythm changes, so talk to your dentist and your rheumatologist about what to expect.

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On MySjögrensTeam, people share their experiences with Sjögren’s disease, get advice, and find support from others who understand.

If you have been diagnosed with Sjögren’s, what’s one of the most effective actions you’ve taken to protect your oral health? Let others know in the comments below.