It’s normal for your mouth to go dry when you’re nervous or haven’t sipped any water all day. But for people whose salivary glands don’t produce enough saliva, dry mouth becomes a chronic condition that can be uncomfortable and even interfere with speaking and swallowing.
“Saliva also plays a critical role in protecting your mouth against bacteria, so people without enough saliva might be more likely to have periodontal disease,” says Felipe Andrade, MD, PhD, Professor of Medicine in the Division of Rheumatology at Johns Hopkins.
Read more about managing oral health problems when you have arthritis.
Symptoms of Dry Mouth
Dry mouth isn’t just about feeling thirsty. People with chronic dry mouth may experience the following symptoms:
- Dryness or stickiness in the mouth
- Thick saliva
- A burning sensation in the mouth
- Changes in the way food tastes
- Sensitivity to acidic or spicy foods
- Trouble chewing or swallowing
- Difficulty speaking
- Bad breath
- Dry, sore throat
- Hoarseness
What Causes Dry Mouth in People with Arthritis?
Medication
Some arthritis medications — such as non-steroidal anti-inflammatory drugs (NSAIDs) like Celebrex — can dry out salivary glands.
Sjögren’s disease
Another major cause of dry mouth is Sjögren’s disease, an autoimmune disorder that targets moisture-producing glands like the ones like make saliva and tears, says Dr. Andrade. The main symptoms of Sjögren’s are dry mouth and dry eyes, but Sjögren’s can also cause fatigue, skin rashes, and joint pain and swelling.
Some of those symptoms may sound very familiar to people with inflammatory arthritis: Sjögren’s is common in people with rheumatoid arthritis (RA). One large U.S. study found that about 30 percent of people with RA also had Sjögren’s, and the chances went up the longer someone had RA.
Treatment for Dry Mouth
There’s no cure for Sjögren’s disease, so treatment mostly centers around making your mouth comfortably moist, and reducing the risk of gum disease and cavities caused by the lack of saliva. Here’s what Alan Baer, MD, Professor of Medicine and Director of the Jerome L. Greene Sjögren’s Disease Center at Johns Hopkins Medicine, recommends to his patients.
Rinse and spit: Prescription SalivaMAX is a supersaturated calcium phosphate rinse that is soothing and helps protect your teeth, says Dr. Baer. (Two others that work similarly are Caphasol and Aquoral.) “You can also make a mouth rinse at home, consisting of one teaspoon salt and one teaspoon of baking soda in one liter of water,” he says. It will hydrate your mouth and neutralize acids to prevent cavities.
Oil up: Spread a few drops of vitamin E oil on your tongue and around the inside of your cheeks. It is soothing and will help protect the integrity of the mucous membranes in your mouth, says Dr. Baer. But be sure to call your doctor if you notice the tissues are red and irritated, he notes. That can be a sign of a fungal (or yeast) infection that needs prescription treatment.
Call in the subs: There are many over the counter “saliva substitutes” available in drugstores and on Amazon that can help replace moisture in the mouth. These sprays, gels, and lozenges most have ingredients like carboxymethylcellulose or hydroxyethylcellulose — substances that increase the viscosity, or thickness, of the fluids — and some also include fluoride to help protect your teeth. Dr. Baer suggests trying several different brands to find what works best for you. He says that some of his patients like Thayer’s Natural Remedies Dry Mouth lozenges, which help stimulate saliva production.
Consider a CoQ10 supplement: Although more research is needed, Dr. Baer says some people with dry mouth may benefit from a dietary supplement known as Coenzyme Q10. One small study in Japan found that taking 100 mg of CoQ10 a day for one month improved saliva flow in people with dry mouth. It wasn’t done specifically in people with Sjögren’s, so more research is needed. Talk to your doctor before starting any supplement.
Ask your doctor about medication: If you’re not able to get relief from other measures, it might be time to consider medications. There are several drugs that are FDA-approved to treat dry mouth, but they have potential side effects and some can interact with other medications or make underlying conditions like heart arrhythmias worse. These include pilocarpine (Salagen) or cevimeline (Evoxac), which boost saliva production.
Switch medications that can be contributing to dry mouth: Talk to your doctor about all the medications you take, as it may be the case that some (even those you take for reasons unrelated to arthritis) can cause dry mouth as a side effect. In particular, antihistamines and decongestants are known for causing dry mouth.
Lifestyle Changes for Dry Mouth
Investigate snoring: Breathing through your mouth can make dry mouth worse. Dry mouth is also more common among people with sleep apnea; snoring is a common sleep apnea symptom. If you know you snore or your partner complains about your snoring, talk to your doctor about a sleep study. Treating sleep apnea could also address your dry mouth.
Moisturize: Add moisture to your room with a humidifier or use lip balm to soothe dry lips.
Avoid foods and drinks that can make dry mouth worse: These include alcohol (including mouthwash that contains alcohol), caffeine, tobacco products, and sugary foods (which can increase your risk of cavities).
Keep sugar-free sweets handy: Chewing gum or sucking on candies stimulates saliva flow, so Dr. Baer suggests that patients keep some on hand. Just make sure they’re sugar-free. Chronic dry mouth increases the risk of cavities, so it’s important to keep sugary treats and drinks to a minimum.
Protect Your Teeth and Gums
Saliva does more than keep your mouth comfortable. It washes away food, fights germs, and helps repair tooth enamel. When Sjögren’s disease cuts back on saliva, cavities can form faster than usual. They often show up in places that are normally less likely to decay, like along the gumline or near the tips of teeth. Many people with Sjögren’s end up needing fillings, crowns, or implants, and dental costs can add up. The good news: a few daily habits and regular dental care can go a long way toward protecting your smile.
Tell your dentist you have Sjögren’s. Your dentist may not know about your diagnosis unless you share it. Knowing helps them check more closely for early decay and recommend the right protective treatments.
Ask about prescription-strength fluoride toothpaste. Fluoride helps strengthen enamel. Your dentist can prescribe a higher-strength toothpaste than you can buy off the shelf, and you use it just like regular toothpaste.
Get fluoride treatments at the dentist. A fluoride varnish painted on your teeth during checkups gives extra protection between visits.
See your dentist more often. Instead of twice a year, many people with Sjögren’s benefit from cleanings and checkups every three to four months. Ask your dentist what schedule is right for you.
Brush and floss after meals when you can. Use a soft toothbrush and fluoride toothpaste, and floss daily. If hand pain or stiffness makes brushing hard, an electric toothbrush or floss picks can help.
Choose sugar-free options, and watch your sipping. Sipping on sugary or acidic drinks, like soda, juice, or sweetened coffee, all day keeps your teeth under constant attack. Water is your best choice. Sugar-free gum or mints with xylitol can help get saliva flowing.
Use an alcohol-free mouthwash. Alcohol can dry your mouth even more. Your dentist may also suggest a rinse that helps protect enamel.
Take extra care with dentures. A dry mouth can make dentures fit poorly and rub sore spots. Take them out at night, clean them daily, and let your dentist know if they feel loose or uncomfortable.
When to Call Your Dentist or Doctor
Reach out if you notice:
- Tooth sensitivity or pain
- Cavities or dark spots near the gumline
- White patches, redness, or burning in your mouth, which can be signs of a yeast infection called thrush
- Painful cracks at the corners of your mouth
- Sores that don’t heal
Dental care can be expensive. See our Co-pay Cards and Financial Assistance page, and ask your dentist’s office about payment plans.
Keep Reading
- Lupus Complications You Should Know About
- What Your Gum Disease Could Reveal About Your Rheumatoid Arthritis Disease Activity
- 12 Healthy Habits for Managing Inflammatory Arthritis
Sources:
Harrold LR, Shan Y, Rebello S, et al. Prevalence of Sjögren’s syndrome associated with rheumatoid arthritis in the USA: an observational study from the Corrona registry. Clin Rheumatol. 2020;39(6):1899-1905. doi:10.1007/s10067-020-05004-8
Ryo K, Ito A, Takatori R, et al. Effects of coenzyme Q10 on salivary secretion. Clin Biochem. 2011;44(8-9):669-674. doi: 10.1016/j.clinbiochem.2011.03.029
Kim H, Cho SK, Kim HW, et al. The prevalence of Sjögren’s syndrome in rheumatoid arthritis patients and their clinical features. J Korean Med Sci. 2020;35(45):e369. doi:10.3346/jkms.2020.35.e369
Marmor MF, Kellner U, Lai TYY, Melles RB, Mieler WF. Recommendations on screening for chloroquine and hydroxychloroquine retinopathy (2016 revision). Ophthalmology. 2016;123(6):1386-1394. doi:10.1016/j.ophtha.2016.01.058
Schirmer’s test. Johns Hopkins Sjögren’s Center. Updated May 20, 2026. Accessed September 22, 2026. https://www.hopkinssjogrens.org/disease-information/diagnosis-sjogrens-disease/schirmers-test/
