Optimize Oral Health & Nourish Your Oral Microbiome: An Overview of the Impacts Xerostomia has on Oral and Systemic Health

As a registered dental hygienist of 10+ years, I’ve seen countless patients suffering from xerostomia. I’ve spent hours of my clinical life talking with and educating patients about the impacts dry mouth has on the oral cavity, and in turn, systemic health. 

While the cause of xerostomia is multifactorial, dysfunction of the salivary glands due to any reason is detrimental to the proper balance of oral and systemic health and is known to decrease quality of life. 

When discussing dry mouth with my patients, one question I often get asked is, “What can I do about it?” 

With this question, I have found myself frustrated with the lack of options available to help alleviate the symptoms and restore balance to several parameters of oral health. 

This conversation became easier for me and has provided relief (both physically and emotionally) for my patients once I started recommending the FDA-approved Periovance Dry Mouth Moisturizing Gel by OraBio. It’s a true game-changer for those suffering from xerostomia, and it has several powerhouse ingredients to sustain the proper balance of the oral ecosystem. 

Before we talk about this gel further, let’s first review important parameters of the oral cavity and review the impact they have on the oral microbiome, oral diseases, and systemic health. 

Importance of the Oral Microbiome

The oral ecosystem is a dynamic and ever-changing environment composed of nine different regions¹¹. Together, they create a unique and complex habitat of over 700 different species of bacteria in addition to viruses, fungi, and other microorganisms⁶, collectively known as the oral microbiome.

A healthy, balanced oral microbiome supports the body’s fight against infection, aids in digestion, and maintains overall balance of systemic health. Conversely, a shift towards an imbalanced state results in dysbiosis, which contributes to the initiation and progression of both oral and systemic diseases. 

Several factors are known to alter the oral microbiome, including (but not limited to) the following⁹:

• Age

• Genetics

• Environment

• Diet & lifestyle habits

• Oral hygiene habits

• Salivary flow 

• Use of medication(s)

• Systemic health status

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One of the biggest impacts that occurs due to oral dysbiosis is chronic inflammation, which is the driving factor of periodontal diseases such as gingivitis and periodontitis; it is also the driver of several systemic diseases such as autoimmune diseases, cancer, cardiovascular diseases, hormonal imbalances, accelerated aging, neurocognitive decline, and more. 

To better understand how these shifts in the oral microbiome impact overall health, let’s take a closer look at one of its key components: saliva. 

Why Saliva Matters

Saliva is best described as a mixed sample of bacteria and various components of the oral microbiome from different regions throughout the mouth. 

Some of the most important substances found in saliva include the following⁵:

• Water

• Electrolytes (minerals)

• Specialized proteins

  • Enzymes

  • Antibodies

Together, they provide several benefits to overall health and oral functions such as lubrication, antibacterial properties, cleansing properties, digestion, taste, pH balance, and tissue repair⁴.

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Without adequate saliva, all of these important functions of saliva are impacted, which ultimately begins and supports the progression of oral and systemic diseases. To better understand how this happens, let’s discuss what saliva does for health. 

Characteristics of Saliva

Much like the oral microbiome as a whole, key characteristics of saliva are ever-changing and are impacted by dietary and lifestyle habits. 

Salivary pH

Salivary pH levels fluctuate based on lifestyle habits such as eating, drinking, smoking/vaping, oral homecare routines, and more. 

• Salivary buffering capacity is the process that either resists changes to salivary pH and/or brings salivary pH levels back to optimal ranges after changes initiated by these habits³

Salivary pH is maintained near neutrality with a normal

range of 6.2 - 7.6 and an average reading of 6.7¹

Salivary Clearance

Salivary clearance defines saliva’s ability to remove various particles and molecules through swallowing, thus eliminating acids within the oral cavity³.

Salivary Flow 

Salivary flow is the rate at which saliva is produced and excreted by major and minor salivary glands located throughout the oral cavity. 

With a decrease in salivary flow, dry mouth begins, salivary clearance decreases, and changes to salivary pH occur. It is these changes to key salivary characteristics that result in damage to oral structures and lead to disease processes such as dental decay, periodontal diseases, fungal overgrowth, and more.

Causes & Symptoms of Xerostomia

Overall, dry mouth is a multifactorial process. However, there are a few well-known causes & symptoms that are of important note. 

Causes

• Medications

• Aging

• Dehydration

• High blood pressure

• Diabetes

• Autoimmune diseases

  • Sjogren’s Syndrome

  • Lupus

• Chemotherapy & radiation treatments

• Stress & anxiety

• Alcohol use

• Caffeine consumption

• Hormonal imbalances

• Mouth breathing

• Sleep apnea treatment

  • CPAP

  • Oral appliance therapy 

• Smoking, vaping & cannabis use 

More than 400 medicines can cause the salivary glands to make less saliva. 

For example, medicines for high blood pressure and depression often cause dry mouth⁸. 

Symptoms

• Poor oral health

  • Increase in biofilm 

  • Increase in decay

  • Gingivitis

  • Periodontitis

• Candidiasis overgrowth

• Mouth sores 

• Plaque-coated tongue

• Acid erosion 

• Tooth sensitivity

• Cracked lips

• Altered taste

• Slow wound healing

• Cobblestone tongue 

• Burning tongue

• Difficulty with speech & swallowing

• Halitosis (i.e., bad breath) 

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Now What?

As you can see, saliva supports several beneficial functions within the oral cavity and is a true foundation to oral and systemic health — without oral health, systemic health is not possible. 

So, where does this leave clinicians and patients in the discussion of “Well, what can I do about my dry mouth?” 

Or “I've tried some products before, but I didn’t feel much of a difference.”

Or “I just try to drink more water.”

The good news is that the science of oral health has advanced significantly over the last several years, and new, innovative products are available to help alleviate xerostomia and support oral health parameters.

If you’re looking for a product that does it all — soothes dry mouth, enhances saliva’s antimicrobial actions & promotes a balanced oral microbiome — I would like to introduce you to my top recommendation: 

Periovance Dry Mouth Oral Moisturizing Gel

This FDA-approved saliva substitute is a clinically tested solution that mimics natural saliva; It contains the same proteins and enzymes that are naturally occurring in saliva, which enables it to support the various characteristics discussed above and thus support symbiosis within the oral cavity.

Ingredient Highlight⁷

Overall, the key ingredients mimic the antibacterial, protective mechanisms of saliva and promote a balanced immune response, ultimately reducing bacterial loads, preventing tooth decay & periodontal diseases, and lowering inflammation.

What’s Inside

Let’s take a deeper look at six key ingredients that make Periovance Dry Mouth Oral Moisturizing Gel a true powerhouse in the treatment of xerostomia and maintenance of oral health:

• Glucose oxidase

  • Produces hydrogen peroxide – reduces S. mutans

  • Kills/inhibits growth of bacteria

  • Supports natural defenses

  • Inhibits P. gingivalis

  • Lowers inflammation 

• Lactoperoxidase

  • Inhibits S. mutans by reducing its ability to produce acid

  • Protects oral mucosa from damage 

  • Anti-fungal properties

• Lysozyme

  • Reduces plaque

  • Inhibits bacterial pathogens by breaking down cell wall

• Colostrum whey

  • Improves the body’s immune response

    • Oral immunity & oral tissue repair

  • Rich in immunoglobulins (IgA)

  • Stimulates saliva 

• Lactoferrin

  • Binds iron

    • Prevent/kill bacteria by depriving them of nutrients (i.e., iron) 

      • S. mutans and P. gingivalis love iron

  • Helps prevent biofilm

• Xylitol

  • Reduces oral bacteria

  • Naturally stimulates saliva 

What’s Not Inside

The Periovance Dry Mouth Oral Moisturizing Gel by OraBio is full of great ingredients; but it’s also important to note the ingredients it does not contain:

• Alcohol

• Menthol

• Detergents

• Artificial flavorings

Long-term use of ingredients such as alcohol and essential oils has been shown to dry the oral cavity in addition to being “too effective.” Use of antimicrobial oral care products is now proven by research to kill harmful pathogens but also too many bacterial strains, which limits the repopulation of beneficial microbes required as part of the oral microbiome to establish a healthy, balanced oral ecosystem. 

Benefits of the Periovance Oral Moisturizing Gel⁷

Overall, Periovance Dry Mouth Oral Moisturizing Gel is a great resource available for many reasons, including those listed below:

• Restores the natural oral microbiome

• Clinically proven to improve dry mouth symptoms

• Enhances saliva’s antibacterial effects

• Promotes oral symbiosis and a balanced oral microbiome 

• Long-lasting dry mouth relief

• Moisturizes, soothes & protects – delivering relief and comfort 

• Reduce the risk of infection, including fungal infections

• Reduce the risk of oral mucositis 

Final Thoughts

The information discussed here highlights the importance of providing comprehensive care to patients in both dental and medical settings as oral health and systemic health coexist in an ever-changing, reciprocal ecosystem within the human body. 

As both patients and providers, it’s important to stay updated with current research data, and update our use of oral care products accordingly. Thus, anyone experiencing the signs and symptoms of oral dysbiosis noted throughout this discussion would benefit from daily use of Periovance Dry Mouth Oral Moisturizing Gel.

Interested in purchasing Periovance Dry Mouth Oral Moisturizing Gel? 

Patients — order here        ●        Providers — order here 

Liz Laney, BSDH, RDH, OMT, is a self-proclaimed dental nerd passionate about educating patients and providers on best practices for achieving optimal whole-body health. As an advocate for elevating the standard of care, Liz is dedicated to creating and implementing protocols that support long-term patient care.

Sources

1. Baliga S, Muglikar S, Kale R. Salivary pH: A diagnostic biomarker. Journal of Indian Society of Periodontology. 2013;17(4):461-465. doi:10.4103/0972-124x.118317

2. Bots, C., Beest, A. & Brand, H. The assessment of oral dryness by photographic appearance of the tongue. Br Dent J 217, E3 (2014). https://doi.org/10.1038/sj.bdj.2014.597

3. Buzalaf MA, Hannas AR, Kato MT. Saliva and dental erosion. Journal of Applied Oral Science. 2012;20(5). doi:10.1590/s1678-77572012000500001

4. Ehtesabi H. Carbon nanomaterials for salivary-based biosensors: A Review. Materials Today Chemistry. 2020;17. doi:10.1016/j.mtchem.2020.100342

5. Liao C, Chen X, Fu Y. Salivary analysis: An emerging paradigm for non‐invasive healthcare diagnosis and monitoring. Interdisciplinary Medicine. 2023;1(3). doi:10.1002/inmd.20230009

6. Pei XM, Zhou LX, Tsang MW, Tai WC, Wong SC. The Oral Microbial Ecosystem in Age-Related Xerostomia: A Critical Review. Int J Mol Sci. 2024;25(23):12815. Published 2024 Nov 28. doi:10.3390/ijms252312815

7. Periovance.com 

8. Ricorg - Dry mouth paitent info: Partnership to reduce cancer in RI: United States. Partnership to Reduce Cancer in Rhode Island. https://www.prcri.org/dry-mouth-patient.

9. Rosier BT, Marsh PD, Mira A. Resilience of the Oral Microbiota in Health: Mechanisms That Prevent Dysbiosis. Journal of Dental Research. 2018;97(4):371-380. doi:10.1177/0022034517742139

10. Talha B, Swarnkar SA. Xerostomia. [Updated 2023 Mar 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545287/

11. Tian S, Ding T, Li H. Oral microbiome in human health and diseases. mLife. 2024;3(3):367-383. doi:10.1002/mlf2.12136

12. Vila T, Rizk AM, Sultan AS, Jabra-Rizk MA (2019) The power of saliva: Antimicrobial and beyond. PLoS Pathog 15(11): e1008058. https://doi.org/10.1371/journal.ppat.1008058