Examination and decay-risk assessment
We look at the pattern of any existing decay, measure gum health, check how much saliva you produce and go through your medical history and prescriptions to pin down the likely cause.
About this treatmentDental condition · Wimpole Street, Marylebone
Dry mouth: why a lack of saliva puts teeth at risk, and what helps
Most people think of saliva as something that simply keeps the mouth wet. In fact it is the mouth’s main defence system. It dilutes sugar, buffers acid within minutes of eating, carries the minerals that rebuild softened enamel, and keeps the bacterial population in check. Take it away and the whole balance tips: decay appears on surfaces that were healthy for decades, the gums become sore, dentures stop gripping and food loses its flavour. A dry mouth in Marylebone is rarely a dental disease in itself. It is usually a side effect of medication, of breathing through the mouth at night, or of a medical condition, and the dentist’s job is twofold: to identify what is driving it, and to protect the teeth while it is addressed. At Wimpole Street we take dryness seriously precisely because the damage it does is quiet until it is advanced.
Recognising it
How it usually feels
Waking with a mouth that feels like paper
Saliva flow drops at night anyway; mouth breathing or medication removes what little remains.
Needing water to swallow dry food
Without lubrication, a bolus of bread or biscuit will not slide down easily.
A tongue that burns, tingles or looks smooth and red
Unprotected mucosa becomes inflamed and loses its normal coating.
Cracked lips and sore corners of the mouth
Often accompanied by a yeast overgrowth that thrives in a dry, acidic environment.
New decay along the gum line or around old fillings
The classic pattern in a dry mouth; these surfaces rely on saliva for protection.
Behind the symptoms
What's going on
- 01
Medication, above everything else
Several hundred commonly prescribed drugs list dryness as a side effect. Antidepressants, antihistamines, blood pressure tablets, bladder medicines, inhalers and many painkillers are frequent culprits, and the effect stacks when several are taken together. This is the single most common reason our patients over fifty have a dry mouth.
- 02
Breathing through the mouth
A blocked nose, enlarged adenoids, snoring or sleep apnoea all mean air passing over the tongue and palate for hours at a time. Evaporation outpaces production, and the dryness is worst first thing in the morning. Treating the nasal problem often does more than any mouth product.
- 03
Autoimmune and systemic disease
Sjögren’s syndrome attacks the salivary glands directly and often presents first as dry eyes and mouth. Poorly controlled diabetes, thyroid problems and some rheumatological conditions also reduce flow. A dentist noticing unexplained dryness in a younger patient is sometimes the first step towards a diagnosis.
- 04
Radiotherapy to the head and neck
Radiation for cancers of the throat, tongue or salivary glands can damage the glands within the treatment field. The resulting dryness may be severe and long-lasting, and these patients need intensive fluoride protection because decay can advance with alarming speed.
- 05
Dehydration, caffeine and alcohol
Simply not drinking enough, combined with the mild diuretic effect of coffee and alcohol, produces a low-grade dryness that many people accept as normal. Alcohol-based mouthwashes, used to freshen a dry mouth, make the problem worse.
Before your appointment
What you can do today
- Sip plain water frequently rather than gulping it occasionally; keep a bottle by the bed for the night.
- Chew sugar-free gum containing xylitol after meals; the chewing action stimulates whatever gland function remains.
- Switch to an alcohol-free mouthwash and a mild toothpaste without sodium lauryl sulphate, which can sting dry tissues.
- Use a saliva-substitute gel or spray from the pharmacy, particularly at bedtime; some are formulated to stay in place for several hours.
- Cut down on caffeine, alcohol and salty snacks, and avoid acidic drinks that a dry mouth cannot neutralise.
- Bring a full list of medicines to your appointment; do not stop any of them without speaking to the prescriber.
These are holding measures, not a substitute for an examination. Use any pain relief exactly as directed on the pack and check with a pharmacist if you take other medicines.
In the chair
How we treat it at Wimpole Street
High-fluoride protection
Professional fluoride varnish applied at each visit, plus a prescription-strength toothpaste for home use, hardens enamel against the acid that a dry mouth cannot buffer.
About this treatmentMore frequent hygiene visits
With less saliva, plaque accumulates faster and matures into a more acidic film. Three- or four-monthly appointments keep it under control and allow early lesions to be spotted.
About this treatmentRepairing early damage
Decay along the gum line or around old restorations is treated with tooth-coloured fillings while it is still small, before it undermines the tooth.
About this treatmentDenture review and adjustment
Dentures rely on a thin film of saliva to seal. In a dry mouth they slip and rub, so we check the fit and may recommend relining or a different design.
About this treatmentFees
Costs to expect
A full examination at Wimpole Street, including gum screening and any X-rays needed to look for hidden decay, is expected to be £95. Fluoride varnish is £40 per application and a hygiene appointment is from £89, with the Airflow version at £142.
Where decay has already taken hold, white fillings are indicative from £185 per tooth. Denture relines and adjustments are quoted after we have assessed the fit. Because a dry mouth is a long-term risk rather than a one-off problem, we set out a maintenance schedule and its annual cost in writing so that you can plan for it.
Figures are indicative prices for Wimpole Street and are confirmed in a written plan once a dentist has examined you. Fees match our South Kensington and St Paul's clinics.
Don't wait if
When to see a dentist
- Your mouth has felt dry most days for more than a fortnight.
- You have started a new medicine and noticed the change since.
- Teeth have become sensitive or you can feel rough edges near the gum.
- Your tongue burns, or you have white patches or sore corners of the mouth.
- A denture that used to fit has started to move or rub.
FAQ
Common questions
Antidepressants, antihistamines, medicines for an overactive bladder and some blood pressure tablets are the usual suspects, but almost any drug with an anticholinergic action can be involved, and the effect adds up when several are taken. We will highlight the likely candidates in a letter to your GP; the decision to change anything is theirs and yours together.
For people whose glands still work but are under-stimulated, yes. Chewing triggers a reflex increase in flow that can last well beyond the chewing itself. Choose a sugar-free gum, ideally with xylitol, and avoid it if you have jaw joint problems or a habit of clenching.
Saliva normally neutralises the acid produced after every meal within about twenty minutes and then redeposits minerals into the enamel. Without it, each acid attack lasts far longer and there is no repair phase. Surfaces near the gum and around fillings, which have the thinnest enamel, give way first.
For anyone with a genuinely dry mouth, we think so. The fluoride concentration is roughly double that of a standard toothpaste, and studies in high-risk groups show a meaningful reduction in new decay. It is used once or twice daily in place of your normal paste, and we can prescribe it after your examination.
It commonly does. Saliva washes away the food debris and dead cells that odour-producing bacteria feed on. When flow drops, particularly overnight, those bacteria flourish on the tongue and between the teeth. Hydration, tongue cleaning and treating any gum inflammation usually improve it considerably.
Marylebone, W1
Wimpole Street opens 1 October 2026
Leave your details and we will be in touch when the Marylebone diary opens. If the problem cannot wait, the same clinicians are already seeing patients in South Kensington and at St Paul's.
Related conditions
Opening 1 October 2026
Wimpole Street is not yet seeing patients. Until then, please book or call our South Kensington clinic on 020 7183 2362 or our St Paul's clinic on 020 7183 3709. Questions about the new clinic: wimpolestreet@md.co.uk.
Until we open
Need an appointment before 1 October 2026?
The same clinical team already works from two other Medical & Dental clinics. Book at either one now and, if you prefer, move your ongoing care to Wimpole Street once the doors open.
South Kensington
- 20 Old Brompton Road, London SW7 3DL
- Open seven days a week
- 020 7183 2362
St Paul's, City of London
- 5 Ave Maria Lane, London EC4M 7AQ
- Open Monday to Friday
- 020 7183 3709
