Saliva substitutes are liquid or spray products that can come to our aid when the salivary glands in our mouth no longer function as they should. Saliva is, in fact, fundamental to oral health. Its absence can cause dry mouth — also known as xerostomia — with the possibility of experiencing not only discomfort and pain, but also genuine damage to teeth and gums as a result of oral pH acidification.

Saliva plays a crucial role in the health of our mouth and our entire body.

Produced by the salivary glands located in different areas of the oral cavity, saliva’s first function is to keep oral tissues hydrated and to help maintain proper oral hygiene. Its composition makes it essential for balancing the mouth’s pH, which naturally tends to become more acidic in the presence of food debris and bacteria. By regulating pH, saliva helps limit the growth of bacteria responsible for plaque and cavities, keeping the mouth healthier.

Keeping the mucous membranes hydrated also protects them from minor injuries that can occur while chewing or swallowing.

But that’s not all! Thanks to its enzymes, saliva also plays an important role in digestion, and it allows us to taste flavors properly by helping transport molecules to the taste buds that detect them.

The most elaborate function of saliva concerns the maintenance and restoration of the correct oral pH. Thanks to one of its components — bicarbonate — saliva performs the role of a buffer system. When we eat, oral pH becomes acidic, but after approximately forty minutes saliva is able to neutralise it.
Why is this so fundamental? Because an acidic mouth is not a healthy mouth: teeth may demineralise, and harmful microorganisms may proliferate, causing troublesome and often very painful conditions such as cavities or oral thrush.

We have seen how important saliva is to our health. When the salivary glands do not function as they should and fail to secrete sufficient saliva, we develop a condition known as xerostomia, or dry mouth. This is a widespread condition, affecting approximately 20% of the population. Women — particularly with the onset of menopause — are more frequently affected, but xerostomia does not spare men either.
The causes are varied, ranging from advancing age — with the consequent slowing of salivary gland function — to the use of certain medications, such as chemotherapy drugs, but also many more commonly used ones, such as antihistamines. Some diseases may also present xerostomia among their various symptoms.

The reduction in saliva production can cause difficulties in swallowing and chewing, alter the sense of taste, and lead to damage to the teeth and gums.

Preventing or alleviating xerostomia is sometimes possible with a few simple measures: limiting alcohol consumption, avoiding smoking, and drinking plenty of water are all strategies that benefit our health — and not just that of our mouth! Care should also be taken with overly aggressive mouthwashes containing alcohol: these can dehydrate the mucous membranes, leading over time to dry mouth.

However, when xerostomia occurs, it’s important to take action and consult a doctor if the condition worsens.

Sometimes, the salivary glands simply need stimulation. In such cases, consuming foods that promote saliva production, such as lemon juice, or chewing xylitol gum can help.

Sometimes, however, this is not sufficient. Whether because xerostomia has become a chronic problem, or because — following specific medical treatments such as radiotherapy or chemotherapy for head or neck tumours — the salivary glands have permanently ceased to function, the use of a saliva substitute may become necessary.

If our body does not produce sufficient saliva, we can find help in saliva substitutes.

These are liquid or spray products to be applied to the oral mucosa. Their purpose is to simulate the effect of saliva by lubricating the mucous membranes and alleviating the discomfort caused by xerostomia: regular use allows for the regulation of oral hydration, thereby limiting difficulties in swallowing and the alteration of the sense of taste.

Saliva substitutes are the closest available alternative to the complex and effective composition of natural saliva.

Today there are numerous options to choose from when a saliva substitute is required. These are generally over-the-counter products capable of providing temporary relief from dry mouth.

Most substitutes are water-based and include agents that replicate saliva’s texture.

Among these options, Cariex® stands out as a particularly effective alternative. It is a product based on natural substances such as xylitol, hyaluronic acid, and bicarbonate. These ingredients work together to achieve a synergistic effect: on one hand, they stabilise oral pH, intervening instantly to reduce acidity; on the other, they help combat any bacterial or fungal infections that may be a cause or secondary effect of xerostomia. Furthermore, Cariex® moisturises the oral mucosa, providing immediate pain relief.

The spray formulation makes Cariex® easy to use – just a few seconds are enough to relieve dry mouth. Its consistency is designed to adhere to the mucous membranes, offering long-lasting relief. This innovation addresses one of the main limitations of saliva substitutes: the need for frequent applications to maintain effectiveness.

The feeling of having a dry mouth is a common discomfort that can stem from many different causes. One of the conditions that deserves particular attention is diabetes, which often includes so-called xerostomia among its symptoms.

Diabetes mellitus is one of the most widespread diseases in the world, and according to the World Health Organization, it affects over 340 million patients. The most common symptoms of diabetes are an uncontrolled increase in the sensation of hunger and thirst, physical malaise, and — in blood tests — an elevated blood sugar concentration. In patients with diabetes, a malfunction occurs in the glucose metabolisation process due to insufficient or absent production of the hormone responsible for this process: insulin.

Some complications of diabetes are well known and routinely monitored, such as vision problems or issues related to peripheral circulation. However, the oral cavity can also be affected. This often results in infections of the oral mucosa or, indeed, xerostomia.

In general, dry mouth can be caused by reduced saliva production by the salivary glands or by changes in the composition of the saliva itself. In the case of diabetes, both factors contribute to the discomfort affecting the oral mucosa.

Dry mouth is a very common condition, affecting up to one-third of the population. However, in people with type 1 and type 2 diabetes, the incidence of xerostomia increases significantly, reaching as high as 50% of diabetic patients.

In the case of individuals affected by diabetes, a true vicious cycle develops: high blood sugar levels lead to an equally high concentration of glucose in the saliva. The harmful microorganisms that naturally inhabit the mouth — and are normally kept under control by the immune system and the action of saliva — feed precisely on sugars. Faced with a particularly abundant feast, they therefore thrive, leading to conditions such as stomatitis or oral thrush. Furthermore, the presence of these pathogenic microorganisms acidifies the oral cavity; in the absence of the correct buffering action of saliva, this acidity damages tooth enamel.

There are several causes behind dry mouth in people with diabetes, and all should be considered as part of proper disease management.

Patients with diabetes are more susceptible to dehydration. In the presence of this disease, glucose — a type of sugar — tends to accumulate in the blood. The kidneys are therefore forced to work overtime to filter and absorb this excess sugar. If diabetes is not correctly managed with the appropriate therapy, the kidneys may struggle to perform this task: the excess glucose is then expelled together with urine, drawing further fluids from the tissues through osmosis. This leads to dehydration, which is further exacerbated by the tendency towards more frequent urination in diabetic patients.

This overload on the kidneys can, over time, compromise their function. One of the most frequent complications of diabetes is in fact progressive renal insufficiency. If left untreated, renal insufficiency can result in severe kidney failure; even in the early stages, however, the condition leads to difficulties in the management of bodily fluids and, as a side effect, the sensation of dry mouth.

Another major warning sign – and one of the most serious conditions linked to diabetes – is elevated blood sugar levels. Hyperglycemia carries several risks, including long-term vision loss. But even at earlier stages, excess blood sugar can translate into a high concentration of glucose in the saliva as well. This consequently makes people with uncontrolled diabetes more susceptible both to xerostomia as a symptom of hyperglycaemia, and to diseases that count dry mouth among their symptoms. Oral candidiasis or oral thrush, for example, thrives in sugar-rich environments… and for people with diabetes, this can be a matter of considerable concern!

Finally, some medications used to treat diabetes may also list dry mouth as a side effect.

A persistent feeling of dry mouth is one of the symptoms that may suggest the presence of diabetes. Therefore, if the condition does not resolve with a few simple measures, it is advisable to consult a doctor for further investigation.

In cases where diabetes has already been diagnosed, the first essential step is adhering to the treatment plan prescribed by a specialist. Taking insulin and other medications used to control blood sugar levels as directed is the foundation for maintaining overall health – and, consequently, oral health as well.

People with diabetes can also adopt healthy habits – always under medical supervision – that help keep the mouth properly hydrated. These include limiting salty or spicy foods and caffeine, avoiding smoking, and paying special attention to oral hygiene. As we’ve seen, the mouth is particularly vulnerable in diabetes, so extra care is often needed.

While certain medications can stimulate saliva production, quick relief from the burning sensation of dry mouth can also be achieved through simple, natural remedies – such as oral sprays like Cariex®. Oral sprays made with natural ingredients, such as baking soda to reduce acidity, xylitol to support dental health, and hyaluronic acid – an intensely hydrating molecule naturally present in our cells – provide fast and soothing comfort. When in doubt, it’s always best to seek professional advice. Living well with diabetes is absolutely possible, and keeping your mouth healthy is everyone’s right.