Dry mouth can be caused from medications, dysfunction of the salivary glands or changes in health.  The loss of regular saliva can lead to a higher rate of dental decay and periodontal loss.  One of the complications that we commonly see is a high amount of decay around existing crowns.  The above image demonstrates recurrent decay at the gingival margin of several porcelain crowns.  These defects can be difficult to manage with fillings as the decay can extend beneath the crowns.  Recurrent decay can easly lead to root sensitivity or even root canal problems.  Frequently, these crowns require replacement or may need to be extracted.  

If the dry mouth symptoms are severe,  its is sometimes necessary to extra several teeth and replace them with dental implants.  The great advantage of titanium implants is the resistance to the decay process which we see in the xerostomatic patient.