How do you counsel a patient with Sjogren's and extremely dry mouth who is losing their ability to taste food?

Agree with Dr. @Dr. First Last, and we cannot overemphasize the candidiasis part. Have a very low threshold for treating candidiasis while at the same time maximizing salivary stimulation (pilocarpine, cevimeline, bethanechol).

When severe xerostomia occurs, as in the question, atypical presentation...

First, I assess if oral candidiasis is present; if so, treat. Consider if there are other cofactors that may be present, such as laryngopharyngeal reflux, B12, or Zn deficiency. If the taste buds are atrophic, you could try oral coconut oil or Vitamin E… but it’s tough. I consider, but it is hard to...