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 presentations of candidiasis are more common. Instead of the classic pseudomembranous candidiasis (white plaques), they'll have a sore red tongue with papillary atrophy (erythematous oral candidiasis), angular ch...

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 know, if cranial nerves are involved (Facial, Glossopharyngeal, Vagus). Also, the CNS gustatory cortex might be involved.

Hope colleagues will weigh in.