Xerostomia is a prevalent and clinically significant condition characterized by reduced salivary secretion and qualitative alterations of saliva, leading to impaired oral function, increased disease susceptibility, and diminished quality of life. Current management relies largely on conventional saliva substitutes and pharmacological sialogogues; however, these approaches remain limited by their palliative nature, lack of biological activity, poor adaptability to dynamic oral conditions, and frequent systemic adverse effects. This review analyzes the pathophysiological basis of xerostomia with a specific focus on the composition, rheological behavior, and clinical performance of artificial saliva formulations. Emphasis is placed on the intrinsic limitations of static saliva substitutes in replicating the viscoelastic and multifunctional properties of natural saliva. Furthermore, emerging electro-responsive and smart material–based systems are explored as innovative therapeutic strategies capable of dynamic interaction with the oral environment. These advanced systems offer potential advantages through adaptive modulation of lubrication, enhanced mucosal retention, and controlled lo
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