OBJECTIVES: To quantify prevalence of dry mouth, association between dry mouth and beverage intake and dietary quality, and association between dry mouth and selfreported dietary accommodations to oral health deficits. DESIGN: Cross-sectional study; data from self-reports. SETTING: Rural North Carolina counties with substantial African-American and American Indian populations. PARTICIPANTS: Six hundred twenty-two participants aged 60 and older. MEASUREMENTS: Data included the 11-item Xerostomia Inventory (higher scores connote greater effect from dry mouth), a food frequency questionnaire (converted into Health Eating Index - 2005 scores), and survey items on foods modified before consumption or avoided because of oral health problems. RESULTS: Dry mouth was associated with being female, lower education, and income below the poverty level. Although overall beverage consumption did not vary with dry mouth, consumption of certain sugar-sweetened beverages was positively associated with dry mouth. Overall dietary quality did not differ with dry mouth, but more-severe dry mouth was associated with lower intake of whole grains and higher intakes of fruits. Dry mouth was strongly associated with self-reported modification and avoidance of foods. Those in the highest tertile of dry mouth were more likely to modify several foods than those in the lowest tertile and were more likely to avoid three or more foods. CONCLUSION: Older adults appear to modify foods or selectively avoid foods in response to perceived dry mouth. Despite these behaviors, dry mouth does not result in poorer dietary quality. J Am Geriatr Soc 59:439-445, 2011. © 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.