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Posted Oct 26 2009 11:07pm

A new and distressing symptom has started. I’m drooling a LOT at night and I awaken with my pillow wet and my face wet.  This has not affected me during the daytime hours, and so I’ve begun some research to find out how to deal with the excess saliva orsialorrhea in medical lingo.

I’ve found that many PWP (people with Parkinson’s) are dealing with this issue and there are some creative and sensible ways to reduce the amount of saliva or deal with leaking saliva without resorting to drug therapy.  At this time in my life, I really do NOT want to take additional meds for any reason.  I am so hopeful that managing the current medications I take will be effective in helping me stay active and effective in  my personal and work life without adding another drug.

While there are some good drug therapies out there to deal with drooling, I will refrain from addressing those here and let you pursue that with your own neurologist or physician.

PWP (people with Parkinson’s) do not have excessive saliva production.  The normal amount of saliva produced by most people is 33 or 50 ounces daily.  That’s roughly 4 to 6 cups of saliva per day.  That’s a LOT of saliva that we normally swallow and don’t notice!  The problem with drooling occurs when the saliva is not being swallowed normally.  In PWP (persons with Parkinson’s) the muscles in our bodies are struggling to operate normally.  The lack of dopamine in our brains directly affects the neural circuits in our brains and that affects our movement.  The muscles in our throat are affected so our automatic swallowing decreases and saliva collects.

Becoming more conscious of swallowing can often help reduce the drooling.  There are strategies to assist in becoming more aware of the need to swallow:

  1. Chew gum or hard candy (hopefully sugar-free) so that the tactile clue from that activity encourages swallowing.
  2. Decrease the amount of sugary foods you intake since sugar increases the production of saliva.
  3. Keep your head tilted upwards with your mouth closed – when not speaking or eating.
  4. Breathe through your nose and keep your lips closed.
  5. Since fluids are lost when drooling, be sure to drink more liquids to stay hydrated.
  6. Drink from a straw whenever you can since that helps to exercise the muscles in the face that keep your lips shut.  Strengthening these muscles will help the saliva to stay in your mouth as you practice keeping your lips shut.
  7. And as I have found that I drool at night – use a small towel on your pillow to absorb the saliva.

During my research on this topic I have found that some PWP respond to the juice in pineapple to help thin their saliva.  For people who are more severely affected by Parkinson’s Disease their caregivers have crushed up pineapple pieces and placed small pieces in their mouths.  I know that the acidity in fresh pineapple can bother some folks. So, I would suggest doing this with small canned pineapple pieces.

The thickening of the saliva can also be a problem for PWP.  Drinking fluids, juices and water are crucial to keeping hydrated.  Some of the drugs we take for PD can also cause our mouths to feel dry and sticky.  Then coughing happens because of the thickness of the saliva and difficulty swallowing.  In this situation others have suggested the pineapple juice diluted with water since pineapple contains enzymes that thin the saliva.

Above I mentioned using a straw to drink liquids.  Using a straw is good for strengthening the mouth and facial muscles.  However, I do know that speech therapists offer excellent exercises that can help in that as well.  If your swallowing (or not swallowing as the case is in drooling) continues to cause problems, I would encourage you to mention this to your doctor/neurologist and get a referral to a speech therapist.

Overall my research has led me to the conclusion that there are no simple answers or solutions to this problem.  As mentioned earlier there are dr ugs (Botulinum toxin injections) that can be injected into the mouth, or surgery to reduce the amount of saliva that is produced.  But short of drug and surgical therapy there isn’t any completely effective way of solving this problem.

So, as we continue to adapt to Parkinson’s Disease in every other facet of our lives – we continue to adapt to the onset of drooling as well.

Keep your sunny side up!

Posted in Drooling Tagged: Parkinson's Disease & Drooling; Excessive Saliva in Parkinson's Disease
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