Sialorrhea (Drooling)
Those with Parkinson’s Disease are not producing excessive saliva. Instead, they are swallowing less often that leads to a build up of saliva. Someone without Parkinson’s Disease swallows anywhere from 1 to 3 times per minute, whereas those with Parkinson’s Disease swallow up to 0.5 times per minute. This is not particularly a problem unless it bothers you or is causing choking.
Non-medication options include using a handkerchief and/or sucking on a sugar-free lollipop or hard candy (which triggers automatic swallowing response).
Medication strategies include botulinum toxin injections (also called Botox or Xeomin) to the parotid glands (glands in the cheeks) every 3 to 6 months as needed and tolerated. Botulinum toxin reduces the amount of saliva that your body produces. Injections take 3 to 7 days to take effect and last anywhere from 2 to 6 months (3 months on average).
Common side effects include minor bleeding, minor swelling, and dry mouth, all of which go away with time (few weeks to short months). It is important to have regular dental appointments and do regular dental hygiene to prevent cavities. You can stop these injections at any time without long-term consequences.
Oral medications can be effective, but these often cause confusion, sleepiness, and gait imbalance. These medications are only used in special situations because of these side effects.
Author Mick Reedy, MD, is a Movement Disorders Specialist with
Inova Parkinson’s and Movement Disorders Center (IPMDC)