Saliva accumulates when the muscles of the face, mouth, and throat become impaired, interfering with swallowing. When this happens, the pooled saliva drips from the mouth. The clinical term for drooling is sialorrhea. Drooling is more prevalent at night when there is naturally less tendency to swallow. Even though drooling is uncontrollable, the person with Parkinson’s often finds it embarrassing. Moisture that is allowed to remain around the mouth can cause chapping and soreness, so it is important to keep saliva wiped from the face.
The anticholinergic medications taken to treat tremors and other neuromuscular symptoms of Parkinson’s sometimes help by drying out mucous membranes, thus reducing the volume of saliva. sublingual atropine slows saliva production. Injections of botulinum toxin into the salivary glands also has been studied. Although such treatments lessen problems with drooling, they can produce the opposite problem, dry mouth. A certain amount of saliva is necessary to mix with food for proper chewing and swallowing, so when saliva volume is reduced, the risk of swallowing problems, including choking, increases. Sufficient saliva also is important for maintaining oral health. in early Parkinson’s the person can make a conscious effort to swallow regularly and frequently, to prevent saliva from pooling. A speech-language therapist can assess the swallowing process and offer exercises and suggestions to maintain good swallowing function for as long as possible.
