Drooling / Dry Mouth
Excessive Salivation also commonly known as drooling can be the result of a reduction in automatic actions such as swallowing which can impact the ability to manage the flow of saliva around the mouth. Saliva is essential for many reasons. It assists with chewing, swallowing, and provides immunity to infection. It also neutralizes acids and prevents tooth decay. People living with Parkinson's produce an average amount of saliva, but when swallowing difficulties persist, saliva can pool in your mouth.
Excessive drooling is another common symptom of PD and can range from mild to severe. When not treated, it may cause irritation or infection in the corners of the mouth. A speech-language pathologist or therapist can assess your swallowing technique and recommend strategies to help you swallow more effectively.
Lack of saliva or dry mouth also known as xerostomia is also common for people with Parkinson's. A dentist may suggest an artificial saliva substitute for anyone that experiences dry mouth.
Tips to Manage Drooling:
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If you are not at risk for choking, to control excess saliva, suck on hard candy or lozenges, or chew gum (ideally sugar-free, sweetened with xylitol).
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Use a straw to help strengthen your lip, mouth, and throat muscles.
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Try to hold your head up and keep your back straight because stooping encourages drooling.
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Swallow first before you speak.
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When you're not eating or speaking, keep your mouth closed and your lips held tightly together. (People with PD tend to let their jaw drop open, which encourages drooling).
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Breathe through your nose (this will help keep your mouth closed, which will then help keep the saliva in your mouth).
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Remind yourself to swallow to help prevent saliva buildup.
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Try rubbing a strong-smelling lip balm over your mouth to remind you to swallow.
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Put one of two drops of atropine eye drops (0.5%) under your tongue to reduce the amount of saliva. (This works for some people, but you should check with your doctor first).
Tips to Manage Dry Mouth:
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Consult with your doctor as you may need to make changes in your medications.
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If you are not at risk of choking, suck on hard candies or chew gum to help keep your mouth lubricated. Eating sour candy can also increase saliva production and help to moisten your mouth.
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Try not to eat too many dry foods like peanut butter, crackers, and chips because they stick to your throat and dry out your mouth.
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Soften foods by adding liquid (e.g., gravy, broth, sauce, melted butter) or dunking them in liquid (e.g., dipping cookies or crackers in milk, coffee or tea).
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Drink between bites to moisten your mouth and help you swallow.
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Breathe through your nose instead of your mouth.
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If you smoke, try to cut down or quit because this can be a major factor in drying out your mouth and causing gum problems.
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Try taking a cotton swab dipped in olive oil and rubbing it on the inside of your mouth every hour or so.
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Do not use a commercial mouthwash that contains alcohol. Your doctor or dentist will be able to recommend an alternative that will not cause dry mouth.
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Ask your doctor or dentist about prescription toothpaste with a higher fluoride content.
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Limit your caffeine intake. Caffeine is a diuretic, meaning it can make you thirstier and cause you to urinate more frequently, resulting in dehydration.
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Consider using an artificial saliva product, but ask your doctor about this first.
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Keep hydrated. For most people, eight glasses of liquid a day is a good rule of thumb. However, if you have a heart problem, consult with your doctor about your fluid intake; he or she may recommend limiting your fluids depending on your condition.
Sources:
Davis Phinney Foundation for Parkinson's. Every Victory Counts, Your Go-To-Resource of Essential Information and Inspiration for Living Well with Parkinson's. Page 88. "Manual." Sixth Edition, 2021.
Marie, Liane. Help for Drooling and Dry Mouth. Chapter 43. Pages, 128-130. The Complete Guide for People with Parkinson's Disease and Their Loved Ones. Purdue University Press, 2022.