Dealing With Drooling in Parkinson’s and other Neurological Conditions
By Mary Spremulli, MA, CCC-SLP
Copyright © 2010
Lately, a number of my patients with Parkinson’s have been reporting drooling as one of the things that is most bothersome to them. Among medical professionals, there seems to be a few different points of view regarding why this drooling occurs and what to do about it. Some subscribe to the notion that the individual is producing too much saliva, and may recommend Botox injections to reduce saliva production. While this might provide some “cosmetic” improvement, too little saliva can also create problems (just ask any head and neck cancer survivor) as saliva is the necessary lubricant that holds our food together and helps to transport it efficiently without particles getting misdirected or sticking in our throat. Some of the early swallowing research also told us that saliva is a weak stimulus (messenger) to the sensory nerves that carry the message to the brain which in turn gives the instruction to swallow. Hence, if the sensory-motor system responsible for swallowing is beginning to work less efficiently, drooling, along with other swallowing issues might be one of the consequences.
If I am saying to a patient to “swallow your saliva," it is because their mouth is open and I am seeing a puddle of liquid ready to drop down on their shirt or my papers. In other words, if your mouth is hanging open, head and upper body leaning forward, saliva, like other liquids in life, will travel quickly out the path of least resistance. So, sitting or standing up straight and closing your lips, is one of the first things you can do to manage your saliva.
Face it, a grown man or woman drooling is not a pretty site. Particularly in this day and age of hand cleansers at every turn, we simply are not inclined to want to touch, hug, or otherwise engage with an adult drooling. So, if this is one of your problems, I will ask you to take a 30 day challenge, and try some of the suggestions below. I say 30 days, because a lesser commitment will simply not be long enough to judge the effect or create a better habit. If you belong to a support group, you might want to challenge other members to “mop it up and drool less.”
1. If you can, chew gum in 15 minute sessions. I recommend bubble gum (Bazooka is my favorite). For that 15 minutes work the gum in your mouth. Use your tongue to move it from side to side, up against the roof of your mouth, and push with your tongue against the resistance of the gum to blow bubbles. Denture wearers, try Freedent. Do this several times a day, right before or right after a meal might help you remember.
2. Use lip gloss (flavored and sticky are my favorites). Apply regularly and use as a sensory cue to keep lips closed, press lips and feel the stickiness. Swallow your saliva and notice the improved pressure when lips are closed.
3. Tart flavors are a good stimulus. Make your own mixture of concentrated lemon juice and water and put in a small spray bottle. Keep it with you in your pocket or purse and spritz frequently to activate a swallow of saliva.
4. Finally, a rolled up, soggy handkerchief or tissue used to wipe your saliva is also a bit yucky. Try a terry cloth wrist band like tennis players use. It’s a handy way to "mop" up drool and can easily be thrown in the wash.
Mary Spremulli, MA, CCC-SLP, is a licensed speech-language pathologist, licensed nurse, and national seminar leader, with publications on the topic of Patient Education and Ethics. Voice Aerobics, LLC, is a private practice offering speech-language pathology treatment and home programs for improving voice, speech, and swallowing for individuals with Parkinson's and other neurological disorders. Voice Aerobics DVD(TM) and Voice Aerobics Grand Slam (TM) are two of the products offered. To learn more visit: http://www.voiceaerobicsdvd.com/