How do I stop drooling in old age? A Comprehensive Guide

According to the American Academy of Family Physicians, Parkinson's disease is the most common cause of drooling in adults. If you're wondering "How do I stop drooling in old age?", understanding the underlying causes and exploring various treatment options is the first step towards managing this issue and improving your quality of life.

Quick Summary

Managing drooling in old age often involves a multifaceted approach, addressing underlying causes such as neurological conditions or oral health problems with strategies ranging from simple posture adjustments and speech therapy exercises to medications and more advanced medical interventions.

Key Points

• Neurological Causes: Conditions like Parkinson's disease, stroke, and ALS are common culprits behind drooling in older adults due to impaired muscle control.

• Oral Health is Key: Poorly fitting dentures, cavities, and gum disease can irritate the mouth and exacerbate drooling; regular dental check-ups are vital.

• Non-Invasive Management: Simple adjustments like improving posture, sleeping position, and performing oral motor exercises can provide relief for mild cases.

• Medical Options: For more severe cases, doctors may prescribe anticholinergic medications like Glycopyrrolate or recommend Botulinum toxin injections.

• Speech-Language Pathology: An SLP can provide targeted therapy to strengthen swallowing muscles and increase oral awareness, improving saliva control.

• Consult a Professional: Due to the varied causes, consulting a healthcare professional is the first and most crucial step to determining the right treatment plan.

Understanding the Causes of Drooling in Older Adults

Drooling, also known as sialorrhea, in older age is usually a result of difficulty managing saliva rather than producing too much of it. Several factors can contribute to this issue:

Neurological Conditions

Conditions that affect the nervous system are a significant cause of drooling in older adults, as they can impair the control of facial and swallowing muscles. These include Parkinson's disease, which affects up to 80% of those diagnosed, as well as stroke, ALS, MS, and cognitive impairments like dementia.

Dental and Oral Health Issues

Poor oral hygiene and dental problems can irritate the mouth and lead to increased saliva production or hinder proper mouth closure. Examples include poorly fitting dentures, infections like cavities or gum disease, and mouth sores.

Medications and Other Factors

Certain medications and other conditions can also contribute to drooling. Some anticholinergic medications may paradoxically increase saliva. Severe acid reflux can trigger a reflex causing excessive saliva flow. Additionally, diet can influence saliva production, and sleeping position can make drooling more likely.

Non-Invasive Strategies and Therapies

Before considering medications or procedures, several less invasive approaches can be effective.

Posture and Positional Adjustments

Maintaining an upright posture with your head neutral or slightly tucked can help control saliva flow, especially during meals. Sleeping on your back with your head elevated can also prevent saliva pooling.

Oral Motor and Swallowing Exercises

A speech-language pathologist (SLP) can create a program to strengthen mouth and throat muscles. This can include exercises for jaw stability and lip closure, and using reminders to swallow more frequently.

Behavioral Modification

This involves retraining behaviors to increase swallowing awareness. Using positive reinforcement and cues can help encourage maintaining a closed mouth and swallowing.

Medical and Clinical Interventions

If non-invasive methods are not enough, healthcare providers may recommend further treatments.

Medications

Anticholinergic medications can be prescribed to reduce saliva production. Glycopyrrolate is a common option, available as tablets or liquid, though side effects like dry mouth are possible. A scopolamine patch is another option. Other medications, including some antidepressants and even atropine eye drops, are sometimes used off-label.

Botulinum Toxin Injections

Botox injections into the salivary glands can provide longer-lasting relief by temporarily reducing saliva production. The effects typically last several months.

Comparison of Treatment Options

Treatment Method	Pros	Cons	Best for	Effectiveness	Duration	Side Effects	Cost
Posture/Exercises	Non-invasive, no side effects	Requires consistent effort, not always effective alone	Mild cases, adjunct therapy	Variable	Ongoing	None	Low
Oral Meds (e.g., Glycopyrrolate)	Effective, widely available	Systemic side effects (dry mouth, constipation)	Moderate cases	High	Daily	High	Medium
Botox Injections	Long-lasting, targeted	Invasive, requires clinical visit, temporary	Moderate to severe cases	High	~3–6 months	Localized, potential for temporary weakness	High
Surgery	Most permanent solution	Irreversible, invasive, risk of complications	Severe, unresponsive cases	Very High	Permanent	Potential facial weakness, dryness	Very High

Finding a Way Forward: Your Action Plan

Managing persistent drooling is possible with the right approach. Consulting a healthcare professional is the first step to identify the cause. A team approach with a doctor, dentist, and speech-language pathologist can provide comprehensive care. Many effective options exist, from simple adjustments to medical therapies, to improve comfort and quality of life.

For further reading and information on swallowing difficulties, visit the Dysphagia Center.

Frequently Asked Questions

Why do some elderly people drool excessively?

Excessive drooling, or sialorrhea, in older people is often not due to overproduction of saliva but rather a difficulty in swallowing or poor muscle control around the mouth. This can be caused by neurological conditions such as Parkinson's disease or a prior stroke, which affect the coordination of the mouth and throat muscles.

Can speech therapy help with drooling in old age?

Yes, a speech-language pathologist (SLP) can be very helpful. They can provide targeted exercises to strengthen the muscles of the lips, tongue, and jaw, as well as techniques to improve swallowing frequency and efficiency. This therapy helps improve overall oral motor control.

Are there medications to stop drooling in old age?

Yes, doctors may prescribe anticholinergic medications like glycopyrrolate or use a scopolamine patch. These medications work by reducing saliva production. It is important to discuss potential side effects, such as dry mouth or constipation, with a healthcare provider.

How can posture help reduce drooling?

Adjusting posture, particularly keeping the head upright and chin slightly tucked in while sitting or resting, can use gravity to your advantage. This prevents saliva from pooling in the front of the mouth and makes swallowing easier. During sleep, a wedge pillow can achieve a similar effect.

When should I see a doctor about drooling?

You should see a doctor if drooling is frequent, severe, and causes distress, social embarrassment, or leads to skin irritation. It is especially important to seek medical advice if drooling is a new symptom, as it could indicate an underlying medical condition.

Can dental problems cause drooling in older adults?

Yes, dental issues like poorly fitting dentures, cavities, gum disease, or oral infections can all cause irritation that leads to increased saliva production. Ensuring proper oral hygiene and regular dental check-ups is crucial for managing drooling related to these issues.

What is the role of Botox injections for drooling?

Botox (botulinum toxin) injections can be a treatment option for more severe cases of drooling. The toxin is injected into the salivary glands, where it temporarily reduces saliva production. The effects are not permanent and usually last for several months.