Q: I have been suffering from excessive saliva for the last six months or more, especially at night. I have a hard time getting to sleep because I will sometimes feel like I am going to choke. Have you ever heard of this? It is very annoying. My doctor does not know of it and told me to write to you, so please respond. Thank you.
A: A person’s salivary glands commonly produce between one and three pints (one half to one and one half liters) of saliva each day. We fail to notice this because swallowing is constant and done without thinking. The process of the salivary glands over-producing is known as sialorrhea or hyper-salivation and the causes are many. For example, medications such as Klonopin and carbidopa-levodopa, gastroesophageal reflux disease (GERD), excessive starch intake, alcoholism, malnutrition, poorly-fitting dentures, inflammation of the mucous membranes in the mouth, tonsillitis, epiglottis, pregnancy, and Parkinson’s disease may be causes. Other less common causes include Bell’s palsy, arsenic/mercury/copper poisoning, liver disease, pancreatitis, and tuberculosis.
Then, too, you may have a problem with one or more of your salivary glands being overactive or you may have difficulties swallowing because of allergies, radiation therapy, acute or chronic sinusitis, enlarged adenoids, or even a tumor. Have you had a change in your dietary preferences lately? Your body will automatically produce more saliva if you ingest spicy foods. Acidic foods will also trigger the production of saliva. A diet modification may be all you need to return things to normal. The concern is whether you are actually producing an excess of saliva or have a decreased ability to swallow. That must be determined if the problem is to be addressed properly. You don’t indicate if you have had contact with an ENT specialist because of your concerns. If you haven’t, perhaps now is the time.
Some individuals find relief by using mouth wash and brushing their teeth – both of which have a drying effect on the mouth. Other than dietary modifications, prescription medications or even BOTOX may be appropriate therapy for you. On the downside, BOTOX only lasts a few months so additional injections into the salivary glands will be required in the future. As a last resort, surgery to either remove a gland or re-route a salivary duct may be performed in extreme cases. The appropriate treatment is best left to a health care specialist who knows your medical history and may have other ideas for control. In summary, hyper-salivation is treated by identifying the underlying cause and taking the appropriate corrective steps.
