Drooling (Sialorrhea)

Why Is Saliva Important?

Saliva plays an important role in maintaining normal digestion, protecting our teeth from cavities, and lubricating our mouth during swallowing and speaking.

Normal Saliva Production

Saliva is produced by major and minor salivary glands in the head and neck. We have six “major” salivary glands, including the parotid glands (in front of the ears), the submandibular glands (behind our jaw) and the sublingual glands (under the tongue). We also have hundreds of tiny “minor” salivary glands, located in the mouth and throat.

How Can Drooling Become a Problem?

Saliva is usually managed effectively by swallowing periodically. Drooling occurs because of an inability to appropriately manage the normal amount of saliva produced by the salivary glands. As a result, saliva can spill over the lips and chin, or drain down the back of the throat. When saliva continuously spills onto the skin of the face and neck, chronic skin problems can occur. When saliva accumulates in the back of the throat, saliva may spill into the airway, potentially causing recurrent pneumonias as well as long-term lung damage.

Treatment of Drooling

Drooling is occasionally treated with specific medications designed to decrease salivary production. In addition to medication, drooling can be reduced through surgical procedures, including:

• Tying off the major salivary ducts within the mouth
• Moving the submandibular ducts under the tongue to the back of the mouth making it easier to swallow the saliva. Often the sublingual glands will be removed at the same time, and sometimes the parotid ducts will be tied off.
• Surgically removing the submandibular salivary glands through two small incisions in the neck. In addition, the parotid salivary ducts may be closed off.