Drooling refers to the unintentional loss of saliva from the mouth. While common in infants, drooling can also affect older adults. This article explores common factors contributing to drooling in older individuals and discusses management strategies.
Why Drooling Occurs
Drooling in older adults is typically not a result of excessive saliva production. Instead, it usually stems from issues with swallowing saliva or maintaining it within the mouth. This can arise from various factors impacting muscle control and oral function.
Neurological conditions frequently contribute to drooling by impairing the muscles involved in swallowing and keeping the mouth closed. Diseases such as Parkinson’s disease, stroke, amyotrophic lateral sclerosis (ALS), and multiple sclerosis can weaken facial and oral muscles. These conditions often reduce the frequency of automatic swallowing, leading to saliva accumulation and spillage. For instance, Parkinson’s disease can affect facial motor control, making it difficult to maintain jaw position and control saliva.
Certain medications commonly prescribed to older adults can also cause drooling as a side effect. Some antipsychotics, cholinesterase inhibitors used for dementia, and sedatives may either increase saliva production (hypersalivation) or relax the muscles around the mouth. This relaxation can hinder the ability to retain saliva or swallow it effectively. Adjusting these medications, under medical guidance, may sometimes alleviate drooling.
Difficulties with swallowing, known as dysphagia, are another common cause of drooling in older adults. Age-related changes or specific health conditions can impair the swallowing reflex, causing saliva to pool in the mouth rather than being cleared. This impaired swallowing can also increase the risk of saliva entering the airways.
Weakness in the facial or oral muscles can make it challenging to keep the lips sealed or to clear saliva efficiently. This reduced muscle strength can be a consequence of aging or related to various medical conditions. When these muscles lack sufficient control, saliva can inadvertently escape the mouth.
Dental issues can also play a role in drooling. Ill-fitting dentures, gum disease, or tooth decay may irritate the mouth, potentially leading to increased saliva production as the body’s response. These problems can also affect proper lip closure, making it harder to contain saliva. Addressing oral health concerns can sometimes help manage drooling.
How Drooling Can Affect Well-being
Persistent drooling can significantly impact an older person’s quality of life. The constant moisture around the mouth and chin can lead to various skin problems, including irritation, redness, chapping, and even the development of rashes or infections.
Drooling can have social and emotional consequences. Individuals may experience embarrassment or reduced self-esteem due to visible drooling, which can lead to social withdrawal and isolation. The need for frequent wiping and concerns about damp clothing also present hygiene challenges.
In more serious instances, impaired swallowing associated with drooling can increase the risk of aspiration. This occurs when saliva inadvertently enters the airways instead of being swallowed down the esophagus. Aspiration can lead to respiratory complications, including aspiration pneumonia, a lung infection.
Strategies for Managing Drooling
Addressing drooling effectively often begins with consulting a healthcare professional. A doctor can help identify the specific underlying cause, assess any medications that might be contributing, and rule out more serious conditions. This initial assessment guides the development of an appropriate management plan.
Good oral hygiene and skin care are important for managing drooling. Regularly cleaning the mouth and keeping the skin around it dry and clean prevents irritation, rashes, and infections. Gently dabbing the area rather than rubbing can help protect the skin.
Speech and swallowing therapy can be beneficial. A speech-language pathologist can evaluate swallowing and provide targeted exercises. These exercises aim to strengthen oral and throat muscles, improve jaw stability, and enhance lip closure. Therapists can also teach compensatory swallowing techniques to help manage saliva more effectively.
Medication adjustments may be considered if specific drugs are identified as contributing to drooling. A doctor might modify current prescriptions or prescribe medications designed to reduce saliva production, such as anticholinergics. These medications work by blocking nerve impulses that stimulate salivary glands.
For severe cases that do not respond to other interventions, botulinum toxin injections can be an option. Small amounts of botulinum toxin are injected into the salivary glands, temporarily reducing saliva production. The effects last for several months, and injections can be repeated.
Lifestyle adjustments can also help manage drooling. Maintaining an upright posture and ensuring proper head positioning, during rest, can help prevent saliva from pooling and escaping the mouth. Regular, small sips of water and frequent dry swallows can also encourage better saliva clearance.