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 are 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)) for the sensory receptors that carry the message to the brain, and which in turn gives us the instruction to swallow. Hence, if the sensory-motor system that participates in swallowing is beginning to work less efficiently, drooling, along with other swallowing issues might be one of the consequences.
If I say to a patient: "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, and your head and upper body stooped 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 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 am asking you to take a 30 day challenge, and try some 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"!
Drool Less Challenge
1. If you can, chew gum in 15 minute sessions. I recommend bubble gum ( Bazooka is my favorite). For that 15 minutes, really work the gum in your mouth. Use yo8ur 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 and sour flavors are good messengers. 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 to wipe your saliva is also a bit "yucky". Try a terry cloth wrist ban like tennis players use. It's a handy way to "mop up" drool and can easily be thrown in the wash.
Good Luck!!
Saturday, January 23, 2010
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