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From toothaches to tonsil infections, a host of oral health issues can lead to excess saliva. See your doctor or dentist if you’re unable to manage hypersalivation on your own, or if you experience signs of an infection, such as pain, swelling, or discharge. Oral health issues other than infections, such as structural defects, can also lead to saliva buildup. Support collars, braces, and other devices are available if any mouth, neck, or jawbone defects make swallowing difficult. This medication can be taken sublingually (under the tongue) to help produce a local drying effect in the mouth. Atropine is an anticholinergic medication, but since it’s being administered at a low dose in the mouth, the side effects that these medications usually cause are much less likely.Similar medications include oral hyoscyamine, oral amitriptyline, and sublingual ipratropium bromide. If other treatment options were unsuccessful, your doctor might advise botulinum (Botox) injections. Using an ultrasound as a guide, a medical professional will inject the salivary glands with a toxin that temporarily blocks their function.  Botox injections need to be administered every 5 to 6 months in order to manage excessive salivation. Make sure that you see an experienced Ear, Nose, and Throat doctor for this treatment option. Surgical removal of the salivary glands is rare, and only advised if hypersalivation significantly impacts quality of life. For instance, choking on excess saliva is potentially life-threatening for a person with an advanced motor neuron disorder, so surgery might be the best solution.  There are a variety of surgical options available. Your doctor, or the medical team of the person in your care, will help determine which is appropriate. Generally, salivary gland surgery is fast and simple. Some surgeries only require local anesthesia, which means the area would be numbed and you’d stay awake during the procedure.
Consult your doctor about treating an oral infection, if necessary. Ask your doctor about 1% atropine eye drops. Discuss Botox injections with your doctor for serious hypersalivation. Consider surgery as a last resort.