What Causes Drooling in Older Adults?

Some people simply sleep in a position that leaves their mouth open causing drool. Underlying conditions that may cause drooling include excess saliva production, medication side effects, stroke, and Parkinson's disease.

Your body is constantly producing saliva. It’s an important fluid for keeping your mouth hydrated, it helps you digest food, and it even plays a role in your immune system. When everything is working effectively, you may never think about your saliva. However, in certain cases, your saliva may become hard to ignore. One of those cases is when you start drooling.

Drooling is common and not a problem in young children or sleeping people. The process of drooling is simple: instead of swallowing the saliva your mouth produces, it leaks out of your mouth. There are a wide variety of reasons this can happen, ranging from harmless to potentially serious.

Occasional drooling happens to most adults, but frequent or significant drooling may point to a problem. Drooling can be the result of too much saliva, the inability to swallow effectively, or the inability to control the mouth and lips. These symptoms can have a number of problems, especially in older adults.

While drooling isn’t necessarily a problem on its own, it is often the result of other health problems. Understanding the signs and causes of drooling can help you get the treatment you need.

There are many potential causes of drooling. Some people simply sleep in a position that leaves their mouths open. Others may have underlying conditions, like:

Excess saliva production

Some people simply produce excess saliva, a condition known as hypersalivation. While this can be linked to a number of other conditions, there is not necessarily another cause. Hypersalivation makes it difficult to swallow saliva as it is produced, potentially leading to drooling.

Medication side effects

Some medications can lead to hypersalivation, particularly medications for psychiatric disorders or Alzheimer’s disease. These medications trigger excess saliva production that may lead to drooling.

Stroke

Strokes can weaken the muscles around the mouth, making it hard to swallow or keep the lips firmly closed when at rest. This can cause saliva to leak out of the mouth. In older adults with sudden onset drooling, a stroke may be the cause.

Parkinson’s disease

Parkinson’s disease can lead to decreased motor control, especially in the fine muscles of the face. As Parkinson’s disease progresses, drooling becomes more likely as swallowing, speaking, and maintaining jaw position get more difficult.

In older adults, frequent drooling can be a sign that your muscle control over your mouth and neck is weakening. When you drool, it’s often because you had more saliva in your mouth than you could control. Whether this is a problem with the lips, the throat or something else can vary.

Other symptoms connected to drooling include:

Congestion

Nasal congestion may make it difficult to breathe through your nose, causing you to breathe through your mouth instead. If this is the case, you may find yourself drooling more frequently since your mouth is often open. This is likely a temporary type of drooling.

Snoring

Outside of acute congestion, it’s still possible for your breathing habits to cause drooling. People who snore or suffer from sleep apnea may find that they drool in their sleep more frequently than others. This is likely because they need to breathe through their mouth in their sleep.

Heartburn

If you experience heartburn, you may be more likely to drool. Gastroesophageal reflux disease (GERD) often causes a symptom known as “waterbrash,” where your mouth suddenly fills with saliva. This sudden, unexpected saliva production may lead to drooling if you’re speaking or eating.

Difficulty speaking

Many conditions that may make the mouth or throat muscles weaker will also affect your ability to speak. If you frequently slur your words or find it difficult to speak clearly, you may also drool more frequently. If you notice that it suddenly becomes difficult to speak, get medical attention immediately.

To have the cause of your drooling diagnosed, speak with your doctor. They may recommend that you change your sleeping position, or they may give you a referral to a specialist. These specialists may test you for a number of neuromuscular disorders. This may include motor control tests, sleep studies, or cognitive tests, depending on your other symptoms.

Drooling while you sleep may be treated by changing the position in which you sleep. This can adjust your head position so your jaw remains shut overnight.

For cases of drooling that is caused by other conditions, treatments can include things like:

• Botox injections to reduce salivation
• Physical therapy to increase muscular coordination
• Anticholinergic medications to induce dry mouth

You can discuss treatment methods with your primary care doctor.