Saliva and Your Mouth

Saliva is a clear liquid made by several glands in your mouth area.

Saliva is an important part of a healthy body. It is mostly made of water. But saliva also contains important substances that your body needs to digest food and keep your teeth strong.

Saliva is important because it:

• Keeps your mouth moist and comfortable
• Helps you chew, taste, and swallow
• Fights germs in your mouth and prevents bad breath
• Has proteins and minerals that protect tooth enamel and prevent tooth decay and gum disease
• Helps keep dentures securely in place

You make saliva when you chew. The harder you chew, the more saliva you make. Sucking on a hard candy or cough drop helps you make saliva, too.

The glands that make saliva are called salivary glands. The salivary glands sit inside each cheek, at the bottom of your mouth, and near your front teeth by the jaw bone.

There are six major salivary glands and hundreds of minor ones. Saliva moves through tubes called salivary ducts.

Normally, the body makes up to 2 to 4 pints of saliva a day. Usually, the body makes the most saliva in the late afternoon. It makes the least amount at night.

But everyone is different. What doctors consider to be a normal amount of saliva varies quite a bit. That makes diagnosing saliva problems a bit of a challenge.

Too Little Saliva

Certain diseases and medicines can affect how much saliva you make. If you do not make enough saliva, your mouth can become quite dry. This condition is called dry mouth (xerostomia).

Dry mouth causes the gums, tongue, and other tissues in the mouth to become swollen and uncomfortable. Germs thrive in this type of setting. A germy, dry mouth leads to bad breath.

Dry mouth also makes you more likely to develop rapid tooth decay and gum (periodontal) disease. That's because saliva helps clear food particles from your teeth. This helps reduce your risk for cavities.

If you have dry mouth, you may also notice you do not taste things like you used to.

Dry mouth is common in older adults, although the reasons are unclear. Diseases that affect the whole body (systemic disorders), poor nutrition, and the use of certain drugs are thought to play a key role.

Too little saliva and dry mouth can be caused by:

• Certain diseases such as HIV/AIDS, Sjogren's syndrome, diabetes, and Parkinson's
• Blockage in one or more tubes that drain saliva (salivary duct obstruction)
• Chemotherapy and radiation therapy
• Dehydration
• "Fight or flight" stress response
• Structural problem with a salivary duct
• Smoking cigarettes

Hundreds of commonly used medicines are known to affect saliva flow and cause dry mouth, such as:

• Antihistamines
• Anxiety medicines
• Appetite suppressants
• Certain types of blood pressure drugs
• Diuretics (water pills)
• Most antidepressants
• Certain pain medicines (analgesics)

Always ask your health-care provider about side effects you might have when taking a medication.

What Can I Do if I Have Too Little Saliva?

Try these tips to help keep your salivary glands healthy and your mouth moist and comfortable:

• Drink plenty of water
• Chew sugar-free gum
• Suck on sugar-free candy

If dry mouth persists, your doctor or dentist may recommend rinsing your mouth with artificial saliva. Artificial saliva is a liquid or spray sold without a prescription. It can be used as often as needed.

Artificial saliva helps keep your mouth moist and comfortable. But it doesn't contain the proteins, minerals, and other substances found in real saliva that help with digestion.

Too Much Saliva

Too much saliva is usually not something to worry about unless it persists. It's normal to make more or less saliva depending on what you eat or drink. Your body usually takes care of excess saliva by swallowing more.

You can make too much saliva if:

• One or more salivary gland is overactive
• You have problems swallowing

It is normal for your salivary glands to go into overdrive when you eat very spicy foods. Taste buds on your tongue play a big role in how much saliva you make. Pop something spicy or very sour in your mouth and your taste buds react by telling your body to make more saliva. Acidic foods tend to trigger a lot more saliva than sweet foods. If excess saliva bothers you, try changing your diet.

If you have a lot of saliva all the time, tell your health-care provider. It could be the side effect of a medication or the result of a medical condition or disease.

If you have problems swallowing, you may feel like you have a lot of saliva in your mouth and may drool. Chronic drooling is most often seen in people who have poor muscle control in the face and mouth.

Diseases and health conditions that can cause too much saliva include:

• Amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease
• Bell's palsy
• Cerebral palsy
• Gastroesophageal reflux disease (GERD)
• Enlarged tongue (macroglossia)
• Intellectual disability
• Parkinson's disease
• Poisoning
• Pregnancy (usually seen in those with extreme nausea and vomiting)
• Rabies
• Stroke

Medications that can cause too much saliva include:

• Some seizure medicines such as Klonopin (clonazepam)
• Schizophrenia medicine called clozapine (Clozaril, Fazaclo ODT)
• Salagen (pilocarpine), used to treat dry mouth in people who have radiation therapy

There are many medical names for excess saliva. What your doctor calls it depends on what is causing the excess saliva. Hypersalivation and sialorrhea are general terms for increased saliva.

What Can I Do if I Have Too Much Saliva?

Treatment for excessive saliva depends on what is causing the problem. It may include:

• Prescription medicine
• Botox shots
• Surgery

Your doctor will probably first recommend a prescription medicine to help reduce the amount of saliva you make. Such medicines include glycopyrrolate and scopolamine. Common side effects include problems urinating, a fast heartbeat, dizziness, blurred vision, and sleepiness.

If you have severe drooling, your doctor may suggest Botox injections into one or more salivary glands. This treatment is considered safe, but results only last a few months. You will need to have more Botox shots in the future.

Surgery to remove a salivary gland or re-route a salivary duct may be done in severe cases. This type of surgery usually provides a permanent cure for excess saliva.

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