One of the most distressing findings for a patient with Parkinson's disease (PD) is sialorrhea.
Factors contributing to sialorrhea in a patient with PD:
(1) decreased swallowing of saliva
(2) poor oral and facial neuromuscular control and coordination
(3) flexed head posture, causing saliva to pool forward and downward
(4) an open mouth with separated lips
(5) poor oral hygiene (with gingivitis and/or dental caries)
Injection of botulinum toxin into salivary glands is an effective therapy. The toxin blocks the release of acetylcholine which reduces the secretion of saliva.
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