Dear doctor;

I have a friend whose mouth cannot hold saliva when he is talking. Dribbles of saliva keeps falling away and it makes things awkward. He has lost two girlfriends because of this problem. Is there a way to help him?

Concerned Friend.

Dear Concerned Friend,

Cause of dribbling saliva or drooling depends on how long it has been happening, is it a long standing problem or developed recently. Babies have dribbling of saliva when they start teething. Women can have it during phases of hormonal changes in life like pregnancy, menopause, among others. But in a normal healthy adult, it is either due to excess production of saliva or inability to retain saliva in mouth or to swallow it.

Excess saliva production mostly occurs due to infections in the mouth or around it. Chronic infections in teeth and or gums lead to excess production of saliva causing drooling. Chronic infections like recurrent herpes labialis can cause dribbling of saliva. Bacterial or fungal infections of the pharynx or any part of the mouth lie palate, lips, among others, can result in drooling apart from pain and swelling at affected site.

Drooling of saliva can also occur due to intake of hot, spicy food like hot red pepper.

Neuromuscular problems like paralysis of palate, mouth or pharynx presents as dribbling of saliva, along with other symptoms. Tumours of throat or any part within the mouth result in inability of the person to swallow saliva causing dribbling. Some drugs like local anesthetic used for dental procedure or pain and anti depressants, cause excess salivation.

Management of the problem lies in identifying and treating the cause.