Q. I sometimes wake up with drool on my pillow, which feels embarrassing and a little gross. Is this normal, and is there anything I can do?
Saliva is one of your body’s unsung heroes. It helps you taste and swallow food, protects your teeth from decay and helps keep harmful pathogens in check, said Dr. Mark Wolff, dean of the University of Pennsylvania School of Dental Medicine. “Without saliva, we’re in trouble,” he added.
Every day, you produce about 0.5 to 1.5 liters of saliva, and drooling is simply what happens when it escapes your mouth. This is generally normal, but understanding how and why you drool can avoid some awkward, uncomfortable moments.
We asked experts what to do about drooling and when to see a doctor about it.
What causes drooling?
Most of the time, drooling happens because saliva builds up faster than you can get rid of it. During the day, you usually manage saliva by swallowing. But while asleep, you swallow less often and have less conscious control over the muscles around your mouth, said Dr. Emily Boss, director of pediatric otolaryngology at Johns Hopkins Medicine.
Breathing through your mouth makes drooling even more likely because saliva has an easier exit, she added. If you sleep on your side or stomach, or you nod off while sitting (like on a bus or train), gravity can also work against you, said Dr. Christine Won, medical director of the Yale Centers for Sleep Medicine.
Children also tend to drool more than adults. Babies and toddlers are still developing control of their lips, tongue, jaw and swallowing muscles, Dr. Boss said, while teething can stimulate extra saliva, helping soothe tender gums.
Young children also explore the world with their mouths — sucking on their thumbs, chewing on toys or sitting with their mouths open — which can increase drooling. For most children, this improves as those muscles and swallowing patterns mature, usually by around age 4, Dr. Boss added.
What can I do to reduce drooling?
Changing sleep positions can help with drooling at night, Dr. Won said. Sleeping on your back is not great for people with sleep apnea, but it’s usually the best position to reduce drooling, she added. If you tend to roll around and have trouble sleeping on your back, placing pillows around your body can act like bumpers, keeping you in place.
Addressing congestion may also help combat drooling. For example, treating allergies or a cold can make it easier to breathe through your nose and potentially reduce drooling, Dr. Won said. Nasal strips might also help, but experts recommended avoiding mouth tape, since that can just make it harder for you to breathe.
You may also want to avoid food and drinks that stimulate saliva before bed. Anything sour can get your salivary glands going, as can sugary food and drinks — though to a lesser extent, Dr. Wolff said. Acid reflux can have a similar effect, so avoid eating too close to bedtime and steer clear of spicy or greasy foods. And if you wear Invisalign, a retainer or some other dental device at night, try not to grind your teeth, since that kind of mechanical stimulation also increases saliva production, Dr. Wolff added.
Should I talk to my doctor?
In general, nighttime drooling is common and usually not a cause for concern. But drooling during the day is a little more worrisome, and you should see a doctor if it abruptly worsens or feels excessive, Dr. Won said, since that might be a sign of a more serious condition.
For example, drooling can sometimes point to sleep apnea or a structural problem that makes it hard to breathe through the nose. In children, this may be enlarged tonsils or adenoids — small pads of tissue that sit in the throat, right behind the nose — that block the airway, Dr. Boss said. In adults, loose or fatty tissue in the back of the throat can have a similar effect, she added.
Drooling can also stem from genetic and neurological conditions that affect muscle control or swallowing, such as cerebral palsy, Down syndrome, Parkinson’s disease, dementia, A.L.S. or a stroke, Dr. Boss said.
The right treatment for excess drooling depends on the cause. If it’s related to an airway problem, something like a tonsillectomy or using a continuous positive airway pressure (or CPAP) machine can help, Dr. Won said. Some patients also benefit from swallowing exercises or mouth therapy to strengthen coordination of the lips, tongue and muscles, Dr. Boss said.
In more severe cases, doctors may prescribe medications to dry the mouth, inject Botox into the salivary glands to temporarily paralyze them, or perform surgery to clip the glands — sometimes called the “drool procedure,” Dr. Boss said. Doctors tend to use these approaches cautiously, because drying out the mouth too much can be pretty uncomfortable.
“Making too little saliva is a bigger problem than making too much,” Dr. Wolff said.
In general, a damp pillow might be embarrassing, but it’s nothing to lose sleep over. “It’s more of a nuisance than an emergency,” Dr. Won said.
Simar Bajaj covers health and wellness for The Times.
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