It may be normal to have a little drool on your pillow as you sleep, but what if it's happening…all the time? To the point where you can feel excessive saliva building up in your mouth?
Your body makes a lot of, well, stuff every day. In fact, it churns out one to two liters of saliva and mucus daily, says Sam Huh, MD, ENT and assistant professor in otolaryngology at Mount Sinai in New York City. "Most of the time, we just swallow [this fluid] without thinking about it," he says.
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You have two main salivary glands on the side of your face by your jaw, two underneath in the middle of your jaw and two under your tongue, Dr. Huh explains.
And there's more: "You have literally hundreds or a thousand minor salivary glands peppered all over your oral cavity, cheeks, lips and down into the throat," he says. (Knowing that, all that daily saliva production isn't that surprising.)
But if you notice you're drooling more, you may either be producing excess saliva (a condition called sialorrhea or ptyalism) or having trouble swallowing the entirely normal amounts your body is making. Either can be a sign to get checked out or talk to your doc.
Here, learn more about drooling causes, and how to treat excessive saliva.
1. You Have Acid Reflux
This is called "water brash," or a sudden rush of saliva, according to the International Foundation for Gastrointestinal Disorders. It happens during reflux when saliva and acid is regurgitated up into your mouth.
If you notice this happening, along with other common symptoms of reflux, including a sour taste in your mouth, frequent burping, heartburn and bad breath, make an appointment with your PCP.
If you feel as if there is something caught in your throat, make an appointment ASAP, as certain cancers, such as esophageal cancer, can cause difficulty swallowing, per the National Institute on Deafness and Other Communication Disorders.
If your reflux is persistent, ask your doctor about trying stronger over-the-counter medications called proton-pump inhibitors like Prilosec or Nexium.
You can also eat acid reflux-reducing foods, like yogurt, fruit and vegetables.
Talk to your doctor if acid reflux is accompanied by stomach pain, nausea or vomiting.
2. You Have Allergies
Your eyes may water and your nose may run as a defense mechanism against any irritant, including dust, pollution and allergies. Irritants in your mouth can also cause an overproduction of saliva, Dr. Huh says.
This could cause you to drool throughout the day, but also drool while you sleep at night. Fortunately, there are plenty of allergy treatments available to help you out.
Allergy symptoms can make life miserable. Though there are a bevy of OTC options available, rather than trying to self-diagnose and treat, see your doctor, who can develop a more honed allergy treatment plan that will stop allergies before they start and keep you feeling good throughout the season.
In the meantime, make sure you're drinking plenty of water to help clear your sinuses and potentially prevent hypersalivation.
3. You Have a Dental Health Issue
Excessive saliva can also indicate that something is going on with your dental health. Having a cavity can cause temporary hypersalivation, as your salivary glands will produce more saliva when an infection is present in your mouth, per the American Dental Association.
Your saliva can also build up if you have dentures or any form of false teeth, which can be remedied if you use an adhesive or adhesive strips, per the dental health brand Oral-B.
If you believe your dental health is the reason behind your excessive saliva, make a trip to the dentist's office. They can search for cavities or gum disease and treat your condition.
4. It’s Your Rx
If you're wondering why your mouth is producing so much saliva suddenly, your medication could be to blame.
Your salivary glands are controlled by your parasympathetic nervous system (PNS), which opposes the sympathetic nervous system (SNS), or your fight-or-flight stress response, Dr. Huh explains. Any medication that turns on your PNS could cause hypersalivation.
"The majority of medications are anti-PNS, so most cause dry mouth," Dr. Huh says.
However, a couple do activate the PNS that could produce excess saliva, including clonazepam (Klonopin), a sedative and anti-seizure, as well as clozapine (Versacloz, FazaClo, Clozaril), an antipsychotic that treats schizophrenia.
If you suspect your medication is causing excessive saliva, talk to your doctor. They may be able to adjust your dose or find a similar medication that does not cause hypersalivation.
Never stop taking your medicine without consulting your doctor, though. If your medicine is absolutely necessary, they can help you come up with side effect relief.
4. It’s an Environmental Chemical
Occasionally, one way to stop too much saliva in your mouth is by taking a look at your environment. The culprit may be a household product.
In fact, there was one point when Dr. Huh had several patients walk through his doors complaining of excessive saliva. "We figured out that it was likely connected to mosquito spray that was being used around the neighborhoods here. These insecticides might act on the PNS," he says.
If you can't figure out what causes your extra saliva, take a look at the products you use around your home or the insecticides used outdoors. They could be to blame.
If so, opt for more natural cleaning and pesticide products and stay informed on your neighborhood's bug spraying schedule, so you can feel prepared.
5. You’re Nauseated
Drooling is often a sign of nausea, as it can cause your mouth to well up with saliva.
"Nausea is controlled in the PNS — sometimes with nausea, your brain thinks you've been poisoned and is trying to get rid of it by telling the stomach to empty," Dr. Huh says.
You might be nauseated because you're sick, pregnant or have motion sickness. Talk to your doctor or pharmacist about medications to treat nausea.
If you're feeling nauseous, try an over-the-counter medication like Nauzene or Dramamine (for motion sickness). You can also try natural remedies like peppermint tea, chewing gum or taking deep breaths.
If your nausea is persistent (due to pregnancy or other conditions), talk to your doctor, who can offer a prescription nausea medication.
6. You Have a Medical Condition
If you're living with a neuromuscular disorder, like Parkinson's disease, trouble swallowing may result in a saliva buildup that leads to drooling, Dr. Huh says.
Other conditions that could cause chronic hypersalivation include: cerebral palsy, facial nerve palsy, stroke or amyotrophic lateral sclerosis (ALS), according to a November 2019 review in Therapeutic Advances in Neurological Disorders.
If you have one of these conditions, consider making an appointment with a speech-language pathologist who can teach you strategies for clearing saliva, like sucking on a piece of hard candy, suggests the Parkinson's Foundation.
Talk with your doctor if you're experiencing symptoms of cognitive decline, reduced motor skills, memory loss or other symptoms of a neuromuscular disorder. They can refer you to a specialist to receive a proper diagnosis.
If you already have a neuromuscular disorder, work with your doctor or a physical therapist to find ways to reduce your excessive salivation.
7. You Have a Vitamin B3 Deficiency
Niacin, or B3, is a vitamin that plays a role in 400 enzymatic reactions in the body. Deficiency, called pellagra, can cause your tongue to turn bright red, along with GI symptoms like vomiting or diarrhea, as well as excessive salivation.
This vitamin deficiency is rare, but it's possible to have suboptimal levels of the vitamin B3, according to the National Institutes of Health. Taking a supplement will restore healthy levels, but make sure to talk to your doctor before you seek one out.
If you think you have a vitamin deficiency, visit your doctor, who can order blood work to determine where your levels are at. If you are deficient, they can recommend over-the-counter or prescription vitamin B3 to replenish your supply.
Tips to Prevent Excessive Saliva
There are a few ways you can prevent hypersalivation from happening if you already know you're prone to it. These can include:
- Eating certain foods to eliminate excess saliva (like bread, oats or salted nuts)
- Sucking on hard candy or sugarless gum, per the Parkinson's Foundation
- Getting botox in your salivary glands, cheek and jaw, per the Parkinson's Foundation
- Wearing a sweatband around your wrist, or keeping napkins close by (to discreetly wipe away saliva), per the Parkinson's Foundation
When to See a Doctor
Sometimes excessive saliva, like drooling in your sleep, is completely normal or caused by a benign issue — like a stuffed nose.
Unfortunately, there are not many over-the-counter medicines for excessive saliva. So, if you find you're experiencing hypersalivation attached to a particular set of symptoms, talk to your doctor, who can narrow down a diagnosis and help you find relief.
Getting to the root cause of hypersalivation (like allergies, nausea, etc.) will help reduce the amount of saliva you produce, and hopefully get you on track to a better quality of life.
1. Why Do I Drool in My Sleep?
Drooling when you sleep is a fairly universal experience, especially if you sleep on your side. But it can also indicate a couple of things. First, you could have a clogged nose due to an infection or cold, leading you to sleep with your mouth open. Strep throat and tonsilitis can cause you to swallow less due to pain, leading to drooling when you sleep, per Penn Medicine.
In some cases, sleep apnea can cause you to drool in your sleep. This is a sleep disorder that causes you to stop breathing for brief periods of time throughout the night. In order to treat it, you'd need to go through a sleep study and then talk to your doctor about treatment options, per Penn Medicine.
2. When Should I Be Worried About Excessive Saliva?
Chronic drooling that is not treated by your doctor may cause a condition called angular cheilitis — painful, cracked sores in the corners of your mouth. It could also cause saliva to be aspirated into your lungs, causing pneumonia.
If you notice that drooling has gone on for a while, comes with other serious symptoms (like those of a neuromuscular disorder) or other at-home treatment options have not helped, talk to your doctor for guidance, per the Cleveland Clinic.
3. Can Anxiety Cause Excessive Saliva?
Typically, anxiety will cause dry mouth along with other symptoms like shaking, sweating or feeling faint, per Harvard Health Publishing. You may even experience dry mouth when waking up as an anxiety symptom.
While it's possible that your anxiety presents in physical symptoms like excessive saliva, it is much less common than dry mouth or feelings like there's cotton in your mouth.
- International Foundation for Gastrointestinal Disorders: “Symptoms of GERD”
- National Institute on Deafness and Other Communication Disorders (NIDCD): “Dysphagia”
- Parkinson’s Foundation: “Drooling”
- National Institutes of Health: “Niacin”
- StatPearls: “Vitamin B3”
- Cleveland Clinic: "Drooling"
- Harvard Health Publishing: "Anxiety Overload"
- The American Dental Association: "Saliva"
- Therapeutic Advances in Neurological Disorders: "The burden of sialorrhoea in chronic neurological conditions: current treatment options and the role of incobotulinumtoxinA (Xeomin®)"
- Oral-B: "Eating and Speaking with Dentures"
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.