Side Effect: Increased Saliva Production

What is Increased Saliva Production?

Increased saliva production, also known as hypersalivation, is a condition where your salivary glands produce more saliva than normal. This can cause drooling, or sialorrhea, which is the unintentional loss of saliva from the mouth. This can be a distressing symptom and lead to skin irritation, social embarrassment, and trouble with swallowing and breathing, which can affect quality of life.

What does Increased Saliva Production look like?

Hypersalivation can look like a pool of water in the mouth, increased wetness around the mouth, and drooling. It can also cause skin irritation around the mouth and chin area.

Who gets Increased Saliva Production?

Hypersalivation can develop for several reasons. All reasons include damage to the salivary glands, which can happen during:

• Radiation therapy
• Chemotherapy
• Oral infection from white blood cell counts being low

The most common cancers having an increased saliva production as a side effect are head and neck cancers. It is also present in neurological conditions that affect the muscles of the mouth or throat.

How to prevent Increased Saliva Production

There are steps to help prevent increased saliva production, but ultimately prevention is difficult while on certain cancer therapies. Some options to prevent increased saliva production include:

• Good oral hygiene
• Avoiding acidic or spicy foods
• Sitting semi-upright during meals to help with absorption and digestion

How to treat Increased Saliva Production

There are several ways to treat increased saliva production in patients with cancer. Some are the same as prevention methods used above. Other options include topical, surgical, or medication interventions:

• Topical agents
  
  • Glycopyrrolate (Cuvposa®)
  • Botulinum toxin (Botox®) injections to the salivary glands
• Surgery
  
  • Salivary gland removal
  • Rerouting of saliva flow – to make saliva more
• Medications – mostly that have anticholinergic properties to help dry out saliva
  
  • Amitriptyline (Elavil®)
  • Atropine – liquid drops to the mouth
  • Benztropine (Cogentin®)
  • Guaifenesin (Mucinex®)
  • N-acetylcysteine (Mucomyst®)
  • Scopolamine (Scopace®)

In treatment management of increased saliva production, it is important to discuss with a healthcare provider regarding symptoms, timeline of symptoms, and duration of treatment for this side effect. Overall, hypersalivation is not as common as other side effects from cancer treatment but is very important to treat if it occurs.