Sialorrhoea (Excessive Drooling)

Sialorrhoea, or excessive drooling, is commonly seen in neurological conditions and is usually due to impaired swallowing rather than increased saliva production.

It can lead to:

• Social discomfort
• Skin irritation
• Increased risk of aspiration
• Difficulty with communication

How treatment works

Botulinum toxin is injected into the parotid and submandibular glands to reduce saliva production.
At GC Rehab, all injections are performed under ultrasound guidance to improve precision and safety.

Who this is for

This treatment may be suitable for patients with:

• Stroke
• Parkinson’s disease
• Motor neurone disease
• Cerebral palsy
• Other neurological conditions affecting swallowing

What to expect

• Performed in the clinic
• Ultrasound-guided injections to the salivary glands
• Typically well tolerated
• Effects usually last 3–6 months

How this differs from other treatments

Other options may include:

• Oral medications (often limited by side effects)
• Behavioural strategies or therapy

Botulinum toxin provides a targeted approach by directly reducing saliva production at the gland level.

When to consider referral

Referral may be appropriate when:

• Drooling is persistent or worsening
• There is risk of aspiration or skin breakdown
• Symptoms impact communication or quality of life
• Conservative measures have been insufficient

Why ultrasound guidance matters

Ultrasound allows accurate localisation of salivary glands, which:

• Improves effectiveness
• Reduces risk of side effects
• Enhances overall safety

Why GC Rehab

Specialist rehabilitation physician with experience in neurorehabilitation and ultrasound-guided injections.

FAQs

What causes sialorrhoea?
Usually, impaired swallowing rather than excess saliva production.

How long does treatment last?
Typically 3–6 months.

Is it safe?
Yes, particularly when performed under ultrasound guidance.