Salivary management for people with neurological condition: Part one

Welcome to the first part of our salivary management series. Let’s delve into managing excessive saliva and how the MSWA Nursing team can support people living with neurological condition include, multiple sclerosis (MS), Parkinson's Disease and more, to improve comfort and enhance your quality of life.

Managing mouth secretions can be a challenge for individuals living with neurological conditions. It is vital for Clients to manage this condition as it impairs the body’s control over saliva and mucus. Excessive or thickened secretions can cause discomfort, swallowing difficulties, respiratory issues, and increase the risk of aspiration pneumonia.

MSWA Nurses play a crucial role in assessing the unique needs of each individual, implementing strategies for airway clearance, and educating Clients and caregivers.

Neurological conditions can cause secretion problems due to:

• Dysphagia known as difficulty in swallowing. Weakness in the muscles used for swallowing may cause saliva to pool in the mouth.
• Reduced or absent cough reflex results in a diminished ability to clear secretions increasing the risk of chest infections.
• A dysfunction autonomic nervous system can lead to excessive saliva production or thickened mucus.
• Certain medications can either increase or decrease secretion levels, which can influence the management strategies employed.

MSWA Nurses can provide effective secretion management through a combination of medications, nursing interventions and lifestyle modifications, including:

• Encourage Clients to sit upright during meals to prevent aspiration.
• Use postural drainage techniques to aid in mucus clearance.
• Reposition Clients regularly to prevent secretions from pooling in the lungs.

• Regular oral care to prevent secretion buildup and reduce infection risks, with support from MSWA Speech Pathologists and Dietitians.
• Suctioning may be necessary to remove excessive saliva or mucus, assisted by respiratory physiotherapists.

• Encourage adequate fluid intake to help thin mucus and make it easier to clear.
• Consider a modified diet for those with swallowing difficulties. Dietetics and speech therapy teams can also assist with tailored programs.

• Drinking water regularly helps to thin secretions and prevent dryness.
• Increase intake of pineapple and pineapple juice, as the fruit has a natural astringent effect on secretions.
• Avoiding dairy may help, as dairy products thicken mucus.
• Using cool mist humidifiers will help maintain airway moisture.

• Speech therapists can teach swallowing techniques to reduce drooling.
• Respiratory physiotherapists can assist with effective mucus clearance.

• Anticholinergics medications can block saliva production and are used for conditions like sialorrhea.
• Botox injections can target the salivary glands to reduce saliva production.
• You can also be prescribed atropine eye drops to reduce secretions.
• There are also medications that can help thin secretions, including mucolytics, used to break down thick mucus to ease clearance, and saline nebulizers which helps to loosen mucus for easier expulsion.

MSWA Nursing team adopts a collaborative care approach to ensure our Clients receive the best possible care and management of symptoms.

They work closely with a variety of specialists, including dietitians, respiratory physiotherapists, speech therapists, occupational therapists, and physiotherapists. As well as external medical teams such as hospital outpatient clinics. 

Proactive management of secretion issues can significantly improve comfort, reduce complications, and enhance the quality of life for people living with neurological conditions.

If you have any queries about salivary management, reach out to MSWA Nursing for more information.