Why your saliva gets thick

Robert Smith, Speech Therapist

You know the feeling. The tongue sticks to the roof of your mouth. Saliva that used to be thin is now paste. Sometimes it pulls into a string when you wipe.

People with Parkinson's tell me about this all the time, and almost nobody has been given a straight answer for it. So here is one.

You already know what old saliva feels like

Think about your mouth first thing in the morning. Thick. Coated. Sticky. Everybody wakes up that way, Parkinson's or not.

Your glands did not switch to making paste overnight. What happened is that for seven hours you barely swallowed. The saliva that was in your mouth at bedtime sat there all night. By morning, the water was gone out of it and the thick part was left behind.

Then you get up, talk, have your coffee, brush your teeth. Your mouth gets busy again, and by mid morning it is slick. Nothing was treated. The old saliva got cleared and fresh saliva took its place.

That is the whole story of thick saliva. In Parkinson's, your mouth does a smaller version of it all day.

What happens to saliva that sits

Saliva is almost all water, with a small amount of mucus mixed in. The mucus is normal. Everyone makes it. Fresh saliva is thin because the mucus is dissolved in plenty of water.

When saliva sits in your mouth, the water leaves it three ways.

The lining of your mouth soaks it up. Saliva is much more watery than the tissue it sits on, so the tissue pulls water out of it. This happens with your lips closed. It only needs time.

If your mouth is open, some of it evaporates.

And when a swallow finally comes, it takes the thin part. The mucus that has had time to stick to your tongue and the roof of your mouth stays behind.

Every one of those takes water and leaves mucus. None of them take mucus and leave water. So saliva that sits long enough always drifts thick. The only thing that resets it is a swallow that comes before it had time to sit.

What changed

You did not used to have thick saliva. Your glands are the same glands. What changed is that in Parkinson's, the automatic swallow happens less often. Not never. Less.

If I stopped swallowing and let my saliva sit, it would thicken the same way. Same for your wife, your kids, anybody. This is not something Parkinson's does to saliva. It is what saliva does when nobody swallows it. Parkinson's took the automatic swallow. The swallow can come back.

That is the same change that causes drooling. In one person the saliva pools and runs out the corner of the mouth. In another it sits, loses its water into the lining, and turns to paste. Thick saliva is drooling that stayed in.

Here is how to check this against your own day. It is worst when you have been sitting quietly for a while. Reading. Watching TV. Riding in the car. It is better after your mouth has been busy. If that matches, this is what is happening to you.

The move

Same idea as drooling. With drooling, the saliva hits your lip, you wipe, then you swallow. The wipe is the cue, not the fix.

With thick saliva, the cue is different. It is the sticky feeling. The string on the tissue. The urge to clear your throat. Any of those means saliva has been sitting too long.

When you notice it, swallow.

If it is already too thick to go down, take a sip of water first. Not to hydrate. To loosen it. The film that stuck to your tongue and the roof of your mouth comes free in the water, and then one swallow can take it. Sip, then swallow.

Do not wipe it and leave it. Do not clear your throat and leave it. Either of those moves it around. Only the swallow takes it out.

Early on you will need the sip most times, because you are catching it late. That is fine. The goal is not to clear thick saliva. The goal is to swallow often enough that it never gets thick.

Return to swallowing all day and there is nothing left to thicken.

The first step back to swallowing all day is the same one I teach for drooling. It is in the free guide, if you never got it or lost it. Same habit, two results. The drooling stops, and the saliva stops getting thick.

If your saliva is thick even after your mouth has been busy for a while, this page is not your reason. Something is drying you out. Usually it is a patch, drops, or a pill you take for drooling, which cuts the saliva but not the mucus, or you are not drinking enough. Look at those two first.

The second behavior

Wipe, then swallow is half the method. It is the half I give away. There is a second behavior, and it is the half I have never put in public.

It is in a short video, with simple instructions you can print and follow.