The injections are administered directly into the salivary glands. While it’s a potent toxin, the small, controlled doses used for sialorrhea injections have a good safety profile and minimal side effects when performed by physicians experienced in this procedure

Botulinum neurotoxin works by temporarily relaxing the muscles. When injected into the salivary glands, it blocks the release of acetylcholine – a chemical messenger that stimulates saliva secretion. By reducing acetylcholine release, the toxin decreases the activation of salivary glands, resulting in less saliva production and decreased drooling.

While not necessarily a first-line option, botulinum toxin injections can be an effective way to reduce debilitating, chronic drooling for certain patients when other approaches have been unsuccessful. A neurologist may recommend botulinum toxin injections for sialorrhea if:

• Drooling is frequent or constant, resulting in significant hygiene or social difficulties
• All reasonable attempts at medical, behavioural or physical therapies have not been effective
• Drooling is due to a neurological disorder such as cerebral palsy, Parkinson’s disease, and amyotrophic lateral sclerosis – ALS.