How do I stop my excessive drooling? Dr MARTIN SCURR answers your health questions 

For several years I’ve had too much saliva, causing drooling. This is embarrassing but my GP says nothing can be done.

Name and address supplied.

This must be hard for you but please be reassured there are possible treatments available.

Excessive production of saliva, also known as hypersalivation (or in medicine, ‘sialorrhea’) typically causes drooling, as you have experienced. 

It is usually the result of poor co-ordination of the many muscles involved in swallowing — and in many cases there is also an increase in saliva production.

It can be a side-effect of medications, including clozapine, a tranquilliser. But the most common cause is nerve malfunction or damage affecting the muscles involved in swallowing, for instance as a result of a disorder that’s affected brain function, such as a stroke.

Possible treatments include anticholinergic drugs however, this group of drugs can be poorly tolerated by older people as they can cause side-effects such as confusion.

Another option is an injection of botulinum toxin (or Botox) into the main salivary glands. Some patients may experience difficulty in swallowing following the injections, but that resolves after a few weeks.

I suggest speaking to your GP about being referred to a skilled neurologist or a maxillofacial specialist to carry out this procedure.

I had a vitrectomy with gas bubble in January to fix a macular hole in my eye, but it didn’t work. My consultant is now recommending a repeat operation using a heavy oil tamponade instead. How successful is it?

John Evans, Forest of Dean, Glos.

The operation you had is used to treat retinal detachment, which can lead to a macular hole. When the retina, the photosensitive layer at the back of the eye, becomes detached, you need immediate surgery to repair it. 

A vitrectomy is the first stage — removing the vitreous gel, the thick fluid that fills the part of the eye behind the lens and maintains the eye’s shape.

The retina is reattached to the wall of the eyeball with cryotherapy, where a very cold probe triggers inflammation that ensures the retina stays attached (the vitreous gel itself reforms over time).

‘Tamponade’ refers to the technique where a tiny gas bubble is left to press the retina in place while the inflammatory process occurs. Slowly gas is absorbed and replaced naturally by the watery fluid found in the eye.

If the reattachment hasn’t worked, one option is a repeat procedure using heavy silicone oil for tamponade.

This has to be removed while the gas bubble does not. But it can potentially damage the optic nerve and trigger inflammation that damages the retina.

However, in a study of 115 cases, the retina completely re-attached in nearly 83 per cent of patients using an oil tamponade. In just over 17 per cent, the retina detached again. 

The figures say it all, and I hope — after further consultation — you go ahead with it and restore your vision.

Write to Dr Scurr

To contact Dr Scurr with a health query, email [email protected] Dr Scurr cannot enter into personal correspondence.

His replies cannot apply to individual cases and should be taken in a general context. Always consult your own GP with any health worries.

In my view… Why do we ban wood fires but still let people smoke?

With more of us spending long hours at home to reduce the spread of coronavirus, and winter nights drawing in, a warm fire becomes an even more cheering, welcome thing.

More than a million homes use wood for fuel — we do in my house as we have no gas and the price of heating oil seems to madly fluctuate between 40p and 80p a litre, a constant worrying expense.

However, burning wood and coal is responsible for 38 per cent of the PM2.5 in the air (these are the tiniest particles — or particulates — of pollution and can get deep into our lungs).

This is why the Government has banned the sale of coal and wet wood for use in homes from February next year.

Particulates are harmful and at last this has been recognised — the impact of air pollution is one of the major health and environmental concerns of our time.

And if government policy is logical, the time must come for the banning of another plant-based product, processed for deliberate inhalation into the lungs and proven to be lethal: tobacco.

The problem is tax derived from tobacco sales is considerable: the Government, does not want to admit it, but in effect they want you to smoke and pay the tax.

Because despite the costs to the NHS in treating conditions associated with tobacco use being vast, balanced against the shorter lives of smokers and savings in pension support… you get my drift.

So will we see tobacco banned any time soon? Don’t hold your breath.