Botulinum toxin (BTX) commercially known as Botox is produced by Clostridium Botulinum, it has many different subtypes. It is a relatively safe agent with very few local and systemic adverse effects, and is currently used in a wide range of medical, dental and cosmetic procedures. BTX has the potential for an expanding range of applications in the future. In this article we review the mechanism of action, and all the well documented applications of BTX with a specific focus on its usage in the treatment of hyper-salivation and drooling. We propose a combination treatment for the above mentioned salivary gland conditions, which consists of BTX and Epidermal Growth Factor (EGF); a well-known potent polypeptide that promotes healing and repair. EGF is secreted though many bodily fluids including saliva. This combination treatment aims to prevent the atrophy of salivary glands that accompanies treatment with BTX. We aim to provide answers to the question whether BTX induced paralysis is a burden or bless? Our proposed combination treatment (BTX + EGF) will hopefully obtain the best of both worlds; the therapeutic effect of BTX and the healing potential of EGF. This will maintain the salivary glands. integrity and will allow for long term treatment with BTX with minimal side effects.
