Sialorrhea, also known as hypersalivation or excessive drooling, occurs when there is an overproduction of saliva in the mouth.
This condition can lead to the unintentional flow of saliva from the mouth, causing discomfort, social anxiety, and skin irritation.
It can be the result of excessive salivary gland activity or difficulties in swallowing saliva, known as dysphagia.
While it isn’t a standalone disease, it often accompanies certain medical conditions or can be a side effect of medications.
Luckily, there are several sialorrhea treatments available to control excessive saliva and improve the quality of life for those affected.
Types of sialorrhea
There are two primary types of sialorrhea:
- Anterior Sialorrhea: Saliva overflows from the front of the mouth, resulting in visible drooling. This type of hypersalivation may affect speech, and chewing, and lead to dermatitis around the mouth. The social implications of anterior sialorrhea can increase anxiety and affect one’s confidence in social situations.
- Posterior Sialorrhea: In this case, saliva flows toward the throat. While it’s not externally visible, it can cause significant discomfort and lead to respiratory problems if untreated.
Common Causes of Sialorrhea in Adults
Several factors can trigger excessive salivation in adults. Some of the most common causes include:
- Medications such as clonazepam, anticonvulsants, antihistamines, and muscle relaxants.
- Poorly fitted dentures or starting orthodontic treatment like braces.
- Gum disease, periodontal disease, or swollen gums.
- Facial paralysis or neuromuscular disorders like multiple sclerosis and amyotrophic lateral sclerosis (ALS).
- Gastroesophageal reflux disease (GERD) or sinus infections.
- Hypothyroidism and autoimmune conditions like Sjögren’s syndrome.
- Tumors in the salivary glands.
- Neurological conditions like Parkinson’s disease or complications from stroke.
Symptoms of Sialorrhea or Hypersalivation
The hallmark of sialorrhea is constant drooling, but other symptoms of excessive saliva production may include:
- Bad breath (halitosis).
- Dry, chapped lips or angular cheilitis from saliva contact.
- Oral sores or skin irritation around the mouth and chin.
- Difficulty swallowing, coughing, or gagging due to excess saliva.
- Difficulty speaking clearly due to excess saliva in the mouth.
- Jaw muscle fatigue from constant movement to clear saliva.
- Anxiety due to the social impact of drooling.
Effective Treatments for Sialorrhea
The treatment for hypersalivation depends on the cause and severity of the condition. The following are the most commonly recommended treatments:
Conservative Treatments for Sialorrhea
Conservative treatments involve non-invasive therapies, which are especially effective for individuals with neurological conditions or facial muscle weakness. These treatments focus on retraining the muscles to control saliva production. They include:
- Physical therapy for facial and chewing muscles.
- Speech therapy to improve swallowing techniques.
- Myofascial therapy to release tight facial muscles.
These therapies can lead to long-term improvements in managing excessive saliva.
Pharmacotherapy for Hypersalivation
In cases where medications are the root cause of sialorrhea, your healthcare provider may switch you to an alternative that does not cause this side effect.
Anticholinergic medications may also be prescribed to reduce saliva production.
Botox Injections to Treat Sialorrhea
For individuals experiencing severe sialorrhea, Botox injections into the salivary glands can provide effective relief.
Botox acts as a localized muscle relaxant, reducing saliva production for several months. This treatment typically lasts around six months, after which follow-up injections are needed.
Surgical Treatments for Severe Sialorrhea
In extreme cases where other treatments do not work, sialorrhea surgery may be necessary. Surgical procedures can involve either:
- Tying off the salivary ducts to prevent saliva from being released into the mouth.
- Removing the salivary glands entirely.
Surgical options are considered irreversible, so they are usually pursued only when conservative treatments and pharmacotherapy have failed.
Is Sialorrhea in Babies Normal?
Yes, it’s normal for babies and toddlers to experience hypersalivation, especially during teething.
Babies often drool because they lack neuromotor control over their swallowing muscles. As they develop, their ability to manage saliva improves, and this type of sialorrhea usually resolves on its own.
FAQs About Hypersalivation
What Medications Can Cause Sialorrhea?
Several medications, including antidepressants, anxiolytics, antihistamines, and muscle relaxants, can lead to excessive saliva production.
Why Does Pregnancy Cause Hypersalivation?
During pregnancy, hormonal changes can lead to temporary sialorrhea, often accompanied by morning sickness. The condition usually resolves on its own after pregnancy.
Which Foods Worsen Hypersalivation?
Certain foods, known as sialogogues, can increase saliva production. These include spicy foods, citrus fruits, and acidic foods. If you have hypersalivation, it’s best to avoid these to help control symptoms.
Which Doctor Treats Sialorrhea?
In most cases, a dentist or a stomatologist will provide initial care. If necessary, they may refer you to specialists such as a neurologist or otolaryngologist (ENT) for further evaluation.
What’s the Difference Between Ptyalism and Sialorrhea?
While both involve excessive saliva production, ptyalism is a temporary condition triggered by emotional responses such as fear or stress.
Sialorrhea, on the other hand, is a chronic issue that requires medical attention.
Conclusion
Sialorrhea, or excessive drooling, can have a profound impact on a person’s daily life, affecting both comfort and social interactions.
The good news is that several treatment options are available, ranging from conservative therapies like speech therapy to advanced interventions like Botox or surgical treatments.
If you or a loved one suffers from this condition, consult a healthcare provider to find the most suitable treatment and regain control over your saliva production.
