Increased salivation or hypersalivation is also known as ptyalism or sialorrhea.
Often the cause is an open mouth, due to diseases of the central nervous system.
When lying down, saliva accumulates in the posterior region of the neck and triggers the natural swallowing reflex.
At rest or immediately after meals, this is more common.
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Who is affected by sialorrhea?
Sialorrhea often occurs:
- in healthy one- or two-year-old children and makes itself felt especially in the period of teething;
- in pregnant women – up to the fourth month of pregnancy;
- in the elderly, because:
- they are more likely to suffer from neurological disorders;
- they are taking medications that cause hypersalivation as a side effect;
- they use dentures that prevent the saliva from swallowing.
Forms of sialorrhea
Increased salivation can be divided as follows:
1. Primary sialorrhea – increased saliva production of the salivary glands (less common).
2. Secondary sialorrhea – a neuromuscular disorder means that the affected person cannot control his mouth and facial muscles or only to a limited extent, which leads to increased salivation.
3. Emotive Sialorrhea – Excitement and stress are the trigger for increased salivation, for example before an exam.
Infrequent or ineffective swallowing of saliva exacerbates the problem.
Causes of sialorrhea or hypersalivation
- Incorrect posture with insufficient head control and muscle weakness in the throat.
- An enlarged tongue or insufficient control over the tongue muscles can promote hypersalivation.
- Caries and mouth or throat infections can significantly increase salivation.
- A sudden onset of hypersalivation can mean poisoning (especially by pesticides), or a reaction to snake or insect venom.
- In some cases, the increased salivation is caused by an anesthetic designed to numb the mouth (for example, at the dentist).
An excess of capsaicin can provoke ptyalism if, for example, hot chili peppers are used in the kitchen. - Insufficient control over the mouth muscles.
- Impaired ability to swallow (dysphagia).
- Decreased swallowing frequency.
- Intellectual disability.
- Malocclusion or structural problems of the mouth.
- Blockage (obstruction) of the upper airways (polyps).
- Medications (for hypertension, painkillers, anticonvulsants, cholinesterase inhibitors.
Diseases that provoke hypersalivation
Nausea and vomiting
Nausea and vomiting often occur with increased saliva production.
After vomiting, the salivary glands increase saliva production.
Vomiting and nausea are common complaints during pregnancy.
Gastroesophageal reflux
Gastroesophageal reflux stimulates saliva production because stomach acid irritates the esophagus and throat.
The esophagus is a muscular tube lined with mucosa. It is about 24 cm long and reaches to the mouth of the stomach.
The esophagus is the narrowest part of the digestive tract.
Typically, reflux-induced salivation occurs after meals and may cause:
- cough,
- bitter taste in the mouth,
- heartburn,
- Pain at the level of the sternum.
Pregnancy vomiting
A severe form of pregnancy vomiting (hyperemesis gravidarum) can lead to increased saliva production.
It is not yet known whether the hormone fluctuations during pregnancy contribute to excessive saliva production.
Neurological disorders in which sialorrhea becomes a problem and can lead to unintentional discharge of saliva from the mouth:
– Parkinson’s disease (almost 80% of sufferers) – Atypical Parkinson’s syndromes – Amyotrophic lateral sclerosis (ALS)
– Cerebral palsy – Pseudobulbar paralysis
– Stroke
Genetic disorders
Down’s syndrome
Other diseases
- Inflammation of the epithelium (epiglottitis)
- Tumor or neoplasia
- Abscess in the mouth (causes pain, swelling and bad breath)
- Hyperthyroidism (hyperthyroidism) )
- Serotonin syndrome – disorder characterized by an accumulation of serotonin provoked by some drugs: antidepressants, lithium, etc.
- Rabies or tetanus
Causes of hypersalivation in children
It is quite normal for saliva to flow from the mouths of newborns and children every now and then.
Only rarely is this a sign of illness or complications.
The teeth may be responsible for sialorrhea.
If sialorrhea is associated with accompanying symptoms, it may be caused by a disease.
When infants or children “drool,” the cause may be:
- an infection in the throat or mouth (e.g. tonsillitis, pharyngitis, mumps, epitheliitis),
- an allergy.
If sialorrhea occurs together with fever or difficulty swallowing, this may indicate a serious condition, such as:
1. Retropharyngeal abscess
2. Peritonsillar abscess
3. Tonsillitis)
Increased salivation during pregnancy
In many women, saliva production is increased; some women experience excessive salivation during pregnancy, which makes the nausea and morning malaise even more unpleasant.
The medical term for an increased amount of saliva is ptyalism.
Ptyalism can occur alone, but is usually provoked by nausea and vomiting in the first months of pregnancy.
Hypersalivation usually intensifies:
- In the morning
- in the evening.
Home remedies that help with morning sickness could also solve the problem of increased salivation, such as taking smaller meals regularly.
One medication for morning sickness and hypersalivation is pyridoxine (Benadone®) or meclozine (Itinerol®), which helps many women.
Ptyalism usually decreases when nausea subsides (between the 12th and 14th week of pregnancy).
In homeopathy, there are remedies for hypersalivation, these include:
- Mercury (Mercurius solubilis)
- White Germer (Veratrum album)
In most pregnant women, the reason for excessive salivation is:
- hormonal imbalance: chorionic gonadotropin present in increased quantities in the first three months of pregnancy and stimulates the salivary glands.
- Nausea: causes difficulty swallowing saliva.
- Relaxation of the sphincter between the esophagus and stomach, the result is gastroesophageal reflux.
Often an overproduction of saliva is noticeable by the fourth month of pregnancy.
Nocturnal sialorrhea due to runny nose and nasal congestion
Each of us has had a cold before.
When going to sleep, the mouth must be kept open if nasal breathing is impaired.
When sitting, hypersalivation does not cause any problems, because the saliva is swallowed or evaporates.
When lying on its side, saliva accumulates in the lower mouth region due to gravity. When the mouth is open, the saliva can leak out and run onto the pillow.
Hypersalivation is a common problem in children with Down syndrome, intellectual disability or cerebral palsy.
Symptoms of sialorrhea
Effect on the patient:
• physical discomfort
• chapped lips • dehydration
• rejection
• isolation
• low self-esteem
Treatment of sialorrhea
Relief measures for excessive salivation:
1. Keep a large cup ready to hold the leaking saliva (the cup can be full within 5 minutes). Clean the cup daily; preferably empty into the sink of the bathroom and not into the kitchen sink. If the cup is not rinsed daily, an unpleasant smell can spread throughout the house.
2. Provide the body with sufficient fluids; Fruit juice can reduce saliva production; consequently, less saliva runs out of the mouth and the feeling of thirst decreases.
3. Line a terry towel at night so that the leaking saliva is absorbed.
4. Use lip care products. Due to the permanent salivation, the lips become chapped and cause pain. A lip balm also helps prevent lip irritation by constantly wiping away the saliva.
Medicines for ptyalism
Anticholinergics (such as scopolamine or glycopyrrolate) may help reduce hypersalivation.
The side effects are:
- disturbance of balance,
- blurred vision,
- mental confusion,
- Tachycardia.
Botulinum toxin injections Ultrasonically guided botulinum toxin infiltrations
at the level of the salivary glands temporarily block saliva production.
The injections are made into:
- parotid glands – produce 25% of saliva, but with stimulation they reach about 50%;
- mandibular salivary glands – produce 70% of saliva;
- Sublingual salivary glands – produce the mucous portion of saliva.
Infiltration occurs on both sides.
The effect lasts about 5 months.
The side effects are:
- inflammation and pain at the injection site,
- dry mouth,
- damage to the facial nerve,
- Infection
- Difficulty chewing.
Homeopathic remedies for hypersalivation
Homeopathy is a holistic medicine that considers and treats the sick person in comprehensive contexts and takes into account both his physical and mental state.
The choice of homeopathic remedy is based on the principle of similarity (similar is cured by similar) and a holistic healing method.
After homeopathy, this is the only way to improve the general state of health, eliminating all signs and symptoms that the patient suffers from.
The aim of homeopathy is not only to cure ptyalism, but also to tackle the underlying cause and take into account personal susceptibility to disease.
As for therapeutic medicines, there are various remedies for sialorrhea, which are used depending on the cause of the complaints.
In order to find the right remedy, a qualified homeopath must be consulted.
The following homeopathic remedies are used to treat hypersalivation:
1. Alumina
2. Ammonium Carbonicum 3. Belladonna
4. Calcarea Carbonica
5. Cantharis
6. Graphites
7. Causticum
8. Chamomilla
9. Ignatia
10. Helonias
Natural remedies for hypersalivation
A doctor must be consulted if, in addition to increased salivation, other symptoms occur, such as morning sickness or heartburn.
Even if there is little you can do against hypersalivation, the symptoms can be kept under control with various home remedies.
These include:
- Clean teeth with a natural mouthwash several times a day.
- Often take smaller, healthy snacks so that large amounts of flour are not consumed in one meal.
- Drink enough water daily to hydrate the body and avoid the feeling of nausea; have a bottle of water ready and drink sips of it frequently throughout the day.
- Hold sugar-free lozenges in your mouth or chew sugar-free gum; even if this does not reduce saliva production, the swallowing of saliva is supported.
- Do not chew acidic or sugary candies because they additionally stimulate saliva production.
- Bite into a slice of lemon or put lemon essential oil on a cloth to inhale.
- Use mouthwash solution, which is also suitable for pregnant women.
- Chew mints or other peppermint-flavored products.
- Brush teeth with peppermint toothpaste.
- Suck ice cubes.
How long does hypersalivation last? Prognosis
Increased salivation persists until the cause is eliminated; For example:
- in pregnancy over the first 3 months,
- in case of infections, a few days to weeks.
