INDEX
- What is sialorrhea?
- Prognosis of the disease
- What are the symptoms?
- Medical tests for sialorrhea
- What are the causes?
- Can it be prevented?
- How is it treated?
- Specialist in charge of treatment
What is hypersalivation?
Sialorrhea, also known as hypersalivation, consists of an excess of saliva that is produced by a neurological disease or by abnormalities of the oral cavity.
It is a common pathology in pregnant women, especially during the first trimester of pregnancy.
Sialorrhea can be classified into two types: anterior sialorrhea and posterior sialorrhea.
- Anterior sialorrhea: it produces an incontinence of saliva and it ends up spilling out of the corners of the mouth or the lower lip, i.e. drooling. In this case, there is excess saliva production and there is an inability to retain saliva in the mouth, which may be due to some type of neuromuscular disease.
- Posterior sialorrhea: this is the flow of saliva from the tongue to the pharynx.
Prognosis of sialorrhea
As such, sialorrhea is not a disease that can evolve into a more serious disease. However, it is obvious that it will have an impact on the life of the person who suffers from it, since he/she will not be able to lead a normal life, especially in those cases in which drooling occurs because he/she is unable to contain the saliva in the mouth.
In turn, this hypersalivation can cause an unpleasant odor in the patient’s breath, i.e. halitosis; at the same time it presents an unpleasant appearance.
Symptoms of sialorrhea
The most common signs of sialorrhea or hypersalivation are as follows:
- Peeling of the lips
- Muscle fatigue
- Dermatitis
- Voice difficulties
- Change in the sense of taste
- Poor appearance
- Halitosis
The amount of saliva may cause the person to swallow saliva into the lungs, which may or may not be accompanied by food or liquid, and may cause coughing and nausea.
Medical tests for hypersalivation
The diagnosis of sialorrhea is simple, and a person may be suspected of having sialorrhea if there is continuous drooling in which the saliva in the mouth cannot be controlled.
To diagnose this hypersalivation problem, there are no tests.
What are the causes of hypersalivation?
The accumulation of saliva in the mouth can have two causes: an excessive production of saliva or difficulty in swallowing the saliva generated.
- Excessive production of saliva: there is a hyperproduction of saliva, and it is related to the use of some medications or drugs.
- Difficulty in swallowing the saliva generated: in this case, saliva production levels are normal. However, the accumulation of saliva will be due to a neurological disease, which makes the person unaware of this hypersalivation. Some of these disorders are: Amyotrophic Lateral Sclerosis (ALS), Parkinson’s, cerebral palsy, facial nerve palsy, Riley-Day Syndrome, sequelae of cerebral infarction or severe brain trauma.
Can it be prevented?
A person normally generates between one and two liters of saliva daily. However, this amount of saliva will vary depending on the time of day and the activity the person is doing. Thus, for example, acidic meals generate more saliva, while sleeping, for example, does just the opposite.
Treatments for hypersalivation
The first thing to do to solve this problem is to know exactly what is the origin of this excess of saliva. The treatments to be performed are the following:
- Oral training.
These are patients with deficiencies in neuromuscular reflexes and oral motor training, so speech therapy exercises, physiotherapy and other specialties are used that allow these patients to improve significantly.
- Pharmacological treatment
If the hypersalivation is caused by the use of a medication, a suspension of this treatment could solve it.
That is to say, in this case, it would be suppressed or replaced by an alternative treatment whose side effects are not an uncontrollable segregation of salivary flow.
In other cases, it may be necessary to prescribe atropine, antispasm or neuropsychotic drugs to control saliva.
- Surgical treatment
In addition to the prescription of medication, there is the possibility of surgical treatment, which consists in the removal of some salivary glands or ligation of the saliva-releasing ducts. Thus, their removal produces a reduction in the amount of saliva.
However, regarding surgical treatment, it should be said that it is only performed in patients who do not respond to pharmacological treatment or those whose excessive saliva prevents them from leading a normal life.
Another treatment that has been shown to be effective in treating hypersalivation is botulinum toxin injections to reduce hypersalivation. However, the effect of Botox lasts between four and six months, so injections are necessary every few months.
What specialist treats hypersalivation?
Hypersalivation can be associated with different causes. The first contact in the event that a person is believed to suffer from hypersalivation should be with an Internal Medicine or Family Physician, who will carry out the first investigations and a review to try to determine the origin of the hypersalivation.
Depending on the origin of the pathology, the specialist in charge of treating it can be several.