Puneet Varma (Editor)

Hypersalivation

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DiseasesDB
  
20764

eMedicine
  
ent/629

MedlinePlus
  
003048

MeSH
  
D012798

Hypersalivation (also called ptyalism or sialorrhea) is excessive production of saliva. It has also been defined as increased amount of saliva in the mouth, which may also be caused by decreased clearance of saliva.

Contents

Hypersalivation can contribute to drooling if there is an inability to keep the mouth closed or in difficulty in swallowing the excess saliva (dysphagia).

Hypersalivation also often precedes emesis (vomiting), where it accompanies nausea (a feeling of needing to vomit).

Excessive production

Conditions that can cause saliva overproduction include:

  • Rabies
  • Pellagra (niacin or Vitamin B3 deficiency)
  • Gastroesophageal reflux disease, in such cases specifically called a water brash, and is characterized by a sour fluid or almost tasteless saliva in the mouth
  • Gastroparesis (main symptoms are nausea, vomiting, and reflux)
  • Pregnancy
  • Excessive starch intake
  • Pancreatitis
  • Liver disease
  • Serotonin syndrome
  • Mouth ulcers
  • Oral infections
  • Medications that can cause overproduction of saliva include:

  • aripiprazole
  • clozapine
  • pilocarpine
  • ketamine
  • potassium chlorate
  • risperidone
  • rabeprazole sodium (Aciphex)
  • Toxins that can cause hypersalivation include:

  • mercury
  • copper
  • organophosphates (insecticide)
  • arsenic
  • Decreased clearance

    Causes of decreased clearance of saliva include:

  • Infections such as tonsillitis, retropharyngeal and peritonsillar abscesses, epiglottitis and mumps.
  • Problems with the jaw, e.g., fracture or dislocation
  • Radiation therapy
  • Neurologic disorders such as myasthenia gravis, Parkinson's disease, multiple system atrophy, rabies, bulbar paralysis, bilateral facial nerve palsy, and hypoglossal nerve palsy.
  • Treatment

    Hypersalivation is optimally treated by treating or avoiding the underlying cause. Mouthwash and tooth brushing may have drying effects.

    In the palliative care setting; anticholinergics and similar drugs that would normally reduce the production of saliva causing a dry mouth could be considered for symptom management: scopolamine, atropine, propantheline, hyoscine, amitriptyline, glycopyrrolate.

    References

    Hypersalivation Wikipedia