Increased salivation or hypersalivation

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, the saliva accumulates in the rear region of the neck and triggers the natural swallowing reflex.
This is more common at rest or immediately after meals.

Who is affected by sialorrhea?

Sialorrhea often occurs:

• at healthy one or two year old children and is particularly noticeable in the period of teething;
• at pregnant women – up to the fourth month of pregnancy;
• at older people, because:

• they are more likely to suffer from neurological disorders;
• you are taking medications that have hypersalivation as a side effect;
• they use a denture that prevents swallowing of the saliva.

Forms of sialorrhea

Increased salivation can be broken down 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 or her mouth and face 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.
The problem is exacerbated by swallowing saliva infrequently or ineffectively.

Causes of sialorrhea or hypersalivation

• Wrong posture with insufficient head control and muscle weakness in the throat.
• A enlarged tongue or insufficient control over the tongue muscles can promote hypersalivation.
• Cariesand mouth or throat infections can significantly increase salivation.
• Sudden hypersalivation can be poisoning (especially pesticides), or a reaction to snake or insect venom.
• In some cases, the increased salivation is caused by a anestheticcaused to numb the mouth (for example at the dentist).
  An excess of capsaicin can cause ptyalism if, for example, hot chili peppers are used in the kitchen.
• Inadequate control over the mouth muscles.
• Impaired swallowing ability (dysphagia).
• Decreased swallowing frequency.
• Mental disability.
• Misaligned teeth or structural problems in the mouth.
• Constipation (obstruction) of the upper respiratory tract (polyps).
• Medicines (for high blood pressure, pain relievers, anticonvulsants, cholinesterase inhibitors.

Diseases that cause 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 in pregnancy.

Gastroesophageal reflux
Gastroesophageal reflux stimulates saliva production because gastric acid irritates the esophagus and throat.
The esophagus is a muscular tube that is lined with mucous membrane. It is about 24 cm long and extends to the stomach mouth.
The esophagus is the narrowest part of the digestive tract.
As a rule, the salivation caused by reflux occurs after meals and may cause:

morning sickness
A strong form of pregnancy sickness (Hyperemesis gravidarum) can lead to increased saliva production.
It is not yet known whether the hormonal fluctuations during pregnancy contribute to excessive saliva production.

Neurological disorders, where sialorrhea becomes a problem and can lead to accidental discharge of saliva from the mouth:

– Parkinson’s disease (almost 80% of sufferers)
– Atypical Parkinson’s syndrome
– amyotrophic lateral sclerosis (ALS)
– brain paralysis
– pseudobulbar paralye
– stroke

gene disorders
Down syndrom

Other diseases

• Inflammation of the epiglottis (epiglottitis)
• Tumor or neoplasia
• Abscess in the mouth (causes pain, swelling and bad breath)
• Hyperthyroidism
• Serotonin syndrome – disorder characterized by an accumulation of serotonin caused by some medications: antidepressants, lithium, etc.
• Rabies or tetanus

Causes of hypersalivation in children

It is normal for saliva to flow from the mouth of newborns and children every now and then.
Only rarely is this a sign of an illness or complications.
The teeth can be responsible for sialorrhea.
If sialorrhea is associated with accompanying symptoms, it can be caused by an illness.
If babies or children are "drooling", the cause may be:

• an infection in the throat or mouth (e.g. tonsillitis, sore throat, mumps, epiglottis),
• an allergy.

If sialorrhea occurs with fever or difficulty swallowing, this may indicate a serious medical condition, such as:
1. Retropharyngeal abscess
2. Peritonsillar abscess
3. tonsillitis (tonsillitis)

Increased salivation during pregnancy

Saliva production is increased in many women; some women experience excessive salivation during pregnancy, which makes nausea and morning sickness even more uncomfortable.
The medical term for an increased amount of saliva is ptyalism.
Ptyalism can occur on its own, but is usually caused by nausea and vomiting in the first months of pregnancy.
Hypersalivation usually increases:

Home remedies that help with morning sickness could also solve the problem of increased salivation, such as eating smaller meals regularly.
A medication for morning sickness and hypersalivation is pyridoxine (Benadon®) or meclozin (Itinerol®), which helps many women.

Ptyalism usually decreases as the nausea subsides (between the 12th and 14th week of pregnancy).
There are remedies for hypersalivation in homeopathy, including:

• Mercury (Mercurius solubilis)
• White Germer (Veratrum album)

For most pregnant women, the reason for excessive salivation is:

• the hormonal imbalance: chorionic gonadotropin present in increased amounts in the first three months of pregnancy and stimulates the salivary glands.
• nausea: Difficulty swallowing saliva.
• The result is relaxation of the sphincter between the esophagus and stomach gastroesophageal reflux.

An overproduction of saliva up to the fourth month of pregnancy is often noticeable.

Nocturnal sialorrhea due to runny nose and stuffy nose

Each of us has had a cold before.
When you go to sleep, you have to keep your mouth open if you have difficulty breathing.
Hypersalivation does not cause any problems when sitting, because the saliva is swallowed or evaporated.
When lying on your side, saliva collects in the lower mouth region due to gravity.
If 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

Impact on the patient:
• physical discomfort
• chapped lips
• dehydration
• rejection
• insulation
• low self-esteem

Treatment of sialorrhea

Remedial measures for excessive salivation:
1. Have a large cup ready to hold the escaping saliva (the cup can be full within 5 minutes). Clean the cup daily; preferably in the bathroom sink and not in the kitchen sink. If the cup is not washed daily, an unpleasant smell can spread throughout the house.
2. Provide the body with sufficient fluid; Fruit juice can reduce saliva production; consequently, less saliva runs out of the mouth and the feeling of thirst subsides.
3. Lay out a terry towel at night so that the leaking saliva is sucked up.
4. Use lip care products. Due to the permanent flow of saliva, the lips become chapped and cause pain. A lip care stick also helps prevent lip irritation by constantly wiping away the saliva.

Medicines for ptyalism

Anticholinergics (e.g. scopolamine or glycopyrrolate) can help reduce hypersalivation.
The side effects are:

Botulinum toxin injections
Ultrasound-controlled botulinum toxin infiltration at the level of the salivary glands temporarily block saliva production.
The injections are made in:

• Parotid glands – produce 25% of the saliva, but when stimulated they reach about 50%;
• Submandibular glands – produce 70% of the saliva;
• Sublingual salivary glands – produce the mucous portion of the saliva.

The infiltration takes place on both sides.
The effect lasts for about 5 months.
The side effects are:

• Inflammation and pain at the injection site,
• dry mouth,
• Facial nerve damage,
• infection,
• Difficulty chewing.

Homeopathic remedies for hypersalivation

Homeopathy is a holistic medicine that looks at and treats the sick person in a comprehensive context and takes into account both his physical and mental state.
The choice of homeopathic remedy is based on the principle of similarity (similar is healed by similar) and a holistic healing method.
After homeopathy, this is the only way to improve overall health, eliminating all the signs and symptoms the patient is suffering from.
The goal of homeopathy is not only to cure ptyalism, it is also addressing the underlying cause and taking into account the susceptibility to illness.
As for therapeutic medicines, there are various cures for sialorrhea that are used depending on the cause of the discomfort.
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 should be consulted if there are other symptoms besides increased salivation, such as morning sickness or heartburn.
Even if there is little you can do about hypersalivation, the complaints can be kept under control with various home remedies.
This includes:

• Clean the 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 keep the body hydrated and to avoid the feeling of nausea; keep a bottle of water ready and drink sips of it throughout the day.
• Hold sugar-free lozenges in your mouth or chew sugar-free gum; even if this does not reduce saliva production, it helps to swallow the saliva.
• Do not chew acidic or sugary sweets because they stimulate saliva production.
• Bite into a lemon wedge or put lemon essential oil on a cloth to inhale.
• Use mouthwash that is also suitable for pregnant women.
• Chew mint candy or other peppermint flavored products.
• Brush your teeth with peppermint toothpaste.
• Suck ice cubes.

How long does hypersalivation last? forecast

Increased salivation continues until the cause has been eliminated; for example:

• in pregnancy for the first 3 months,
• in the case of infections, a few days to weeks.

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