Sialorrhea or hypersalivation. Causes and treatment.

Sialorrhea or hypersalivation is a condition characterized by excessive saliva production. It may be a symptom of another condition or it may be an independent problem.

Causes

There are several possible causes for sialorrhea, including nervous system disorders, endocrine system disorders, infections, medications and even certain foods.

One of the most common causes of sialorrhea is a nervous system condition called Sjogren’s syndrome.

It affects the salivary and lacrimal glands, causing reduced production of tear and salivary fluid. Other causes of sialorrhea can include endocrine system conditions such as diabetes, thyroid gland problems, or nervous system conditions such as head trauma or Parkinson’s disease.

Infections, such as those of the throat or lungs, can also cause sialorrhea. Also, some medications, such as antidepressants, antihistamines and cholesterol control drugs, can have the side effect of increasing saliva production.

In some cases, sialorrhea may be caused by certain foods or drinks, such as those containing sugar or coffee. These can stimulate saliva production, causing sialorrhea.

Treatment

Treatment of sialorrhea varies depending on the underlying cause. If the cause is an underlying condition, such as Sjogren’s syndrome or diabetes, treatment will focus on treating this condition. If the cause is an infection, treatment will include antibiotics or other antiviral drugs.

If the cause is a drug, the doctor may recommend changing the drug or reducing the dose. If the sialorrhea is caused by food or drink, avoiding these may help reduce symptoms.

In severe cases of sialorrhea, the doctor may recommend oxide-ion therapy or surgery. Oxide-ion therapy involves injecting a substance that reduces saliva production in the salivary glands. This can be a temporary or long-term option, depending on the patient’s needs.

Surgery may be an option for patients with severe sialorrhea who do not respond to other treatments. It may involve removing the salivary glands or portions of the nerve responsible for controlling saliva production.

It is important to discuss the right treatment for sialorrhea with your doctor, as each case is unique and may require different approaches. Patients with sialorrhea may also find it helpful to avoid foods and drinks that stimulate saliva production, such as those containing sugar or coffee, and to drink plenty of water to keep the mouth light.

Saliva is the secretory product of the three major glands, parotid, sublingual and submandibular, as well as other minor, less active glands.

In the oral cavity, saliva helps all processes run smoothly and helps maintain the health and integrity of the mucous membranes.

Thus, during chewing, there is an increased production of saliva to form the food bowl which then travels down the pharynx, down the esophagus and finally into the stomach.

Saliva also helps to self-clean the oral cavity through its constant and continuous flow.

Sialorrhea or hypersalivation, on the other hand, is a change in the normal salivary flow, characterized by an excessive amount secreted in excess of what is needed.

Why does hypersalivation occur?

Excessive parasympathetic stimulation: if saliva-producing stimuli are intentional, the result is a hyperproduction of fluid.

• Pathologies of the gastro-esophageal tract: disorders of the digestive system can increase the amount of saliva produced. Thus, we have hypersalivation in case of esophageal foreign bodies, cancer, duodenal ulcer, hiatal hernia or tonsillitis.

• Tooth eruption: in children, during tooth eruption, intense processes take place and the teeth have to pierce the gingival mucosa. The inflammation of the mucous membrane thus produced leads to increased salivary flow.

• Full dentures: after fitting, until the body adjusts, it considers full dentures as foreign bodies and there is a natural reaction to remove them. The salivary flow increases initially but will regulate over time with the functional integration of the prosthetic work.

• Poisoning: when toxic substances are ingested, the body tries to neutralize their destructive effect. Thus, the secretion of saliva increases, in order to dilute the concentration of toxic found in the segments of the digestive system.

• Paralysis of some cranial nerves

• Endocrine pathologies: hyperthyroidism and hyperparathyroidism

• Some substances in medicines that have a salivary stimulatory effect, such as pilocarpine.

Hypersalivation is always disturbing for the patient.

Phonation, swallowing and aesthetics are affected. During phoneme pronunciation there is a risk of salivary fluid projection out of the oral cavity, which is particularly disturbing and embarrassing for the patient.

It can have severe psychological consequences.

Due to the excess saliva, aspiration pneumonia may occur, where saliva enters the airways. These effects are not at all negligible and seriously disrupt the patient’s quality of life.

Steps to follow in patients with hypersalivation

In order to treat hypersalivation, it is necessary to identify the cause, as in any pathology.

As a condition that occurs in the oral cavity, regardless of which organ is the cause, hypersalivation is identified by the dentist.

The patient should mention whether they are taking medication or if they can associate the condition with any event.

This is followed by an endo-oral check-up, where the dentist will look for mouth ulcers, infections or other pathologies that can trigger hypersalivation.

If the origin of the saliva is in the oral cavity¸ the doctor will treat the present conditions and the salivary flow will soon regulate.

If the origin is other than dental, the patient will be referred to a specialist in another field, in accordance with the information obtained by the doctor during the medical history.

In general, sialorrhea is a treatable condition, and patients can improve symptoms by properly addressing the underlying cause and avoiding factors that may aggravate symptoms. It is important to discuss any suspected symptoms of sialorrhea with your doctor to identify the cause and start appropriate treatment.