Drooling
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| Ptyalism Classification and external resources | |
| ICD-10 | K11.7 |
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| ICD-9 | 527.7 |
| DiseasesDB | 20764 |
| MedlinePlus | 003048 |
| eMedicine | ent/629 |
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Drooling (also known as ptyalism or sialorrhea) is when saliva flows outside the mouth. Drooling is generally caused by excess production of saliva, inability to retain saliva within the mouth, or problems with swallowing.
Some people with drooling problems are at increased risk of inhaling saliva, food, or fluids into the lungs. However, this is unlikely to cause harm, unless the body's normal reflex mechanisms (such as gagging and coughing) are also impaired.
Common causes
Isolated drooling in infants and toddlers is normal and is unlikely to be a sign of either disease or complications. It may be associated with teething. Drooling in infants and young children may be exacerbated by upper respiratory infections and nasal allergies.
Drooling associated with fever or trouble swallowing may be a sign of a more serious disease including:
- Retropharyngeal abscess
- Peritonsillar abscess
- Tonsilitis
- Mononucleosis
- Strep throat
- Parkinson's disease
A sudden onset of drooling may indicate poisoning (especially by pesticides) or reaction to snake or insect venom or in some cases of a numbed mouth from either orajel, or when going to the dentist office. Some medications can cause drooling as well such as the pain reliveing orajel medication. Some neurological problems also cause drooling. Excess Capsaicin can cause drooling as well, an example being the ingestion of particularly high Scoville Unit chili peppers.
Another form of ptyalism is associated with pregnancy, most common in women with a condition known as Hyperemesis Gravidarium, or uncontrollable and frequent nausea and vomiting during pregnancy which is far worse than typical "morning sickness". With Hyperemesis, ptyalism is a side-effect, which is a natural response to uncontrollable vomiting. With normal vomiting, salivary glands are stimulated to lubricate the esophagus and mouth to aid in expelling of stomach contents. During a hyperemetic pregnancy, many woman complain of excessive saliva and an inability to swallow this saliva. Some women note having to carry around a "spitoon" or using a cup to spit. Swallowing their own saliva has been noted to gag and further nauseate the women making the hyperemesis that much worse.
There are several theories as to the causes of hyperemesis and related symptoms such as ptyalism. Many physicians are reluctant to treat hyperemesis since they don't see it as a true physiological illness but rather "in the patient's mind" [note: this is an old fashioned view and the medical community now considers hyperemesis as a real and serious physiological condition]. Many pregnant women who suffer end up terminating the pregnancy. Others refuse to carry another child. The most frequent act is preparing for the onset of hyperemesis if a subsequent pregnancy is expected.
Home care
Care for drooling due to teething includes good oral hygiene. Ice pops or other cold objects (e.g., frozen bagels) may be helpful. Care must be taken to avoid choking when a child uses any of these objects.
Drooling also is common in children with neurological disorders and those with undiagnosed developmental delay.
The reason for excessive drooling seems to be related to;
- lack of awareness of the build-up of saliva in the mouth,
- infrequent swallowing,
- inefficient swallowing.
Treatment of excessive drooling is related to these causes;
- increased awareness of the mouth and its functions,
- increased frequency of swallowing,
- increased swallowing skill.
Sialorrhea
Sialorrhea is a condition characterized by the secretion of drool in the resting state. It is often the result of open-mouth posture from CNS depressants or sleeping on one's side. In the resting state, saliva may not build at the back of the throat, triggering the normal swallow reflex, thus allowing for the condition.
Treatment
A comprehensive treatment plan incorporates several stages of care: correction of reversible causes, behavior modification, medical treatment, and surgical procedures. Atropine sulfate tablets are indicated to reduce salivation and may be prescribed by doctors in conjunction with behaviour modification strategies. In general, surgical procedures are considered after evaluation of non-invasive treatment options.
External links
WikiDoc Research Resources for Drooling | |
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| Articles on Drooling | Most recent articles on Drooling • Most cited articles on Drooling • Review articles on Drooling • Articles on Drooling in N Eng J Med, Lancet, BMJ |
| Media (Slides, Video, Images, MP3) on Drooling | Powerpoint slides on Drooling • Images of Drooling • Photos of Drooling • Podcasts & MP3s on Drooling • Videos on Drooling |
| Evidence Based Medicine Regarding Drooling | Cochrane Collaboration on Drooling • Bandolier on Drooling • TRIP on Drooling |
| Cost Effectiveness of Drooling | Cost Effectiveness of Drooling |
| Clinical Trials Involving Drooling | Ongoing Trials on Drooling at Clinical Trials.gov • Trial results on Drooling • Clinical Trials on Drooling at Google |
| Guidelines / Policies / Government Resources (FDA/CDC) Regarding Drooling | US National Guidelines Clearinghouse on Drooling • NICE Guidance on Drooling • NHS PRODIGY Guidance • FDA on Drooling • CDC on Drooling |
| Textbook Information on Drooling | Books and Textbook Information on Drooling |
| Pharmacology Resources on Drooling | Dosing of Drooling • Drug interactions with Drooling • Side effects of Drooling • Allergic reactions to Drooling • Overdose information on Drooling • Carcinogenicity information on Drooling • Drooling in pregnancy • Pharmacokinetics of Drooling • |
| Genetics, Pharmacogenomics, and Proteinomics of Drooling | Genetics of Drooling • Pharmacogenomics of Drooling • Proteomics of Drooling |
| Newstories on Drooling | Drooling in the news • Be alerted to news on Drooling • News trends on Drooling |
| Commentary on Drooling | Blogs on Drooling |
| Patient Resources on Drooling | Patient resources on Drooling • Discussion groups on Drooling • Patient Handouts on Drooling • Directions to Hospitals Treating Drooling • Risk calculators and risk factors for Drooling |
| Healthcare Provider Resources on Drooling | Symptoms of Drooling • Causes & Risk Factors for Drooling • Diagnostic studies for Drooling • Treatment of Drooling |
| Continuing Medical Education (CME) Programs on Drooling | CME Programs on Drooling |
| International Resources on Drooling | Drooling en Espanol • Drooling en Francais |
| Business Resources on Drooling | Drooling in the Marketplace • Patents on Drooling |
| Informatics Resources on Drooling | List of terms related to Drooling |
de:Hypersalivationnl:Speekselvloed
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
