Drooling

Drooling
A drooling Malamute
Classification and external resources
ICD-10	K11.7
ICD-9-CM	527.7
DiseasesDB	20764
MedlinePlus	003048
MeSH	D012798

Drooling (also known as salivation, driveling, dribbling, slobbering, or, in a medical context, sialorrhea) is the flow of saliva outside the mouth. Drooling can be caused by excess production of saliva, inability to retain saliva within the mouth (incontinence of saliva), or problems with swallowing (dysphagia or odynophagia).

There are some frequent and harmless cases of drooling. For instance, a numbed mouth from either Orajel, or when going to the dentist office.

Isolated drooling in healthy infants and toddlers is normal and may be associated with teething. It is unlikely to be a sign of disease or complications. Drooling in infants and young children may be exacerbated by upper respiratory infections and nasal allergies.

Some people with drooling problems are at increased risk of inhaling saliva, food, or fluids into the lungs, especially if drooling is secondary to a neurological problem. However, if the body's normal reflex mechanisms (such as gagging and coughing) are not impaired, this is not life-threatening.

Causes

Drooling or sialorrhea can occur during sleep. It is often the result of open-mouth posture from CNS depressants intake or sleeping on one's side. Sometimes while sleeping, saliva does not build up at the back of the throat and does not trigger the normal swallow reflex, leading to the condition.

Other causes include:

• Stroke and other neurological pathologies
• Intellectual disability
• Adenoid
• Cerebral palsy^[1]
• Amyotrophic lateral sclerosis
• Tumors of the upper aerodigestive tract
• Parkinson's disease^[2]
• Rabies
• Mercury poisoning

Drooling associated with fever or trouble swallowing may be a sign of an infectious disease including:

• Retropharyngeal abscess
• Peritonsillar abscess
• Tonsilitis
• Mononucleosis
• Strep throat
• Exercise, especially cardiovascular activities, can cause a severe amount of saliva build up in the mouth, making it difficult to breathe.

A sudden onset of drooling may indicate poisoning (especially by pesticides or mercury) or reaction to snake or insect venom. Some medications can cause drooling as well such as the pain relief medication Orajel, by mucosa numbness. 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.

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 is also common in children with neurological disorders or undiagnosed developmental delay. The reason for excessive drooling seems to be related to:

1. Lack of awareness of the build-up of saliva in the mouth,
2. Infrequent swallowing,
3. Inefficient swallowing,
4. Impossibility of swallowing by obstructive diseases (tumors, stenosis),
5. Impossibility of swallowing by neurodegenerative diseases (amyotrophic lateral sclerosis).

Treatment of excessive drooling is related to these causes:

1. Increased awareness of the mouth and its functions,
2. Increased frequency of swallowing,
3. Increased swallowing skill,
4. Diminishing of saliva production by the local use of botulinum toxin A,
5. Surgical interventions (salivary duct relocalization, resection of salivary glands) in severe cases.

Treatment

A comprehensive treatment plan depends from the etiology and incorporates several stages of care: correction of reversible causes, behavior modification, medical treatment, and surgical procedures.

Atropine sulfate tablets are used in some circumstances to reduce salivation. The same for anticholinergic drugs which can be also a benefit because they decrease the activity of the Acetylcholine Muscarinic Receptors and can result in decreased salivation. They may be prescribed by doctors in conjunction with behavior modification strategies. In general, surgical procedures are considered after proper diagnosis of the cause and evaluation of non-invasive treatment options.

Some drugs had been used as glycopyrrolate and botulinum toxin A (Botox injection in salivary glands).^[3][4][5]

History

Freud's theory was that drooling occurs when in a deep sleep and within the first few hours of falling asleep. This is why those who are affected by the unfortunate disease suffer severe cases while napping rather than a nights sleep.

See also

• Slobbers
• Salivary microbiome

References

External links

Look up drool in Wiktionary, the free dictionary.

• NIH site on drooling