Causes of Excess Saliva in the Mouth and Their Treatments

Causes of Increased Saliva Production in the Mouth

Variations in the saliva levels within the mouth, in response to food and drink intake, are considered a natural occurrence. Hence, an increase in saliva, medically termed hypersalivation, should not typically raise concerns. Salivary glands may elevate their secretion in certain cases, sometimes leading to inadvertent drooling due to saliva accumulation. Hypersalivation can either be temporary or chronic, depending on the underlying cause. In older children and adults, its occurrence might signify underlying health issues. The causes for increased saliva production can be related to health problems that stimulate saliva production or conditions that hinder its expulsion, resulting in accumulation within the mouth. Additionally, there may be instances where individuals are unable to close their mouths properly. Below, we explore these causes in greater detail:

Natural Causes

Certain acidic, spicy, or hot foods tend to stimulate higher saliva production compared to sweet foods. This is attributed to the role of taste buds located on the tongue, which significantly influence the volume of saliva produced. Consequently, modifying one’s diet could alleviate excessive saliva production if it becomes bothersome.

Excessive Saliva Production

Various health conditions can lead to the overproduction of saliva, resulting in an increase in oral saliva levels. Key contributors include:

  • Jaw fractures or dislocations.
  • Chronic infections such as rabies or tuberculosis.
  • Throat infections, sinusitis, or peritonsillar infections.
  • Morning sickness or nausea during pregnancy.
  • Oral ulcers due to dentures.
  • Poor oral hygiene or infections causing pain in the mouth.
  • Exposure to certain poisonous fungi, spider bites, or reptile venom.
  • Saliva reflux while experiencing heartburn.
  • Medication side effects that increase saliva production, particularly those used for:
    • Xerostomia treatment in radiation therapy patients, such as pilocarpine.
    • Psychoactive disorders like clozapine, occasionally used for schizophrenia.
    • Alzheimer’s disease.
    • Myasthenia gravis.
    • Seizures, for instance, clonazepam.

Difficulties in Saliva Expulsion

Some individuals might struggle with saliva expulsion due to symptoms linked to specific medical conditions. These include:

  • Stroke.
  • Parkinson’s disease.
  • Down syndrome.
  • Autism.
  • Sensory integration issues, where one may not realize saliva is dripping from their mouth.
  • Amyotrophic lateral sclerosis (ALS).

Inability to Keep the Mouth Closed

Factors leading to the inability to maintain a closed mouth, which may result in saliva drooling, encompass:

  • Nasal obstruction.
  • Constantly open mouth.
  • Weakened tongue mobility or tongue enlargement.
  • Dental misalignment.
  • Decreased tactile sensitivity.
  • Neuromuscular weakness around the mouth, a condition often seen in cerebral palsy.
  • Poor control over the head and lips.

Treatment of Hypersalivation

Numerous treatment options are available for hypersalivation, and the choice of method is tailored to the individual’s specific causes and contributing factors. Consequently, treatment plans are customized for each patient. Generally, the management approach may include one or more of the following categories:

  • Home Remedies: Rinsing the mouth with an appropriate mouthwash and regular brushing can temporarily alleviate mouth wetness. Additionally, adequate water intake might help in reducing saliva production.
  • Behavioral Modifications and Speech Therapy: These therapies aim to enhance head control and posture, teaching those with hypersalivation effective techniques for keeping the lips closed and improving swallowing and tongue control.
  • Medications: Certain medications can assist in decreasing saliva production, including:
    • Glycopyrrolate: This medication inhibits nerve signals directed at the salivary glands, effectively reducing saliva volume and is commonly utilized.
    • Scopolamine: This medication operates similarly by blocking nerve signals to the salivary glands and is available as a transdermal patch applied behind the ear.
  • Injections: In persistent cases of hypersalivation, treatment may involve injecting the major salivary glands with botulinum toxin, which paralyzes the nerves and muscles in the injection area.
  • Surgical Interventions: In severe instances of hypersalivation, a physician might recommend surgical procedures on the major salivary glands, either through complete removal or relocation to allow saliva to release at the back of the mouth, facilitating swallowing.
  • Radiation Therapy: In cases where surgery is not a viable option, the major salivary glands may be treated with radiation, which induces oral dryness.

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