A drooling Malamute
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Drooling (also known as 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).
Frequent and harmless cases are a numbed mouth from either Orajel, or when going to the dentist office.
Isolated drooling in healthy 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.
Some people with drooling problems are at increased risk of inhaling saliva, food, or fluids into the lungs, mainly 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.
Drooling or sialorrhea can happen in sleep. It is often the result of open-mouth posture from CNS depressants intake or sleeping on one's side. In sleep, saliva may not build at the back of the throat, triggering the normal swallow reflex, thus allowing for the condition.
Other causes include:
- Stroke and other neurological pathologies
- Intellectual disability
- Cerebral palsy
- Amyotrophic lateral sclerosis
- Tumors of the upper aerodigestive tract
- Parkinson's disease
- Mercury poisoning
Drooling associated with fever or trouble swallowing may be a sign of an infectious disease including:
- Retropharyngeal abscess
- Peritonsillar abscess
- 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.
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 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,
- Impossibility of swallowing by obstructive diseases (tumors, stenosis),
- Impossibility of swallowing by neurodegenerative diseases (amyotrophic lateral scleroris).
Treatment of excessive drooling is related to these causes:
- Increased awareness of the mouth and its functions,
- Increased frequency of swallowing,
- Increased swallowing skill,
- Diminishing of saliva production by the local use of botulinum toxin A,
- Surgical interventions (salivary duct relocalization, resection of salivary glands) in severe cases.
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.
Freuds 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.
- "The Relationship Between Oral Sensation and Drooling in Persons With Cerebral Palsy". Retrieved 2013-10-02.
- "Prevalence and definition of drooling in Parkinson’s disease: a systematic review". Retrieved 2013-10-02.
- "Reduction of salivary flow with botulinum toxin: extended report on 33 patients with drooling, salivary fistulas, and sialadenitis". Retrieved 2013-10-26.
- "A randomized trial of botulinum toxin A for treatment of drooling". Retrieved 2013-10-02.
- "Treatment of Sialorrhea With GlycopyrrolateA Double-blind, Dose-Ranging Study". Retrieved 2013-10-02.
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