Characteristics And Treatment Of Involuntary Drooling

Sialoré – or ptyalism – is what we refer to in ordinary language as “drooling”. Of course, this condition is very normal among children who are between 15 and 36 months old. However, it is considered abnormal if it occurs after the age of four. Today we take a closer look at the characteristics and treatment of involuntary drooling.

Although involuntary drooling appears to be a condition that only affects the appearance, it can also have to do with serious health conditions. These include, for example, cerebral palsy or Parkinson’s disease. It can also be due to pregnancy or from taking certain medications.

What is involuntary drooling and what causes it?

Sialoré is a condition characterized by the inability to keep saliva inside the mouth and direct it towards the digestive tract. There is excessive production of saliva or an anomaly in the processing.

The most common causes of sialoré are neurological diseases. Among them we find, as we mentioned, cerebral palsy and Parkinson’s disease. However, it also occurs in those suffering from amyotrophic lateral sclerosis (ALS), familial dysautonomia or the effect of cerebral infarction.

In addition , this condition is common in those taking antipsychotic, hypnotic or sedative medications. Similarly, it is common for a sudden increase in saliva production to occur during pregnancy between the second and fourth week of pregnancy.

The characteristics of this disorder

The salivary glands are responsible for producing saliva. We have three major ones: the parotid gland, the lower jaw gland and the lower tongue gland. The first produces watery saliva, while the other two generate a thicker liquid continuously. This is the type of saliva that most often causes suffocation.

Every day, they produce about 50 grams of saliva, of which 70% comes from the lower jaw and lower tongue. As such , involuntary drooling is not a disease that develops into another more serious condition. However, it seriously affects a person’s quality of life.

There is no specific doctor who specializes in the treatment of sialoré. If you suspect this disorder, you should consult your GP. He or she will refer you to a specialist, depending on the cause of the problem.

Classification of sialoré

As for the origin, there are two types of sialoré:

• Anterior sialoré: Stems from a neuromuscular deficiency combined with excessive salivation. This causes the fluid to spill from the corners of the mouth or lower lip.
• Posterior sialoré: When the problem originates in the salivary flow from the tongue to the pharynx.

According to the Thomas-Stonell and Greenberg classification scales, it is also possible to classify sialorea according to severity or frequency. From this point of view, the grading is as follows:

• Dry mouth
• Mild (wet lips)
• Moderate (wet lips and chin)
• Serious (wet clothes)
• Plenty (clothes, hands and utensils are wet)

Depending on the frequency, the scale is as follows:

• Never drool
• Droolies occasionally
• Frequent shilling
• Constant drooling

Consequences of involuntary drooling

Involuntary drooling is a relevant medical problem. It causes not only a noticeable inhibition, but also additional difficulties in dealing with patients with neurological problems. In general, this condition has consequences. For example, this may include flaky lips, muscle fatigue, dermatitis, changes in the sense of taste and voice difficulties.

From a physical point of view, however, the greatest risk is aspiration pneumonia due to difficulty in swallowing food. These patients are also more prone to oral infections.

At the same time, the psychosocial consequences can be very serious. Cycling generates social rejection, even from caregivers. This also limits the normal performance of daily activities.

Treatment of involuntary drooling

There are three ways to treat involuntary drooling: speech therapy, pharmacology and surgery. The approach through speech therapy involves performing a series of exercises to inhibit the pathological reflexes. To be more specific, the goal is to improve the closing of the lips and the sucking or swallowing of saliva. Continuous exercise can lead to improvement.

When it comes to pharmacological treatment, it involves anticholinergics, which help reduce the secretion of saliva. However, these medications must go hand in hand with exercises. Unfortunately, some people experience intolerance to this type of medication.

It is also possible to treat involuntary drooling by injecting botulinum toxin type A (TBA). This is applied directly to the salivary glands and also reduces saliva production. The most positive thing is that it generates very few side effects.

Finally, if none of these measures work, the specialist will probably decide to perform a surgical procedure. In each case, each patient is different, and sometimes a combination of measures is needed to achieve efficacy.