There are a variety of reasons why you may experience excessive salivation. This is also known as ptyalism/sialorrhea. Saliva is very important in keeping your body healthy. It helps aid digestion, prevent tooth decay and keep your mouth hydrated. Sometimes however, your body will start to produce excessive amounts of saliva which can cause pain, embarrassment and irritation around the mouth. Doctors will try to find the underlying cause of the problem to help sufferers. Understanding the cause can help patients return to a normal life. This article will give you more insight into why we produce excess saliva, common medical conditions and modern treatments available.

What Is Excessive Salivation?

We all produce between 1-2 liters of saliva each day. This is normally regulated by our nervous system so you won’t even realize you are swallowing extra. However sometimes the glands can produce too much saliva. The main types of excessive saliva are true hyper-salivation caused by overactive glands and anterior sialorrhea caused by saliva dripping out of the mouth due to difficulties swallowing. These can be caused by various physical, neurological or chemical issues.

What Are the Common Causes of Ptyalism?

There are lots of common causes for excessive salivation:

  • Spicy, acidic and sour foods can cause the taste buds to activate producing extra saliva.

  • Hormonal changes during pregnancy can cause mild ptyalism in the first trimester.

  • Nausea and gut problems cause the brain to produce extra mucus and saliva to protect the oesophagus.

  • Teething in babies can cause excessive saliva as new teeth come through sore and inflamed gums.

  • Poor oral hygiene or mouth ulcers can irritate the mucous membranes.

What Medical Conditions Cause Excessive Salivation?

Sometimes severe or chronic hyper-salivation can be a sign of an underlying medical condition. Often neurological conditions can cause issues with swallowing.

  • Parkinson’s disease can cause damage to nerves causing issues with swallowing and saliva pooling in the mouth.

  • Amyotrophic lateral sclerosis causes weakness of the throat and tongue making it impossible to swallow.

  • Cerebral palsy causes lack of muscle control in the face and mouth causing constant dribbling.

  • Rabies infections cause aggressive stimulation of the salivary glands.

  • Gastroesophageal reflux disease causes irritation to the oesophagus resulting in more saliva production.

Which Medications Can Cause Excessive Salivation?

Many medications can cause sialorrhea as a side effect. Often chemicals can cause changes to the nervous system and increase gland secretions.

  • Anti-psychotics, particularly clozapine can cause excessive salivation.

  • Cholinergic agonists imitate neurotransmitters causing an increase in gland secretions.

  • Some anti-epileptic medications can cause changes to the brain increasing moisture in the mouth.

  • Sedatives cause the throat muscles to relax slowing down the swallowing reflex.

What Dental Problems Cause Excessive Salivation?

Problems within the mouth can cause excessive saliva production. The brain can cause a sense of urgency.

  • Ill-fitting dentures or braces can cause irritation to the gums increasing saliva.

  • Tooth cavities and gum infections can cause irritation locally increasing saliva.

  • Tongue-tie can cause the tongue to have limited movement causing issues with regular swallowing.

  • Injuries or surgery to the mouth can cause temporary swelling.

Which Lifestyle Factors Cause Excessive Salivation?

Your lifestyle can cause your glands to produce excessive saliva. Your body can be affected by external factors.

  • Smoking can cause irritation in the mouth and throat increasing saliva production.

  • Chewing tobacco can cause constant secretion from the glands.

  • High stress and anxiety can cause changes to the autonomic nervous system increasing saliva.

  • Exposure to toxins or heavy metals can cause poisoning of the nervous system causing extreme ptyalism.

How Do Doctors Diagnose Excessive Salivation?

Doctors will carry out a full assessment to find out why you are experiencing excessive salivation. They will carry out a physical examination looking at your mouth, throat and teeth. They will ask about your medical history to find out if any medication is causing the issue or if there is an underlying neurological issue. They will perform neurological tests to see how well your muscles are working and if your swallowing reflex is affected. Occasionally imaging may be used to see if there are any obstructions or abnormal growths in the salivary glands. This will help ensure the correct treatment.

What Are the Effective Treatments for Excessive Salivation?

Depending on how severe the issue is, there are a variety of effective treatments.

  • Therapy and speech exercises can help strengthen the throat muscles.

  • Anti-cholinergic medications can help block nerve signals preventing the glands from secreting.

  • Botulinum injections can be used on the glands to reduce saliva temporarily.

  • Surgery can be performed to reposition or remove the glands if suffering from severe chronic cases.

  • Treating the underlying cause such as acid reflux or mouth infections can help completely cure secondary ptyalism.

When Should You See a Professional?

If you experience any of the following symptoms you should seek help.

  • If you are struggling to breathe or swallow seek emergency help.

  • If you are suddenly experiencing facial paralysis or weakness you should seek hospital treatment as this could be a serious neurological event.