Sialorrhea is excessive drooling or excessive salivation\/hyper-salivation that occurs as a result of neuromuscular dysfunction, motor dysfunction or sensory dysfunction. It is a condition that mostly affects neurologically impaired children (those with cerebral palsy or mental retardation) and adults who have Parkinson\u2019s disease or have had a stroke.<\/p>\n
There are two primary ways that sialorrhea manifests in patients, and they are:<\/p>\n
Most patients often have a mixture of both types of sialorrhea.<\/p>\n
The most common cause of sialorrhea is poor oral or facial muscle control. The lack of oral control results in the inability to swallow saliva normally or inattention to the need to swallow saliva.<\/p>\n
Other causes of excessive saliva production that can lead to hypersalivation include:<\/p>\n
Sialorrhea causes a range of psychosocial and physical complications such as dehydration, perioral chapping, odor, and social stigmatization. This can be devastating to both the patients and their families.<\/p>\n
A number of patients of Parkinson\u2019s disease tend to experience sialorrhea. It can cause such patients to have social embarrassment and aspiration pneumonia. However, sialorrhea in Parkinson\u2019s disease is thought to be caused by infrequent or impaired saliva swallowing, rather than hypersecretion.<\/p>\n
It is easy to identify the symptoms of anterior sialorrhea as the drooling is often quite visible. The excessive drooling is usually accompanied by chronic wet clothing. The drooling can sometimes be worse at night with bed wetting in the morning especially in children.<\/p>\n
The symptoms of posterior sialorrhea are more difficult to be seen but they include visible chocking and coughing, or the patient being prone to repeated episodes of aspiration pneumonia.<\/p>\n
Other symptoms of hypersalivation include:<\/p>\n
Diagnosing hypersalivation helps in pin-pointing the underlying cause of the condition.<\/p>\n
Anterior sialorrhea is easily diagnosed by those close to the patient such as family or care givers through observation of the excessive drooling.<\/p>\n
Posterior sialorrhea can be suggested by the history of repeated pneumonia and chocking.<\/p>\n
Additional tests that may be done include swallowing evaluations done jointly by radiologists and speech pathologists. An x-ray imaging may be done during the act of swallowing.<\/p>\n
The doctor will also examine the following:<\/p>\n
Existing medical conditions and ongoing medication as well as how and when the hypersalivation occurs will be considered during the diagnosing.<\/p>\n
Treatment for sialorrhea is best done by a clinical team comprising of primary healthcare providers, dentists, occupational therapists, speech pathologists, neurologists, orthodontists, and otolaryngologists.<\/p>\n
Treatment options include:<\/p>\n