Definition of sialorrhea
Sialorrhea And ptialism they are synonyms, taken from the medical language, which denote an abnormal and excessive accumulation of saliva in the mouth cavity, sometimes associated with a "salivary hypersecretion. The term" sialorrhea "derives from the Greek root" σάλιο "(saliva) and indicates" flowing ”of the saliva that accumulates in the mouth and often drips from the lips.
Characteristics of saliva
Incidence of drooling
Sialorrhea can manifest itself as a primary or secondary condition; moreover, abundant and excessive salivation could represent an occasional phenomenon, then resolve itself during the day, or depend on secondary factors that we will analyze in the course of the article.
We talk about emotional drooling when the abnormal salivary production is caused by psychogenic factors: actually, it is not unusual to notice an overabundant production of saliva in anxious subjects. To give an example, in particularly agitated patients who undergo dental interventions, there is an excessive production of saliva , so much so as to force the dentist to continuously aspirate the saliva from the patient's mouth with the cannulae.
In any case, sialorrhea is a recurring phenomenon also (and above all) during pregnancy and senescence, periods of life in which many cases of sialorrhea are recorded.
Sialorrhea and pregnancy
During pregnancy, pregnant women often complain of "uncontrolled, abundant and annoying salivation" which generally lasts until the third-fourth month of gestation. Hyperemesis gravidarum indicates a condition related to pregnancy in which the future mother suffers from nausea and vomiting, disorders that create considerable discomfort: it is understandable how the two phenomena (sialorrhea and hyperemesis gravidarum) are closely linked.
Sialorrhea in pregnancy seems to be caused not so much by an increase in salivary secretion as by considerable difficulty in swallowing. Sialorrhea during pregnant is considered a real emotional ptyalism, since many women are particularly sensitive to stress induced by pregnancy. : in the latter case, sialorrhea could continue even after the fourth month of gestation, even lasting for all nine months of pregnancy. By reflex, the woman tends to continuously swallow the saliva produced in excess: in doing so, however, she also introduces air, which in turn could be a possible trigger for aerophagia and disorders affecting the digestive system. in general.
Sialorrhea and senescence
Sialorrhea is a very common condition among the elderly, substantially caused by dental prostheses, which could generate a certain difficulty in swallowing: in this regard, saliva tends to come out of the mouth and deposit on the sides of the lips. Again, in similar circumstances, salivation it seems increased, but in reality the amount of saliva remains unchanged: the cause that causes the accumulation of saliva is related to the mere difficulty in swallowing.
As "it is known, with advancing age, men and women are more prone to pathologies, due to a general weakening of the organism: the statistics have recorded a correlation between Parkinson's disease, extrapyramidal syndromes and myasthenia gravis, typical of old age. Many elderly people, therefore, are assiduous consumers of some drugs, which, as we will see in the next paragraph, contribute to the formation of sialorrhea.
Sialorrhea and drugs
The excessive use of drugs could also cause consequences in terms of salivation and generate sialorrhea: if during pregnancy and senescence sialorrhea is mainly associated with a accumulation of saliva in the mouth, taking particular medications could cause not only a further accumulation of saliva, but also a overproduction of the same.
Numerous pharmaceutical substances can induce drowsiness and slow movements, causing difficulty in swallowing with consequent "stagnation" of saliva in the mouth cavity. Benzodiazepines in general and nitrazepam in particular could cause an abnormal accumulation of saliva in the mouth and stimulate the hyper secretion of the salivary glands. Neuroleptic drugs can generate opposite side effects: some medicinal specialties can cause dry mouth, others sialorrhea (eg . clozapine and olanzapine). Again, adrenaline, albumin (important in the regulation of plasma volume), irinotecan (chemotherapeutic) and cholinergic drugs (used, for example, in Alzheimer's) stimulate the production of saliva, while it has been observed that suxamethonium (a substance used as an adjuvant in anesthesia and orthopedic treatments) exerts its effect by preventing correct swallowing, thus favoring sialorrhea.
Sialorrhea and related disorders
Sialorrhea could be a source of embarrassment, as well as creating, in some cases, significant relational and language problems; when saliva is particularly thick and abundant, sialorrhea can in fact create considerable difficulties in interpersonal relationships, up to inducing a rejection of Therefore, sialorrhea can also reflect psychological conditions that could sometimes lead to pseudo-depressive forms.
Care
When sialorrhea is caused by the psychotic state of the patient, the doctor can recommend drugs that alleviate the anxiety state of the subject, since consequently, the anxiolytic effect causes a decrease in the production of saliva. The specialist can also recommend anticholinergic medicines, designed to weaken the secretion of saliva without completely eliminating it.
When sialorrhea represents a very problematic phenomenon for verbalization and interpersonal relationships, parasympathetic denervation is the surgical treatment of choice, the "last resort" to eliminate sialorrhea.
