Sialorrhea (also known as ptyalism or hypersalivation) is the term given to excessive salivation 1. It is less common than xerostomia, the term for patients with hyposalivation 5.
It may be subdivided into true sialorrhea in which there is a real increase in salivary production/secretion, or false sialorrhea, in which there is no change in the production/secretion of saliva but an inability to swallow it 5.
- physiological: normal in infants
- pregnancy: ptyalism gravidarum 2
- also in early menstruation for some women
- sialogogue administration: e.g. lemon juice
- cholinergic effects: clozapine 3, pilocarpine 5, tetrabenazine 5
- infant teething
- inflammatory oral diseases
- nasogastric intubation
Patient is unable to swallow a normal quantity of saliva.
- obstruction of the pharynx/esophagus: malignancy, etc.
- SATB2-associated syndrome (SAS) 4
Treatment and prognosis
- initially management of the primary cause 5
- specific treatments to reduce salivary production
- antisialogogues: usually anticholinergic medications, e.g. hyoscine, atropine 6
- rarely, surgical relocalisation of the salivary ducts to drain into the oropharynx 5
- 1. William Alexander Newman Dorland. Dorland's Illustrated Medical Dictionary. (2018) ISBN: 9781416023647
- 2. Suzuki S, Igarashi M, Yamashita E, Satomi M. Ptyalism gravidarum. (2009) North American journal of medical sciences. 1 (6): 303-4. Pubmed
- 3. Chen SY, Ravindran G, Zhang Q, Kisely S, Siskind D. Treatment Strategies for Clozapine-Induced Sialorrhea: A Systematic Review and Meta-analysis. (2019) CNS drugs. 33 (3): 225-238. doi:10.1007/s40263-019-00612-8 - Pubmed
- 4. Scott J, Adams C, Beetstra S, Zarate YA. SATB2-associated syndrome (SAS) and associated dental findings. (2019) Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry. 39 (2): 220-224. doi:10.1111/scd.12340 - Pubmed
- 5. Scully C, Felix DH. Oral medicine -- update for the dental practitioner: dry mouth and disorders of salivation. (2005) British dental journal. 199 (7): 423-7. doi:10.1038/sj.bdj.4812740 - Pubmed
- 6. Kuijpers MA, Vissink A, Ren Y, Kuijpers-Jagtman AM. The effect of antisialogogues in dentistry: a systematic review with a focus on bond failure in orthodontics. (2010) Journal of the American Dental Association (1939). 141 (8): 954-65. Pubmed