|Other names||Salivation, driveling, dribbling, slobbering, sialorrhea|
|A drooling Malamute|
Drooling, or slobbering, is the flow of saliva outside the mouth. Drooling can be caused by excess production of saliva, inability to retain saliva within the mouth (incontinence of saliva), or problems with swallowing (dysphagia or odynophagia).
There are some frequent and harmless cases of drooling. For instance, a numbed mouth from either Orajel, or when going to the dentist's office.
Isolated drooling in healthy infants and toddlers is normal and may be associated with teething. It is unlikely to be a sign of disease or complications. Drooling in infants and young children may be exacerbated by upper respiratory infections and nasal allergies.
Some people with drooling problems are at increased risk of inhaling saliva, food, or fluids into the lungs, especially if drooling is secondary to a neurological problem. However, if the body's normal reflex mechanisms (such as gagging and coughing) are not impaired, this is not life-threatening.
Drooling or sialorrhea can occur during sleep. It is often the result of open-mouth posture from CNS depressants intake or sleeping on one's side. Sometimes while sleeping, saliva does not build up at the back of the throat and does not trigger the normal swallow reflex, leading to the condition. Freud conjectured that drooling occurs during deep sleep, and within the first few hours of falling asleep, since those who are affected by the symptom suffer the most severe harm while napping, rather than during overnight sleep.
A sudden onset of drooling may indicate poisoning – especially by pesticides or mercury – or reaction to snake or insect venom. Excess capsaicin can cause drooling as well, an example being the ingestion of particularly high Scoville Unit chili peppers. Some neurological problems cause drooling. Medication can cause drooling, either due to primary action or side-effects; for example the pain-relief medication Orajel can numb the mucosa.
- exercise, especially cardiovascular exercise
- stroke and other neurological pathologies
- intellectual disability
- adenoid hypertrophy
- cerebral palsy
- amyotrophic lateral sclerosis
- tumors of the upper aerodigestive tract
- Parkinson's disease
- mercury poisoning
Drooling associated with fever or trouble swallowing may be a sign of an infectious disease including:
- retropharyngeal abscess
- peritonsillar abscess
- strep throat
- obstructive diseases (tumors, stenosis)
- inability to swallow due to neurodegenerative diseases (amyotrophic lateral sclerosis)
A comprehensive treatment plan depends on the cause and incorporates several stages of care: Correction of reversible causes, behavior modification, medical treatment, and surgical procedures.
Atropine sulfate tablets are used in some circumstances to reduce salivation. The same for anticholinergic drugs which can be also a benefit because they decrease the activity of the acetylcholine muscarinic receptors and can result in decreased salivation. They may be prescribed by doctors in conjunction with behavior modification strategies. Other drugs used are glycopyrrolate and botulinum toxin A – botox injection in salivary glands to diminish saliva production.
In general, surgical procedures are considered after clear diagnosis of the cause and evaluation of non-invasive treatment options. Severe cases can be sometimes be treated by surgical intervention – salivary duct relocalization, or in extreme cases resection of salivary glands.
Care for drooling due to teething includes good oral hygiene. Ice pops or other cold objects (e.g., frozen bagels) may be helpful. Care must be taken to avoid choking when a child uses any of these objects. Drooling is also common in children with neurological disorders or undiagnosed developmental delay.
Excessive drooling seems to be due to:
- lack of awareness of the build-up of saliva in the mouth
- infrequent swallowing
- inefficient swallowing
Treatment of excessive drooling addresses its cause:
- cultivating awareness of the mouth and its functions
- increased frequency of swallowing
- cultivating swallowing skill
- Common Baby Teething Symptoms & Signs Kute Keiki. Retrieved on 2019-12-05
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- Ellies Maik (2004). "Reduction of salivary flow with botulinum toxin: Extended report on 33 patients with drooling, salivary fistulas, and sialadenitis". The Laryngoscope. 114 (10): 1856–1860. doi:10.1097/00005537-200410000-00033. PMID 15454785.
- Lipp, A.; Trottenberg, T.; Schink, T.; Kupsch, A.; Arnold, G. (2003). "A randomized trial of botulinum toxin A for treatment of drooling". Neurology. 61 (9): 1279–1281. doi:10.1212/WNL.61.9.1279. PMID 14610139. S2CID 42377134. Retrieved 2013-10-02.
- Mier, Richard J.; Bachrach, Steven J.; Lakin, Ryan C.; Barker, Tara; Childs, Judith; Moran, Maria (2000). "Treatment of Sialorrhea With GlycopyrrolateA Double-blind, Dose-Ranging Study". Archives of Pediatrics & Adolescent Medicine. 154 (12): 1214–8. doi:10.1001/archpedi.154.12.1214. PMID 11115305. Retrieved 2013-10-02.
- "Definition of DROOL". www.merriam-webster.com. Retrieved 2020-06-13.
- "DROOL | meaning in the Cambridge English Dictionary". dictionary.cambridge.org. Retrieved 2020-06-13.
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