Hypersalivation is excessive production
of saliva. It has also been defined as increased amount of saliva in the mouth,
which may also be caused by decreased clearance of saliva.
Hypersalivation can contribute to drooling if there is an inability to
keep the mouth closed or in difficulty in swallowing the excess saliva.
Hypersalivation also often precedes emesis, where it accompanies nausea.
Causes =Excessive production=
Conditions that can cause saliva overproduction include:
Rabies Gastroesophageal reflux disease, in such
cases specifically called a water brash, and is characterized by a sour fluid or
almost tasteless saliva in the mouth Pregnancy
Excessive starch intake Pancreatitis
Liver disease Serotonin syndrome
Mouth ulcers Oral infections
Medications that can cause overproduction of saliva include:
ketamine potassium chlorate
risperidone rabeprazole sodium
Toxins that can cause hypersalivation include:
=Decreased clearance=Causes of decreased clearance of saliva
include: Infections such as tonsillitis,
retropharyngeal and peritonsillar abscesses, epiglottitis and mumps.
Problems with the jaw, e.g., fracture or dislocation
Radiation therapy Neurologic disorders such as myasthenia
gravis, Parkinson’s disease, multiple system atrophy, rabies, bulbar
paralysis, bilateral facial nerve palsy, and hypoglossal nerve palsy.
Treatment Hypersalivation is optimally treated by
treating or avoiding the underlying cause. Mouthwash and tooth brushing may
have drying effects. In the palliative care setting;
anticholinergics and similar drugs that would normally reduce the production of
saliva causing a dry mouth could be considered for symptom management:
scopolamine, atropine, propantheline, hyoscine, amitriptyline, glycopyrrolate.