Hypersalivation

Overview

Hypersalivation is the excess of saliva. This can be due to either excessive production or decrease in clearance of saliva. This can contribute to drooling or difficulty swallowing. While drooling is common in babies, it is considered abnormal after the age of 4.

There are many causes of hypersalivation, including: cerebral palsy,neurodegenerative disorders, vitamin B3 deficiency, gastroparesis, pancreatitis, oral infections, rabies, many medications and several toxins.


Symptoms and History

Hypersalivation is associated with either excess saliva production or decreased clearance. Patients may drool if unable to close the mouth and also present with difficulty swallowing (dysphagia). Patients may also feel nausea and the need to vomit.


Diagnosis

  • Clinical Exam
  • Clinical exam will be tailored towards patient’s symptoms and history.

Imaging

Ultrasound may demonstrate enlarged salivary glands in certain cases. Normal size of the salivary glands does not exclude the diagnosis.


Treatment

There are many different ways of managing hypersalivation.

  • Clinical observation and to avoid any underlying causes (starch-rich foods, medications, toxins), as well as oral-motor exercises to improve swallow musculature coordination
  • Medical management with anti-cholinergic medications (predominantly palliative)
  • Surgical resection
  • Radiation therapy
  • Salivary gland botoxin injection