MOUTH – Drooling – Sialorrhoea
Drooling saliva is an involuntary dripping of saliva with reduction in the
sensory awareness necessary for swallowing it. This overflow / increased
flow of saliva is medically termed as
sialorrhoea. Drooling is considered a normal happening in children,
till they gain adequate control over neck position, oral muscle functions and
coordination of muscles of face, i.e. till the age of one-and-a-half years.
Children also suffer with drooling saliva in a more intensified manner while
they begin to teeth, change in positions during developments, etc. in that
period. Children can wear bibs for mopping up excess saliva but for adults,
those circumstances are very awful. It may look awkward and make one feel
guilty when saliva drips in front of others. Also, sometimes, they may develop
the shameful habit and horrible environment by spitting constantly.
Saliva can drool out involuntarily on many occasions even in adults. One
might experience it at one or the other occasion, spoiling pillows / bed /
dresses (especially with deep sleep) with improper closure of lips, face down
and also while lying in reclined positions. Drooling saliva may also be
indicative of being stunned (after magical performance, mouth-watering
delicious sweets, etc.) and drowsy nature where the situation goes out of
control.
Incidences
Normally, it is more common in infants with postural changes, teething and
while developing speech functions. It gets controlled naturally as they grow
with postures and lip control, but in case of those with developmental delays
and mental retardation, the drooling process may prolong or persist
continuously. It is also common in elderly people who have just lost their
teeth or who wear new dentures or who suffer from paralysis, etc. Saliva
secretions will also be more with any lesions in the mouth.
Causes
Saliva naturally runs down to the
throat with gravity, positions / movement of tongue and jaw. Deviation from
nature often brings discomfort. This is true with saliva too, i.e., when it
overflows or flows out one gets embarrassed. Swallowing saliva requires good
lips closure, pushing movements of tongue and jaw.
There are various reasons for saliva to drool out. They are
Increased saliva secretion / production
Non-closure / improper closure of lips
Down position of head
Lack of coordinated action of muscles of face – while eating, speaking,
etc.
Lack of proper movement of tongue / jaw while eating, speaking, etc.
Difficulty in swallowing the saliva (due to congenital cricopharyngeal
achalasia, paralysis of throat muscles, obstacles with mal-positions or
tumours, jaw problems, mandibular joint problems, etc.)
Lack or delay in developing skills related with lifting / turning head,
eating, speaking,
Generally, children suffer with drooling when there is delay in
development, deficiencies, poor posture, lack of neck control, mental
retardation, mumps,mouth ulcers, tonsillitis, quinsy (peritonsillar abscess),
etc. In the case of adults, people commonly have dribbling saliva with
dentures, structural deformities of face, mouth ulcers, epiglotitis, rabies,
pancreatitis, jaundice, GERD, etc. Females have excessive salivation during
pregnancy with hormonal changes. Salivation can also be in excess and go
uncontrollable with nervous lesions like Extrapyramidal cerebral palsy , Bell’s
palsy, facial palsy, stroke , Parkinson’s disease, myasthenia gravis, brain
tumours , and benign and carcinamatous tumours of the mouth, etc.
Symptoms
Drooling itself comes as a symptom rather than a disease. It also usually
accompanies with a variety of other symptoms. For example:
·
Constant spitting
·
Nausea and vomiting
·
Discomfort and difficulty in feeding
·
Difficulty in speech
Diagnosis
is very important to aim and fix the
treatment. Drooling saliva should be analysed in every aspect to get it
corrected soon.
·
Postural analysis (wide open mouth / hanging jaw
position, neck down position, etc.)
·
Palpation for swellings in the salivary glands
·
Sputum culture / biopsy to identify and confirm
infections / disease
·
X-ray / CT or MRI scan to show any pathology related with
oral cavity or salivary glands and to proceed to treatment systematically.
Prevention
Postural and behaviour training can
prevent drooling. In addition, one needs to
·
Maintain good oral hygiene with habits of brushing and
cleanliness
·
Avoid highly sour and sweet foods / drinks to avoid
excessive saliva secretion / production
·
Develop eating and drinking skills with good posture
Complication
Drooling can bring complications when it is left untreated or when it could
not be controlled with treatment. The common complications are:
·
Feeling bad in the midst of a gathering (need places /
tissues to spit or wipe off making one feel embarrassed)
·
Dehydration and weight loss with excessive salivation
·
Nausea and feeding difficulties
·
Halitosis
·
Depression with quality of life
General treatment
Generally, treatment involves finding any correctable causes and fixing
those, if possible. According to the causes, treatment may vary i.e.:
·
For glandular infections, mouth ulcers – antibiotics and
anti-inflammatory drugs
·
Lack of muscle tone / muscle control / nerve stimulation
in face – supplements and physiotherapy
·
Lack of speech or jaw movement coordination – speech
therapy
·
Developmental delays and neurological problems –
symptomatic treatment
·
Habits with positions – behaviour or postural training.
The person other than the one who suffers with infections will be directed
to undergo habit or behaviour or postural or physiotherapy training to aid good
lip closure and to direct saliva down to the pharynx with neck positioning. In
those conditions, where training response is poor, surgical option (bilateral
submandibular gland / sublingual gland excision and parotid duct repositioning)
will be tried to cut down saliva production and to direct saliva straight to
the pharynx.
Homeopathic treatment
Homeopathy can support one to ease
the situation with comfort in addition to behaviour or postural or
physiotherapy training to aid good lips closure and to direct saliva down to
the pharynx with neck positioning. Homeopathy has splendid medicines to improve
quality of saliva secretions. It can control (hyper functioning salivary gland)
excessive saliva secretion by recovering normal glandular functions. With the
most apt drug, Homeopathy can control infection, modify secretions and can
streamline saliva by enhancing facial muscles tone, power and nerve
stimulations.
Homeopathic medicines commonly used for drooling are Acid nit, Acid
Aconite, Anti crud, Apis mel, Ars alb, Arum triphyllum, Baryta carb, Baryta
iod, Baryta mur, Bryonia, Calc carb, Cocculus, Hepar sulph, Hyoscyamus,
Lachesis, Merc sol, Nat mur, Onosmodium, Opium, Phosphorus, Phytolacco,
Pulsastilla, Rhus tox, Sanicula, Silicea, Sulphur, Veratrum alb, etc. A few
characteristic specifics are
·
Viscid saliva which needs to be spit constantly or the
constant desire to spit saliva – Cocculus
·
Constantly spitting frothy saliva – Stramonium
·
Offensive fluid saliva – Baptisia, Baryta Mur, Merc sol,
Nitric acid,
·
Ropy Saliva – Iris vers, Kali Bich, Picric acid,
·
Offensive saliva – Baptisia, Baryta Mur, Merc sol, Nitric
acid,
·
Salty saliva – Cyclamen
·
Sour saliva – Ignatia
·
Tasteless saliva – Veratrum alb
·
Sweetish saliva – Chamomilla
·
These Medicines should be taken under the advice and diagnosis of a
qualified Homeopath.
for
new hope
Dr. S. Chidambaranathan, BHMS, MD (Homeo)
Laxmi Homeo Clinic
24 E. New Mahalipatti Road
Madurai, TN 625 001
India
Tel: +91-984-319-1011 (Mob /
Whatsapp)
E-mail: drcheena@gmail.com
(Disclaimer: The
contents of this column are for informational purpose only. The content is not
intended to be a substitute for professional healthcare advice, diagnosis, or
treatment. Always seek the advice of healthcare professional for any health
problem or medical condition.)