Erica Brownfield, MD

Disclosures

May 19, 2004

Question

What are the common or uncommon etiologies for hypersalivation? Is there any specific treatment?

Response from Erica Brownfield, MD

Saliva is produced in and secreted from the salivary glands in the body and functions to initiate digestion. The secretion of saliva is under the control of the autonomic nervous system. Hypersalivation, or increased saliva, can be caused by overproduction or decreased clearance of saliva. There are many medical conditions that can cause hypersalivation; therefore, it is a common symptom.

Causes of saliva overproduction include pregnancy, excessive starch intake, gastroesophageal reflux disease, pancreatitis, liver disease, serotonin syndrome, oral ulcers, and oral infections. Medications that can cause saliva overproduction include clozapine, pilocarpine, ketamine, and potassium chlorate. Toxins can also cause hypersalivation. These include mercury, copper, organophosphates, and arsenic.

Causes of hypersalivation due to decreased clearance of saliva include infections such as tonsillitis, retropharyngeal and peritonsillar abscesses, epiglottitis, and mumps. It can also be caused by problems with the jaw such as fracture or dislocation; radiation therapy; and neurologic disorders such as myasthenia gravis, Parkinson's disease, rabies, bulbar paralysis, bilateral facial nerve palsy, and hypoglossal nerve palsy.

Treatment of hypersalivation should be directed toward the underlying cause. Some patients find relief with use of mouthwash and tooth brushing, which might have a drying effect.

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