Drooling

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 benzocaine, or when going to the dentist's office.

Isolated drooling in healthy infants and toddlers is normal and may be associated with teething.[1] 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.

## Contents

* 1 Causes
* 2 Treatment
* 3 Popular culture
* 4 See also
* 5 References
* 6 External links

## Causes

Smiley drooling during sleep

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 experience the most severe harm while napping, rather than during overnight sleep.[2]

Causes include:

* exercise, especially cardiovascular exercise[3]
* stroke and other neurological pathologies
* intellectual disability
* adenoid hypertrophy
* cerebral palsy[4]
* amyotrophic lateral sclerosis
* tumors of the upper aerodigestive tract
* Parkinson's disease[5]
* rabies
* mercury poisoning

Drooling associated with fever or trouble swallowing may be a sign of an infectious disease including:

* retropharyngeal abscess
* peritonsillar abscess
* tonsillitis
* mononucleosis
* strep throat
* obstructive diseases (tumors, stenosis)
* inability to swallow due to neurodegenerative diseases (amyotrophic lateral sclerosis)

## Treatment

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.[6][7][8]

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.[9]

## Popular culture

Smiley drooling as a sign of desire

Increased production of saliva, for which drooling is a convenient visual representation, is an autonomic response to noticing (or thinking of) desirable food; cf. the adjective "mouthwatering".[10][11] Based on this association, the scope of the meaning of the term drool in popular use has expanded to include any occasion wherein someone highly desires something.[12][13]

## See also

* Slobbers
* Salivary microbiome

## References

1. ↑ Common Baby Teething Symptoms & Signs Kute Keiki. Retrieved on 2019-12-05
2. ↑ Almeida, Cristiana; Almeida, Isabel; Vasconcelos, Carlos (2015). "Quality of life in systemic sclerosis". Autoimmunity Reviews 14 (12): 1087–1096. doi:10.1016/j.autrev.2015.07.012. PMID 26212726.
3. ↑ Ligtenberg, Antoon J. M.; Brand, Henk S.; van den Keijbus, Petra A. M.; Veerman, Enno C. I. (2015-11-01). "The effect of physical exercise on salivary secretion of MUC5B, amylase and lysozyme". Archives of Oral Biology 60 (11): 1639–1644. doi:10.1016/j.archoralbio.2015.07.012. ISSN 0003-9969. https://www.sciencedirect.com/science/article/pii/S0003996915300121.
4. ↑ Weiss-Lambrou, R.; Tetreault, S.; Dudley, J. (1989). "The relationship between oral sensation and drooling in persons with cerebral palsy". American Journal of Occupational Therapy 43 (3): 155–161. doi:10.5014/ajot.43.3.155. PMID 2735376. http://ajot.aota.org/article.aspx?articleid=1880049. Retrieved 2013-10-02.
5. ↑ Kalf, J.G. (2009). "Prevalence and definition of drooling in Parkinson's disease: A systematic review". Journal of Neurology 256 (9): 1391–1396. doi:10.1007/s00415-009-5098-2. PMID 19288042.
6. ↑ 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.
7. ↑ 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. http://www.neurology.org/content/61/9/1279.short. Retrieved 2013-10-02.
8. ↑ 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. http://archpedi.jamanetwork.com/article.aspx?articleid=352611. Retrieved 2013-10-02.
9. ↑ Hockstein, Neil G.; Samadi, Daniel S.; Gendron, Kristin; Handler, Steven D. (2004-06-01). "Sialorrhea: A Management Challenge" (in en). American Family Physician 69 (11): 2628–2635. ISSN 1532-0650. https://www.aafp.org/afp/2004/0601/p2628.
10. ↑ Thompson, Andrea (3 February 2013). "Why Do Our Mouths Water?". Live Science. https://www.livescience.com/32465-why-do-our-mouths-water.html.
11. ↑ Horowitz, Kate (6 January 2021). "Why Does Seeing Food Make Your Mouth Water?". Mental Floss. https://www.mentalfloss.com/food/why-does-seeing-food-make-your-mouth-water.
12. ↑ "Definition of DROOL" (in en). https://www.merriam-webster.com/dictionary/drool.
13. ↑ "DROOL | meaning in the Cambridge English Dictionary" (in en). https://dictionary.cambridge.org/dictionary/english/drool.

## External links

Classification|

* ICD-10: K11.7
* ICD-9-CM: 527.7
* MeSH: D012798
* DiseasesDB: 20764

|

External resources|

* MedlinePlus: 003048

* NIH site on drooling

* v
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* e

Oral and maxillofacial pathology (K00–K06, K11–K14, 520–525, 527–529)

Lips

* Cheilitis
* Actinic
* Angular
* Plasma cell
* Cleft lip
* Congenital lip pit
* Eclabium
* Herpes labialis
* Macrocheilia
* Microcheilia
* Nasolabial cyst
* Sun poisoning
* Trumpeter's wart

Tongue

* Ankyloglossia
* Black hairy tongue
* Caviar tongue
* Crenated tongue
* Cunnilingus tongue
* Fissured tongue
* Foliate papillitis
* Glossitis
* Geographic tongue
* Median rhomboid glossitis
* Transient lingual papillitis
* Glossoptosis
* Hypoglossia
* Lingual thyroid
* Macroglossia
* Microglossia
* Rhabdomyoma

Palate

* Bednar's aphthae
* Cleft palate
* High-arched palate
* Palatal cysts of the newborn
* Inflammatory papillary hyperplasia
* Stomatitis nicotina
* Torus palatinus

Oral mucosa – Lining of mouth

* Amalgam tattoo
* Angina bullosa haemorrhagica
* Behçet's disease
* Bohn's nodules
* Burning mouth syndrome
* Candidiasis
* Condyloma acuminatum
* Darier's disease
* Epulis fissuratum
* Erythema multiforme
* Erythroplakia
* Fibroma
* Giant-cell
* Focal epithelial hyperplasia
* Fordyce spots
* Hairy leukoplakia
* Hand, foot and mouth disease
* Hereditary benign intraepithelial dyskeratosis
* Herpangina
* Herpes zoster
* Intraoral dental sinus
* Leukoedema
* Leukoplakia
* Lichen planus
* Linea alba
* Lupus erythematosus
* Melanocytic nevus
* Melanocytic oral lesion
* Molluscum contagiosum
* Morsicatio buccarum
* Oral cancer
* Benign: Squamous cell papilloma
* Keratoacanthoma
* Malignant: Adenosquamous carcinoma
* Basaloid squamous carcinoma
* Mucosal melanoma
* Spindle cell carcinoma
* Squamous cell carcinoma
* Verrucous carcinoma
* Oral florid papillomatosis
* Oral melanosis
* Smoker's melanosis
* Pemphigoid
* Benign mucous membrane
* Pemphigus
* Plasmoacanthoma
* Stomatitis
* Aphthous
* Denture-related
* Herpetic
* Smokeless tobacco keratosis
* Submucous fibrosis
* Ulceration
* Riga–Fede disease
* Verruca vulgaris
* Verruciform xanthoma
* White sponge nevus

Teeth (pulp, dentin, enamel)

* Amelogenesis imperfecta
* Ankylosis
* Anodontia
* Caries
* Early childhood caries
* Concrescence
* Failure of eruption of teeth
* Dens evaginatus
* Talon cusp
* Dentin dysplasia
* Dentin hypersensitivity
* Dentinogenesis imperfecta
* Dilaceration
* Discoloration
* Ectopic enamel
* Enamel hypocalcification
* Enamel hypoplasia
* Turner's hypoplasia
* Enamel pearl
* Fluorosis
* Fusion
* Gemination
* Hyperdontia
* Hypodontia
* Maxillary lateral incisor agenesis
* Impaction
* Wisdom tooth impaction
* Macrodontia
* Meth mouth
* Microdontia
* Odontogenic tumors
* Keratocystic odontogenic tumour
* Odontoma
* Dens in dente
* Open contact
* Premature eruption
* Neonatal teeth
* Pulp calcification
* Pulp stone
* Pulp canal obliteration
* Pulp necrosis
* Pulp polyp
* Pulpitis
* Regional odontodysplasia
* Resorption
* Shovel-shaped incisors
* Supernumerary root
* Taurodontism
* Trauma
* Avulsion
* Cracked tooth syndrome
* Vertical root fracture
* Occlusal
* Tooth loss
* Edentulism
* Tooth wear
* Abrasion
* Abfraction
* Acid erosion
* Attrition

Periodontium (gingiva, periodontal ligament, cementum, alveolus) – Gums and tooth-supporting structures

* Cementicle
* Cementoblastoma
* Gigantiform
* Cementoma
* Eruption cyst
* Epulis
* Pyogenic granuloma
* Congenital epulis
* Gingival enlargement
* Gingival cyst of the adult
* Gingival cyst of the newborn
* Gingivitis
* Desquamative
* Granulomatous
* Plasma cell
* Hereditary gingival fibromatosis
* Hypercementosis
* Hypocementosis
* Linear gingival erythema
* Necrotizing periodontal diseases
* Acute necrotizing ulcerative gingivitis
* Pericoronitis
* Peri-implantitis
* Periodontal abscess
* Periodontal trauma
* Periodontitis
* Aggressive
* As a manifestation of systemic disease
* Chronic
* Perio-endo lesion
* Teething

Periapical, mandibular and maxillary hard tissues – Bones of jaws

* Agnathia
* Alveolar osteitis
* Buccal exostosis
* Cherubism
* Idiopathic osteosclerosis
* Mandibular fracture
* Microgenia
* Micrognathia
* Intraosseous cysts
* Odontogenic: periapical
* Dentigerous
* Buccal bifurcation
* Lateral periodontal
* Globulomaxillary
* Calcifying odontogenic
* Glandular odontogenic
* Non-odontogenic: Nasopalatine duct
* Median mandibular
* Median palatal
* Traumatic bone
* Osteoma
* Osteomyelitis
* Osteonecrosis
* Bisphosphonate-associated
* Neuralgia-inducing cavitational osteonecrosis
* Osteoradionecrosis
* Osteoporotic bone marrow defect
* Paget's disease of bone
* Periapical abscess
* Phoenix abscess
* Periapical periodontitis
* Stafne defect
* Torus mandibularis

Temporomandibular joints, muscles of mastication and malocclusions – Jaw joints, chewing muscles and bite abnormalities

* Bruxism
* Condylar resorption
* Mandibular dislocation
* Malocclusion
* Crossbite
* Open bite
* Overbite
* Overeruption
* Overjet
* Prognathia
* Retrognathia
* Scissor bite
* Maxillary hypoplasia
* Temporomandibular joint dysfunction

Salivary glands

* Benign lymphoepithelial lesion
* Ectopic salivary gland tissue
* Frey's syndrome
* HIV salivary gland disease
* Necrotizing sialometaplasia
* Mucocele
* Ranula
* Pneumoparotitis
* Salivary duct stricture
* Salivary gland aplasia
* Salivary gland atresia
* Salivary gland diverticulum
* Salivary gland fistula
* Salivary gland hyperplasia
* Salivary gland hypoplasia
* Salivary gland neoplasms
* Benign: Basal cell adenoma
* Canalicular adenoma
* Ductal papilloma
* Monomorphic adenoma
* Myoepithelioma
* Oncocytoma
* Papillary cystadenoma lymphomatosum
* Pleomorphic adenoma
* Sebaceous adenoma
* Malignant: Acinic cell carcinoma
* Adenocarcinoma
* Adenoid cystic carcinoma
* Carcinoma ex pleomorphic adenoma
* Lymphoma
* Mucoepidermoid carcinoma
* Sclerosing polycystic adenosis
* Sialadenitis
* Parotitis
* Chronic sclerosing sialadenitis
* Sialectasis
* Sialocele
* Sialodochitis
* Sialosis
* Sialolithiasis
* Sjögren's syndrome

Orofacial soft tissues – Soft tissues around the mouth

* Actinomycosis
* Angioedema
* Basal cell carcinoma
* Cutaneous sinus of dental origin
* Cystic hygroma
* Gnathophyma
* Ludwig's angina
* Macrostomia
* Melkersson–Rosenthal syndrome
* Microstomia
* Noma
* Oral Crohn's disease
* Orofacial granulomatosis
* Perioral dermatitis
* Pyostomatitis vegetans

Other

* Eagle syndrome
* Hemifacial hypertrophy
* Facial hemiatrophy
* Oral manifestations of systemic disease

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