{"id":13187,"date":"2025-11-11T14:33:50","date_gmt":"2025-11-11T13:33:50","guid":{"rendered":"https:\/\/platondental.com\/?p=13187"},"modified":"2026-01-15T11:09:57","modified_gmt":"2026-01-15T10:09:57","slug":"sialorrhea","status":"publish","type":"post","link":"https:\/\/platondental.com\/en\/sialorrhea\/","title":{"rendered":"Sialorrhea, clinical treatment of excessive saliva"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"13187\" class=\"elementor elementor-13187 elementor-12714\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-134cc1de e-flex e-con-boxed e-con e-parent\" data-id=\"134cc1de\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-31deb90e elementor-widget elementor-widget-text-editor\" data-id=\"31deb90e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Sialorrhea<\/strong>, also known as <strong>ptyalism<\/strong>, is a condition characterised by <strong>excessive saliva production or difficulty controlling it in the mouth<\/strong>. Although it is usually associated with young children or certain neurological conditions, it can also occur in adults, especially when there is an imbalance between the amount of saliva produced and the ability to swallow it.<\/p><p>Under normal conditions, the salivary glands (parotid, submandibular, and sublingual) produce around 1 to 1.5 litres of saliva per day. This fluid performs essential functions: it keeps the mucosa hydrated, facilitates swallowing, initiates digestion, and protects the teeth from bacteria. When production increases or neuromuscular control is altered, <strong>saliva accumulates or overflows<\/strong>, causing both physical and social discomfort.<\/p><p>Sialorrhea can be:<\/p><ul><li><strong>Physiological<\/strong>, as occurs in babies or during teething, without pathological implications.<\/li><li><strong>Pathological<\/strong>, when it appears in adults or persists in older children, usually associated with neurological diseases, side effects of medications, or oral disorders.<\/li><\/ul><p>Beyond aesthetic discomfort, this condition can affect the patient&#8217;s communication, eating habits, and self-esteem, and therefore warrants medical attention and specialised treatment.<\/p><table><thead><tr><td><p><strong>Type of sialorrhea<\/strong><\/p><\/td><td><p><strong>Main cause<\/strong><\/p><\/td><td><p><strong>Clinical characteristics<\/strong><\/p><\/td><td><p><strong>Common example<\/strong><\/p><\/td><\/tr><\/thead><tbody><tr><td><p><strong>Physiological<\/strong><\/p><\/td><td><p>Normal stimulation of salivary glands (babies, teething)<\/p><\/td><td><p>Transient, without underlying disease<\/p><\/td><td><p>Infants aged 3 to 18 months<\/p><\/td><\/tr><tr><td><p><strong>Pathological<\/strong><\/p><\/td><td><p>Neurological or mechanical impairment<\/p><\/td><td><p>Excess saliva that leaks from the corners of the mouth or accumulates in the oral cavity.<\/p><\/td><td><p>Parkinson&#8217;s disease, ALS, poorly fitted prostheses<\/p><\/td><\/tr><tr><td><p><strong>Pharmacological<\/strong><\/p><\/td><td><p>Adverse effect of certain medicines<\/p><\/td><td><p>Increased salivary secretion after starting treatment<\/p><\/td><td><p>Clozapine, pilocarpine, morphine<\/p><\/td><\/tr><tr><td><p><strong>Situational or temporary<\/strong><\/p><\/td><td><p>Hormonal changes, stress, reflux, or pregnancy<\/p><\/td><td><p>Mild and temporary hypersalivation, improves when the causal factor is corrected.<\/p><\/td><td><p>Pregnancy or acute anxiety<\/p><\/td><\/tr><\/tbody><\/table>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0526548 elementor-widget elementor-widget-image\" data-id=\"0526548\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"534\" src=\"https:\/\/platondental.com\/wp-content\/uploads\/Silorrea-Exceso-saliva-1024x683.jpg\" class=\"attachment-large size-large wp-image-13182\" alt=\"Paciente con sialorrea en consulta\" srcset=\"https:\/\/platondental.com\/wp-content\/uploads\/Silorrea-Exceso-saliva-1024x683.jpg 1024w, https:\/\/platondental.com\/wp-content\/uploads\/Silorrea-Exceso-saliva-300x200.jpg 300w, https:\/\/platondental.com\/wp-content\/uploads\/Silorrea-Exceso-saliva-768x512.jpg 768w, https:\/\/platondental.com\/wp-content\/uploads\/Silorrea-Exceso-saliva-200x133.jpg 200w, https:\/\/platondental.com\/wp-content\/uploads\/Silorrea-Exceso-saliva.jpg 1536w\" sizes=\"(max-width: 800px) 100vw, 800px\" title=\"Paciente con sialorrea en consulta\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5abc06d elementor-widget elementor-widget-text-editor\" data-id=\"5abc06d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Main causes of excessive salivation<\/strong><\/p><p>Sialorrhea is not a disease in itself, but rather a <strong>clinical symptom<\/strong> that can have multiple causes. In some cases, there is actual hyperproduction of saliva, but often the problem lies in an alteration of motor control or swallowing. Correctly identifying the origin is essential for choosing the appropriate treatment.<\/p><p><strong>Table: causes of sialorrhea, mechanism and therapeutic approach<\/strong><\/p><table><thead><tr><td><p><strong>Category<\/strong><\/p><\/td><td><p><strong>Specific cause<\/strong><\/p><\/td><td><p><strong>Pathophysiological mechanism<\/strong><\/p><\/td><td><p><strong>Guidance-oriented therapeutic approach<\/strong><\/p><\/td><\/tr><\/thead><tbody><tr><td><p><strong>Neurological<\/strong><\/p><\/td><td><p>Parkinson&#8217;s disease, cerebral palsy, ALS, stroke<\/p><\/td><td><p>Difficulty coordinating oral and swallowing muscles; reduced swallowing reflex<\/p><\/td><td><p>Orofacial rehabilitation, physiotherapy, botulinum toxin in salivary glands<\/p><\/td><\/tr><tr><td><p><strong>Pharmacological<\/strong><\/p><\/td><td><p>Clozapine, pilocarpine, morphine, lithium<\/p><\/td><td><p>Stimulation of muscarinic receptors \u2192 increased salivary secretion<\/p><\/td><td><p>Adjustment or change of medication, anticholinergic treatment (glycopyrrolate, scopolamine)<\/p><\/td><\/tr><tr><td><p><strong>Oral the place<\/strong><\/p><\/td><td><p>Oral infections, poorly fitting dentures, mouth ulcers or gum irritation<\/p><\/td><td><p>Reflex stimulation of salivary glands due to inflammation or mechanical trauma<\/p><\/td><td><p>Dental treatment, denture adjustment, anti-inflammatory mouthwashes<\/p><\/td><\/tr><tr><td><p><strong>Endocrine or physiological<\/strong><\/p><\/td><td><p>Pregnancy, gastroesophageal reflux, anxiety or stress<\/p><\/td><td><p>Hormonal or autonomic changes that increase secretion<\/p><\/td><td><p>Management of the underlying cause, hygiene and dietary measures<\/p><\/td><\/tr><tr><td><p><strong>Toxic or infectious<\/strong><\/p><\/td><td><p>Poisoning by mercury, organophosphate insecticides, or systemic infections<\/p><\/td><td><p>Intense parasympathetic stimulation of the glands<\/p><\/td><td><p>Emergency treatment and detoxification<\/p><\/td><\/tr><tr><td><p><strong>Postural or mechanical<\/strong><\/p><\/td><td><p>Mandibular abnormalities, macroglossia, weak lips<\/p><\/td><td><p>Difficulty retaining or directing saliva within the mouth<\/p><\/td><td><p>Speech therapy exercises, kinesiotape, postural re-education<\/p><\/td><\/tr><\/tbody><\/table><p>In adults, neurological and pharmacological causes are the most common, while in children, the neuromotor or postural form predominates. The correct diagnosis should include neurological assessment and review of current medication, as both factors often coexist.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-da8898f elementor-widget elementor-widget-image\" data-id=\"da8898f\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"682\" height=\"1024\" src=\"https:\/\/platondental.com\/wp-content\/uploads\/Diagnostico-Sialorrea-682x1024.png\" class=\"attachment-large size-large wp-image-13183\" alt=\"Diagnosis of Sialorrhea\" srcset=\"https:\/\/platondental.com\/wp-content\/uploads\/Diagnostico-Sialorrea-682x1024.png 682w, https:\/\/platondental.com\/wp-content\/uploads\/Diagnostico-Sialorrea-200x300.png 200w, https:\/\/platondental.com\/wp-content\/uploads\/Diagnostico-Sialorrea-768x1154.png 768w, https:\/\/platondental.com\/wp-content\/uploads\/Diagnostico-Sialorrea-1022x1536.png 1022w, https:\/\/platondental.com\/wp-content\/uploads\/Diagnostico-Sialorrea-1363x2048.png 1363w, https:\/\/platondental.com\/wp-content\/uploads\/Diagnostico-Sialorrea.png 1604w\" sizes=\"(max-width: 682px) 100vw, 682px\" title=\"Diagnosis of Sialorrhea\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-52b66d1 elementor-widget elementor-widget-text-editor\" data-id=\"52b66d1\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h2>Types and clinical classification of sialorrhea<\/h2><p>From a medical point of view, sialorrhea can be classified according to its origin, location, or duration. This classification is essential for guiding diagnosis, as not all types of sialorrhea respond equally to treatment.<\/p><p><strong>Comparative table: types of sialorrhea and clinical characteristics<\/strong><\/p><table><thead><tr><td><p><strong>Type of sialorrhea<\/strong><\/p><\/td><td><p><strong>Description<\/strong><\/p><\/td><td><p><strong>Location of excess saliva<\/strong><\/p><\/td><td><p><strong>Clinical consequences<\/strong><\/p><\/td><td><p><strong>Typical example<\/strong><\/p><\/td><\/tr><\/thead><tbody><tr><td><p><strong>Previous<\/strong><\/p><\/td><td><p>Saliva spills out through the corners of the mouth.<\/p><\/td><td><p>Mouth \u2192 lips \u2192 chin<\/p><\/td><td><p>Perioral skin irritation, unpleasant odour, aesthetic impact.<\/p><\/td><td><p>Patients with Parkinson&#8217;s disease or facial paralysis.<\/p><\/td><\/tr><tr><td><p><strong>Rear<\/strong><\/p><\/td><td><p>Saliva accumulates in the oropharynx and may be swallowed or aspirated.<\/p><\/td><td><p>Mouth \u2192 throat \u2192 airway<\/p><\/td><td><p>Coughing, choking, risk of pulmonary aspiration.<\/p><\/td><td><p>Patients with ALS or bulbar lesions.<\/p><\/td><\/tr><tr><td><p><strong>Chronicle<\/strong><\/p><\/td><td><p>Persistent for more than three months.<\/p><\/td><td><p>Variable depending on the case.<\/p><\/td><td><p>It interferes with eating, speaking and self-esteem.<\/p><\/td><td><p>Hypersalivation due to established neurological injury.<\/p><\/td><\/tr><tr><td><p><strong>Acute or transient<\/strong><\/p><\/td><td><p>Short-lived, associated with irritation, infections, or pregnancy.<\/p><\/td><td><p>Located.<\/p><\/td><td><p>It disappears when the cause is treated.<\/p><\/td><td><p>Excessive salivation due to mouth ulcers, reflux or pregnancy.<\/p><\/td><\/tr><tr><td><p><strong>Physiological<\/strong><\/p><\/td><td><p>Excessive saliva in normal situations.<\/p><\/td><td><p>Widespread.<\/p><\/td><td><p>No treatment required.<\/p><\/td><td><p>Infants or teething.<\/p><\/td><\/tr><tr><td><p><strong>Pathological<\/strong><\/p><\/td><td><p>Excess due to neurological, pharmacological or anatomical causes.<\/p><\/td><td><p>Variable.<\/p><\/td><td><p>He needs medical or speech therapy intervention.<\/p><\/td><td><p>Parkinson&#8217;s disease, clozapine, macroglossia.<\/p><\/td><\/tr><\/tbody><\/table><p><strong>Difference between sialorrhea and ptyalism<\/strong><\/p><table><thead><tr><td><p><strong>Term<\/strong><\/p><\/td><td><p><strong>Definition<\/strong><\/p><\/td><td><p><strong>Key difference<\/strong><\/p><\/td><\/tr><\/thead><tbody><tr><td><p><strong>Sialorrhea<\/strong><\/p><\/td><td><p>Excessive saliva flow due to difficulty controlling or swallowing it.<\/p><\/td><td><p>It may be due to either hypersalivation or motor problems.<\/p><\/td><\/tr><tr><td><p><strong>Ptialism<\/strong><\/p><\/td><td><p>Actual increase in salivary secretion.<\/p><\/td><td><p>It always involves excessive production, not a control problem.<\/p><\/td><\/tr><\/tbody><\/table><p>In medical practice, the term <em>sialorrhea<\/em> encompasses both mechanisms\u2014hyperproduction and poor neuromotor control\u2014but differentiating between the two helps to determine whether treatment should be <strong>pharmacological<\/strong> (reducing secretion) or <strong>rehabilitative<\/strong> (improving swallowing).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-77ce93d elementor-widget elementor-widget-text-editor\" data-id=\"77ce93d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h2>Diagnosis and medical evaluation of sialorrhea<\/h2><p>The diagnosis of sialorrhea requires determining whether the problem is due to excess production or difficulty in controlling and swallowing saliva. To do this, a comprehensive assessment is carried out that combines a physical examination, analysis of medical history, and additional tests.<\/p><p>The diagnostic process seeks to answer three key questions:<\/p><ol><li>Is too much saliva being produced?<\/li><li>Is there a motor or neurological disorder that prevents you from controlling it?<\/li><li>What impact does it have on the patient&#8217;s quality of life?<\/li><\/ol><p><strong>Table: main diagnostic methods and their purpose<\/strong><\/p><table><thead><tr><td><p><strong>Assessment method<\/strong><\/p><\/td><td><p><strong>Clinical objective<\/strong><\/p><\/td><td><p><strong>What information does it provide?<\/strong><\/p><\/td><\/tr><\/thead><tbody><tr><td><p><strong>Complete medical history<\/strong><\/p><\/td><td><p>Identify possible medical or pharmacological causes.<\/p><\/td><td><p>Temporary relationship with neurological diseases, pregnancy, or drugs (e.g., clozapine).<\/p><\/td><\/tr><tr><td><p><strong>Oral and dental examination<\/strong><\/p><\/td><td><p>Assess the anatomy and condition of the prostheses or mucous membranes.<\/p><\/td><td><p>Detects local irritation, infections, or poor prosthetic fit.<\/p><\/td><\/tr><tr><td><p><strong>Neurological and motor assessment<\/strong><\/p><\/td><td><p>Analyse the coordination of oral muscles and swallowing reflex.<\/p><\/td><td><p>Determine whether there is motor dysfunction, as in Parkinson&#8217;s disease or ALS.<\/p><\/td><\/tr><tr><td><p><strong>Clinical scales (DSS, DFSS)<\/strong><\/p><\/td><td><p>Measure the severity and frequency of drooling.<\/p><\/td><td><p>They enable the progress and effectiveness of treatment to be quantified.<\/p><\/td><\/tr><tr><td><p><strong>Imaging tests (ultrasound, MRI)<\/strong><\/p><\/td><td><p>Examine the salivary glands.<\/p><\/td><td><p>Detects inflammation or glandular hypertrophy.<\/p><\/td><\/tr><tr><td><p><strong>Pharmacological study<\/strong><\/p><\/td><td><p>Review current medications.<\/p><\/td><td><p>It allows the identification of drugs that stimulate salivary secretion.<\/p><\/td><\/tr><\/tbody><\/table><p><strong>Clinical note:<\/strong> <strong>drooling severity scales<\/strong>, such as the <a href=\"https:\/\/cde-fe.ninds.nih.gov\/ninds\/noc-report\/F0785\/Drooling%20Severity%20and%20Frequency%20Scale%20(DSFS)\" target=\"_blank\" rel=\"noopener\"><em>Drooling Severity and Frequency Scale<\/em><\/a>, help to standardise assessment and adjust treatment based on the social and physical impact on the patient.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-643939f elementor-widget elementor-widget-text-editor\" data-id=\"643939f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h2>Medical and pharmacological treatment of sialorrhea<\/h2><p>The management of hypersalivation depends on its cause, severity, and functional or social impact. In many cases, treatment combines medical, pharmacological, and rehabilitative measures to achieve a gradual and safe reduction in excess saliva. The aim is not to completely eliminate saliva production\u2014which would be harmful\u2014but to control it within physiological levels.<\/p><p>The approach should be multidisciplinary, involving dentists, neurologists, speech therapists, and orofacial physiotherapists.<\/p><table><thead><tr><td><p><strong>Type of treatment<\/strong><\/p><\/td><td><p><strong>Mechanism of action<\/strong><\/p><\/td><td><p><strong>Clinical indications<\/strong><\/p><\/td><td><p><strong>Observations or side effects<\/strong><\/p><\/td><\/tr><\/thead><tbody><tr><td><p><strong>Oral anticholinergics<\/strong> (glycopyrrolate, scopolamine, atropine)<\/p><\/td><td><p>Block muscarinic receptors in salivary glands \u2192 reduce saliva production<\/p><\/td><td><p>Mild to moderate hypersalivation, especially in patients with Parkinson&#8217;s disease or ALS<\/p><\/td><td><p>Dry mouth, blurred vision, constipation; contraindicated in glaucoma and frail elderly patients.<\/p><\/td><\/tr><tr><td><p><strong>Scopolamine transdermal patch<\/strong><\/p><\/td><td><p>Inhibits salivary secretion through progressive skin absorption.<\/p><\/td><td><p>Alternative in patients with poor oral compliance<\/p><\/td><td><p>May cause dizziness or drowsiness; the application area should be rotated.<\/p><\/td><\/tr><tr><td><p><strong>Botulinum toxin type A (BoNT-A)<\/strong><\/p><\/td><td><p>Inhibits the release of acetylcholine in the parotid and submandibular glands.<\/p><\/td><td><p>Moderate or severe neurological hypersalivation<\/p><\/td><td><p>Temporary effect (3\u20136 months); requires ultrasound-guided infiltration<\/p><\/td><\/tr><tr><td><p><strong>Selective breast radiation therapy<\/strong><\/p><\/td><td><p>Reduces the function of the salivary glands through targeted radiation.<\/p><\/td><td><p>Severe cases or cases resistant to pharmacological treatment<\/p><\/td><td><p>Risk of excessive dryness and permanent salivary hypofunction<\/p><\/td><\/tr><tr><td><p><strong>Selective surgery<\/strong> (ligation or resection of glands)<\/p><\/td><td><p>Permanent mechanical reduction of salivary flow<\/p><\/td><td><p>Severe cases with recurrent aspirations or failure of other treatments<\/p><\/td><td><p>Irreversible intervention, requires hospital assessment<\/p><\/td><\/tr><tr><td><p><strong>Speech therapy \/ orofacial physiotherapy<\/strong><\/p><\/td><td><p>Neuromuscular retraining and improvement of tongue and jaw posture<\/p><\/td><td><p>Complementary in all phases of treatment<\/p><\/td><td><p>Improves swallowing and reduces dependence on medication<\/p><\/td><\/tr><\/tbody><\/table><p>Botulinum toxin type A is considered the treatment of choice in patients with Parkinson&#8217;s disease or ALS, as it achieves stable results and significantly improves quality of life without significant systemic effects. In mild cases, a combination of speech therapy and anticholinergic drugs is usually sufficient to control symptoms.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cb07fae elementor-widget elementor-widget-image\" data-id=\"cb07fae\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"800\" height=\"534\" src=\"https:\/\/platondental.com\/wp-content\/uploads\/Tratamientos-sialorrea-1024x683.png\" class=\"attachment-large size-large wp-image-13184\" alt=\"Treatments for Sialorrhea\" srcset=\"https:\/\/platondental.com\/wp-content\/uploads\/Tratamientos-sialorrea-1024x683.png 1024w, https:\/\/platondental.com\/wp-content\/uploads\/Tratamientos-sialorrea-300x200.png 300w, https:\/\/platondental.com\/wp-content\/uploads\/Tratamientos-sialorrea-768x512.png 768w, https:\/\/platondental.com\/wp-content\/uploads\/Tratamientos-sialorrea-1536x1024.png 1536w, https:\/\/platondental.com\/wp-content\/uploads\/Tratamientos-sialorrea-2048x1366.png 2048w, https:\/\/platondental.com\/wp-content\/uploads\/Tratamientos-sialorrea-200x133.png 200w\" sizes=\"(max-width: 800px) 100vw, 800px\" title=\"Treatments for Sialorrhea\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c1dad19 elementor-widget elementor-widget-text-editor\" data-id=\"c1dad19\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h2>Natural and supportive treatments for excessive salivation<\/h2><p>In addition to drugs and botulinum toxin, there are complementary strategies that help to <strong>reduce hypersalivation in a non-invasive way<\/strong>. These treatments are especially useful in patients with mild hypersalivation, in the early stages or as maintenance after medical therapy.<\/p><p>The aim is to improve muscle control, re-educate swallowing and reduce stimuli that increase salivary production, while maintaining the lubricating and protective function of saliva.<\/p><table><thead><tr><td><p><strong>Tailored therapy<\/strong><\/p><\/td><td><p><strong>Main objective<\/strong><\/p><\/td><td><p><strong>Clinical evidence or efficacy<\/strong><\/p><\/td><td><p><strong>Observations<\/strong><\/p><\/td><\/tr><\/thead><tbody><tr><td><p><strong>Neuromuscular re-education and speech therapy<\/strong><\/p><\/td><td><p>Training tongue control, swallowing and jaw posture<\/p><\/td><td><p>High in mild to moderate sialorrhea (complementary to other treatments)<\/p><\/td><td><p>Requires regular sessions with a specialist speech therapist.<\/p><\/td><\/tr><tr><td><p><strong>Orofacial kinesiotape<\/strong><\/p><\/td><td><p>Stimulate proprioception and improve lip closure<\/p><\/td><td><p>Growing evidence in orofacial physiotherapy<\/p><\/td><td><p>It does not produce side effects if applied correctly.<\/p><\/td><\/tr><tr><td><p><strong>Postural and breathing exercises<\/strong><\/p><\/td><td><p>Re-educate head position and breathing control<\/p><\/td><td><p>Moderate, improves swallowing in neurological patients<\/p><\/td><td><p>They must be prescribed by a specialist physiotherapist.<\/p><\/td><\/tr><tr><td><p><strong>Herbal medicine (sage, thyme, mint)<\/strong><\/p><\/td><td><p>Reduce salivary secretion due to its mild anticholinergic effect.<\/p><\/td><td><p>Low to moderate; useful as natural support<\/p><\/td><td><p>It does not replace medical treatment.<\/p><\/td><\/tr><tr><td><p><strong>Enhanced oral hygiene<\/strong><\/p><\/td><td><p>Reduce irritation and infections that increase salivation<\/p><\/td><td><p>High; essential for the success of any therapy<\/p><\/td><td><p>Use of mild, alcohol-free mouthwashes<\/p><\/td><\/tr><tr><td><p><strong>Avoid acidic or highly spiced foods.<\/strong><\/p><\/td><td><p>Reduce excessive salivary stimulation<\/p><\/td><td><p>Practical evidence<\/p><\/td><td><p>General dietary recommendation<\/p><\/td><\/tr><\/tbody><\/table><p>Natural treatments are most effective when combined with speech therapy and orofacial physiotherapy. Their effect is not immediate, but they help maintain long-term salivary control stability and reduce the need for medication.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0dcfe81 elementor-widget elementor-widget-image\" data-id=\"0dcfe81\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"460\" src=\"https:\/\/platondental.com\/wp-content\/uploads\/Tratamientos-naturales-sialorrea-e1762352516142.png\" class=\"attachment-large size-large wp-image-13185\" alt=\"Natural treatments Sialorrhea\" srcset=\"https:\/\/platondental.com\/wp-content\/uploads\/Tratamientos-naturales-sialorrea-e1762352516142.png 936w, https:\/\/platondental.com\/wp-content\/uploads\/Tratamientos-naturales-sialorrea-e1762352516142-300x172.png 300w, https:\/\/platondental.com\/wp-content\/uploads\/Tratamientos-naturales-sialorrea-e1762352516142-768x441.png 768w, https:\/\/platondental.com\/wp-content\/uploads\/Tratamientos-naturales-sialorrea-e1762352516142-200x115.png 200w\" sizes=\"(max-width: 800px) 100vw, 800px\" title=\"Natural treatments Sialorrhea\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4bffbe7 elementor-widget elementor-widget-text-editor\" data-id=\"4bffbe7\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h2>Complications and quality of life in patients with sialorrhea<\/h2><p>Beyond aesthetic or social discomfort, hypersalivation can cause physical, respiratory, and emotional complications that significantly affect the patient&#8217;s daily life. Therefore, treatment should not be limited to reducing saliva production, but also to preventing the consequences of its persistence.<\/p><table><thead><tr><td><p><strong>Type of complication<\/strong><\/p><\/td><td><p><strong>Common manifestations<\/strong><\/p><\/td><td><p><strong>Potential consequences<\/strong><\/p><\/td><td><p><strong>Preventive or therapeutic measures<\/strong><\/p><\/td><\/tr><\/thead><tbody><tr><td><p><strong>Dermatological<\/strong><\/p><\/td><td><p>Irritation, erythema, and maceration of the skin around the mouth and neck<\/p><\/td><td><p>Skin infections, pain or unpleasant odour<\/p><\/td><td><p>Use barrier creams, keep the area dry and ventilated.<\/p><\/td><\/tr><tr><td><p><strong>Respiratory<\/strong><\/p><\/td><td><p>Aspiration of saliva into the airways<\/p><\/td><td><p>Chronic cough, aspiration pneumonia<\/p><\/td><td><p>Postural and swallowing re-education, botulinum toxin, respiratory physiotherapy<\/p><\/td><\/tr><tr><td><p><strong>Oral and digestive<\/strong><\/p><\/td><td><p>Alteration of oral pH, tooth decay, halitosis<\/p><\/td><td><p>Infections, gingivitis, or tooth loss<\/p><\/td><td><p>Enhanced oral hygiene, mild mouthwashes, regular dental check-ups<\/p><\/td><\/tr><tr><td><p><strong>Social and emotional<\/strong><\/p><\/td><td><p>Isolation, anxiety, embarrassment, or difficulty speaking<\/p><\/td><td><p>Decreased self-esteem and emotional well-being<\/p><\/td><td><p>Psychological support, environmental education, comprehensive treatment<\/p><\/td><\/tr><tr><td><p><strong>Nutritional<\/strong><\/p><\/td><td><p>Weight loss or difficulty feeding<\/p><\/td><td><p>Malnutrition in severe cases<\/p><\/td><td><p>Adapted diet and speech therapy assistance during feeding<\/p><\/td><\/tr><\/tbody><\/table>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-37288c5 elementor-widget elementor-widget-image\" data-id=\"37288c5\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"288\" height=\"432\" src=\"https:\/\/platondental.com\/wp-content\/uploads\/Sialorrea-calidad-de-vida.png\" class=\"attachment-large size-large wp-image-13186\" alt=\"Hypersalivation, quality of life\" srcset=\"https:\/\/platondental.com\/wp-content\/uploads\/Sialorrea-calidad-de-vida.png 288w, https:\/\/platondental.com\/wp-content\/uploads\/Sialorrea-calidad-de-vida-200x300.png 200w\" sizes=\"(max-width: 288px) 100vw, 288px\" title=\"Hypersalivation, quality of life\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5c00cca elementor-widget elementor-widget-text-editor\" data-id=\"5c00cca\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h2>Final reflection: how to address excessive salivation holistically<\/h2><p><strong>Sialorrhea<\/strong> is a complex symptom that can affect both the physical health and quality of life of the patient. Although there is not always a definitive cure, <strong>it can be controlled<\/strong> through a multidisciplinary medical approach that combines accurate diagnosis, pharmacological or rehabilitative treatment, and personalised support measures.<\/p><p>The success of the treatment depends on three pillars:<\/p><ol><li><strong>Identify the cause<\/strong> (neurological, pharmacological, postural, or physiological).<\/li><li><strong>Apply the appropriate treatment<\/strong> (from speech therapy to botulinum toxin or selective surgery).<\/li><li><strong>Maintain constant monitoring<\/strong> to adjust interventions according to the patient&#8217;s progress.<\/li><\/ol><p>Patient and carer education is key: understanding the mechanisms that cause excess saliva and knowing how to manage it in daily life reduces complications, improves self-esteem and restores autonomy and well-being.<\/p><p><strong>Clinical conclusion:<\/strong><\/p><p>With proper diagnosis and personalised treatment, most cases of sialorrhea can improve significantly. The key is to <strong>not resign yourself to the symptom<\/strong> and seek specialised medical help as soon as possible.<\/p><table><thead><tr><td><p><strong>Management stage<\/strong><\/p><\/td><td><p><strong>Recommended action<\/strong><\/p><\/td><td><p><strong>Professional involved<\/strong><\/p><\/td><td><p><strong>Clinical objective<\/strong><\/p><\/td><\/tr><\/thead><tbody><tr><td><p><strong>1. Initial assessment<\/strong><\/p><\/td><td><p>Medical history, medication review, and neurological examination<\/p><\/td><td><p>Dentist, neurologist<\/p><\/td><td><p>Determine the root cause<\/p><\/td><\/tr><tr><td><p><strong>2. Functional diagnosis<\/strong><\/p><\/td><td><p>Swallowing assessment, drooling scales, imaging tests<\/p><\/td><td><p>Speech therapist, physiotherapist<\/p><\/td><td><p>Quantify severity<\/p><\/td><\/tr><tr><td><p><strong>3. Medical or rehabilitative treatment<\/strong><\/p><\/td><td><p>Anticholinergics, botulinum toxin, or intensive speech therapy<\/p><\/td><td><p>Specialist doctor, speech therapist<\/p><\/td><td><p>Control secretion and improve coordination<\/p><\/td><\/tr><tr><td><p><strong>4. Monitoring and adjustment<\/strong><\/p><\/td><td><p>Quarterly or half-yearly review of therapeutic effect<\/p><\/td><td><p>Multidisciplinary team<\/p><\/td><td><p>Maintaining results and preventing complications<\/p><\/td><\/tr><tr><td><p><strong>5. Education and support<\/strong><\/p><\/td><td><p>Hygiene tips, habits, and emotional support<\/p><\/td><td><p>Caregivers, psychologist<\/p><\/td><td><p>Promoting adherence and quality of life<\/p><\/td><\/tr><\/tbody><\/table><blockquote><p>A comprehensive approach to sialorrhea combines medicine, rehabilitation, and patient education to achieve sustained control and a more comfortable life.<\/p><\/blockquote>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-73ba26d elementor-widget elementor-widget-text-editor\" data-id=\"73ba26d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h2>Frequently asked questions about excessive salivation<\/h2><p>Below are the most common questions from patients and carers about sialorrhea, along with clear answers based on medical evidence. This format helps to quickly resolve doubts and improves understanding of treatments and their expectations.<\/p><h2>FAQ<\/h2><h3><strong>1. Is there a definitive cure for excessive salivation?<\/strong><\/h3><p>In most cases, sialorrhea can be effectively controlled, although it is not always completely eliminated. Speech therapy, anticholinergic drugs, and botulinum toxin type A can reduce saliva production and improve oral control. In severe or persistent cases, there are surgical options that offer lasting results.<\/p><h3><strong>2. Why does excessive salivation occur in Parkinson&#8217;s disease?<\/strong><\/h3><p>In Parkinson&#8217;s disease, saliva production is not higher than normal, but patients swallow less frequently per minute due to slow movements and muscle rigidity. This causes saliva to accumulate in the mouth and eventually leak out. Treatments aim to stimulate swallowing and reduce secretion.<\/p><h3><strong>3. What role does botulinum toxin play in the treatment of excessive salivation?<\/strong><\/h3><p>Botulinum toxin type A is considered the most effective and safest treatment for neurological hypersalivation. It is injected into the parotid and submandibular salivary glands, temporarily inhibiting the release of acetylcholine, which reduces saliva production for 3 to 6 months.<\/p><h3><strong>4. Can excessive salivation be treated during pregnancy?<\/strong><\/h3><p>Yes. During pregnancy, excessive salivation is usually caused by hormonal and digestive changes and tends to improve after the first trimester. It is recommended to stay well hydrated, chew xylitol gum, and drink mild sage or mint tea, avoiding medication except in severe cases.<\/p><h3><strong>5. What foods or habits worsen excessive salivation?<\/strong><\/h3><p>Acidic, spicy, or highly seasoned foods stimulate the salivary glands and can worsen symptoms. Stress, tobacco, and certain medications such as clozapine or pilocarpine also increase salivary secretion. Controlling these factors helps improve the condition.<\/p><h3><strong>6. How can excessive salivation be reduced naturally?<\/strong><\/h3><p>The most effective natural options are speech therapy (to improve tongue control and swallowing) and orofacial kinesiotaping, which promotes lip closure. Infusions of sage, thyme or mint can complement the treatment, but should never replace medical intervention.<\/p><h3><strong>7. What is the difference between sialorrhea and ptyalism?<\/strong><\/h3><p><strong>Sialorrhea<\/strong> can be caused by either excessive production or poor management of saliva within the mouth. <strong>Ptyalism<\/strong>, on the other hand, involves an actual increase in salivary secretion, without neuromotor alteration. In clinical practice, both terms are used similarly, although they are not identical.<\/p><h3><strong>8. Can excessive salivation cause respiratory infections?<\/strong><\/h3><p>Yes. When saliva accumulates and goes unnoticed in the airways, it can cause chronic coughing, bronchoaspiration, or aspiration pneumonia. It is important to monitor body position and perform swallowing exercises to reduce this risk.<\/p><h3><strong>9. Which specialists treat excessive salivation?<\/strong><\/h3><p>It depends on the cause. Treatment usually involves dentists, neurologists, speech therapists, orofacial physiotherapists, and ENT specialists. The most effective treatment is achieved through a coordinated approach between these specialists.<\/p><h3><strong>10. What happens if hypersalivation is not treated?<\/strong><\/h3><p>If left untreated, hypersalivation can cause skin irritation, halitosis, feeding problems, and social isolation. In severe cases, it also increases the risk of lung infections and malnutrition. It is therefore recommended to see a specialist as soon as symptoms persist for more than two weeks.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e8e850f elementor-widget elementor-widget-html\" data-id=\"e8e850f\" data-element_type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t\t<script type=\"application\/ld+json\">\r\n{\"@context\":\"https:\/\/schema.org\",\"@type\":\"FAQPage\",\"mainEntity\":[{\"@type\":\"Question\",\"name\":\"\u00bfLa sialorrea tiene cura definitiva?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"En la mayor\u00eda de los casos, la sialorrea puede controlarse eficazmente, aunque no siempre se elimina por completo. Los tratamientos logop\u00e9dicos, los f\u00e1rmacos anticolin\u00e9rgicos y la toxina botul\u00ednica tipo A logran reducir la producci\u00f3n de saliva y mejorar el control oral. En casos severos o persistentes, existen opciones quir\u00fargicas que ofrecen resultados duraderos.\"}},{\"@type\":\"Question\",\"name\":\"\u00bfPor qu\u00e9 ocurre la sialorrea en la enfermedad de Parkinson?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"En el Parkinson no se produce m\u00e1s saliva de lo normal, sino que el paciente traga menos veces por minuto debido a la lentitud de los movimientos y la rigidez muscular. Esto hace que la saliva se acumule en la boca y termine saliendo. Los tratamientos buscan estimular la degluci\u00f3n y reducir la secreci\u00f3n.\"}},{\"@type\":\"Question\",\"name\":\"\u00bfQu\u00e9 papel tiene la toxina botul\u00ednica en el tratamiento de la sialorrea?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"La toxina botul\u00ednica tipo A se considera el tratamiento m\u00e1s eficaz y seguro para la sialorrea de origen neurol\u00f3gico. Se inyecta en las gl\u00e1ndulas salivales par\u00f3tidas y submandibulares, inhibiendo temporalmente la liberaci\u00f3n de acetilcolina, lo que reduce la producci\u00f3n de saliva durante 3 a 6 meses.\"}},{\"@type\":\"Question\",\"name\":\"\u00bfSe puede tratar la sialorrea durante el embarazo?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"S\u00ed. En el embarazo, la sialorrea suele deberse a cambios hormonales y digestivos y tiende a mejorar despu\u00e9s del primer trimestre. Se recomienda mantener una buena hidrataci\u00f3n, mascar chicles de xilitol y tomar infusiones suaves de salvia o menta, evitando medicaci\u00f3n salvo casos graves.\"}},{\"@type\":\"Question\",\"name\":\"\u00bfQu\u00e9 alimentos o h\u00e1bitos empeoran la sialorrea?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Los alimentos \u00e1cidos, picantes o muy condimentados estimulan las gl\u00e1ndulas salivales y pueden empeorar los s\u00edntomas. Tambi\u00e9n el estr\u00e9s, el tabaco y ciertos medicamentos como la clozapina o la pilocarpina aumentan la secreci\u00f3n salival. Controlar estos factores ayuda a mejorar el cuadro.\"}},{\"@type\":\"Question\",\"name\":\"\u00bfC\u00f3mo se puede reducir la sialorrea de forma natural?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Las opciones naturales m\u00e1s eficaces son la reeducaci\u00f3n logop\u00e9dica para mejorar el control lingual y la degluci\u00f3n, y el kinesiotape orofacial, que favorece el cierre labial. Las infusiones de salvia, tomillo o menta pueden complementar el tratamiento, pero nunca sustituir la intervenci\u00f3n m\u00e9dica.\"}},{\"@type\":\"Question\",\"name\":\"\u00bfQu\u00e9 diferencia hay entre sialorrea y ptialismo?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"La sialorrea puede deberse tanto a un exceso de producci\u00f3n como a una mala gesti\u00f3n de la saliva dentro de la boca. El ptialismo, en cambio, implica un aumento real de la secreci\u00f3n salival, sin alteraci\u00f3n neuromotora. En la pr\u00e1ctica cl\u00ednica, ambos t\u00e9rminos se usan de forma similar, aunque no son id\u00e9nticos.\"}},{\"@type\":\"Question\",\"name\":\"\u00bfLa sialorrea puede causar infecciones respiratorias?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"S\u00ed. Cuando la saliva se acumula y pasa inadvertida hacia las v\u00edas respiratorias, puede provocar tos cr\u00f3nica, broncoaspiraci\u00f3n o neumon\u00eda por aspiraci\u00f3n. Es importante controlar la posici\u00f3n corporal y realizar ejercicios de degluci\u00f3n para reducir este riesgo.\"}},{\"@type\":\"Question\",\"name\":\"\u00bfQu\u00e9 especialistas tratan la sialorrea?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Depende de la causa. En su manejo suelen intervenir odont\u00f3logos, neur\u00f3logos, logopedas, fisioterapeutas orofaciales y otorrinolaring\u00f3logos. El tratamiento m\u00e1s eficaz se obtiene con un enfoque coordinado entre estos especialistas.\"}},{\"@type\":\"Question\",\"name\":\"\u00bfQu\u00e9 pasa si no se trata la sialorrea?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Si no se trata, la sialorrea puede causar irritaci\u00f3n de la piel, halitosis, problemas de alimentaci\u00f3n y aislamiento social. En casos graves, tambi\u00e9n aumenta el riesgo de infecciones pulmonares y desnutrici\u00f3n. Por eso se recomienda acudir a un especialista en cuanto los s\u00edntomas persistan m\u00e1s de dos semanas.\"}}]}\r\n\u2003<script>\r\n\u2003\r\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>M\u00e1s que est\u00e9tica, la cirug\u00eda maxilofacial restaura la funci\u00f3n, la simetr\u00eda y la armon\u00eda facial, mejorando la salud y la confianza del paciente.<\/p>\n","protected":false},"author":2,"featured_media":13182,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"content-type":"","_joinchat":[],"footnotes":""},"categories":[195],"tags":[],"class_list":["post-13187","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-oral-surgery-2"],"acf":[],"_links":{"self":[{"href":"https:\/\/platondental.com\/en\/wp-json\/wp\/v2\/posts\/13187","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/platondental.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/platondental.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/platondental.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/platondental.com\/en\/wp-json\/wp\/v2\/comments?post=13187"}],"version-history":[{"count":6,"href":"https:\/\/platondental.com\/en\/wp-json\/wp\/v2\/posts\/13187\/revisions"}],"predecessor-version":[{"id":13193,"href":"https:\/\/platondental.com\/en\/wp-json\/wp\/v2\/posts\/13187\/revisions\/13193"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/platondental.com\/en\/wp-json\/wp\/v2\/media\/13182"}],"wp:attachment":[{"href":"https:\/\/platondental.com\/en\/wp-json\/wp\/v2\/media?parent=13187"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/platondental.com\/en\/wp-json\/wp\/v2\/categories?post=13187"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/platondental.com\/en\/wp-json\/wp\/v2\/tags?post=13187"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}