Editing Drooling

{{Short description|Unintentional loss of saliva from the mouth}}
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{{Infobox medical condition (new)
| name = Drooling
| synonyms = Salivation, driveling, dribbling, slobbering, sialorrhea
| image = 2008-08-12 White German Shepherd drooling in the sun.jpg
| alt = A white German Shepherd drooling
| caption = A dog drooling
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'''Drooling''', or '''slobbering''', is the flow of [[saliva]] outside the [[mouth]]. Drooling can be caused by [[hypersalivation|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]].<ref>[https://www.kutekeiki.com/teething/baby-teething-symptoms-signs/ Common Baby Teething Symptoms & Signs] Kute Keiki. Retrieved on 2019-12-05</ref> It is unlikely to be a sign of disease or complications. Drooling in infants and young children may be exacerbated by [[upper respiratory infection]]s 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 [[gag reflex|gagging]] and [[cough]]ing) are not impaired, this is not life-threatening.

== Causes ==
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. [[Sigmund Freud|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.<ref>{{cite journal |author1=Almeida, Cristiana |author2=Almeida, Isabel |author3=Vasconcelos, Carlos |year=2015 |title=Quality of life in systemic sclerosis |journal=Autoimmunity Reviews |volume=14 |issue=12 |pages=1087–1096 |doi=10.1016/j.autrev.2015.07.012|pmid=26212726 }}</ref>

A ''sudden'' onset of drooling may indicate [[poison]]ing – especially by [[pesticide]]s or [[Mercury (element)|mercury]] – or reaction to [[snake]] or [[insect]] [[venom (poison)|venom]]. Excess [[capsaicin]] can cause drooling as well, an example being the ingestion of particularly high [[Scoville Unit]] chili peppers. Some neurological problems cause drooling. Medication can cause drooling, either due to primary action or side-effects; for example the pain-relief medication [[Orajel]] can numb the mucosa.{{citation needed|date=December 2021}}

Causes include:
* [[exercise]], especially [[cardiovascular exercise]]{{citation needed|date=April 2014}}
* [[stroke]] and other neurological pathologies
* [[intellectual disability]]
* [[adenoid hypertrophy]]
* [[cerebral palsy]]<ref>{{cite journal |url=http://ajot.aota.org/article.aspx?articleid=1880049 |title=The relationship between oral sensation and drooling in persons with cerebral palsy |journal=American Journal of Occupational Therapy |volume=43 |issue=3 |pages=155–161 |access-date=2013-10-02|doi=10.5014/ajot.43.3.155 |year=1989 |last1=Weiss-Lambrou |first1=R. |last2=Tetreault |first2=S. |last3=Dudley |first3=J. |pmid=2735376 |doi-access=free |url-access=subscription }}</ref>
* [[amyotrophic lateral sclerosis]]
* [[tumors]] of the upper aerodigestive tract
* [[Parkinson's disease]]<ref>{{cite journal |title=Prevalence and definition of drooling in Parkinson's disease: A systematic review | doi=10.1007/s00415-009-5098-2| pmid=19288042|volume=256 |issue = 9|journal=Journal of Neurology |pages=1391–1396 |author=Kalf, J.G. |pmc=2733191|year = 2009}}</ref>
* [[rabies]]
* [[mercury poisoning]]

Drooling associated with [[fever]] or trouble swallowing may be a sign of an infectious disease including:
* [[retropharyngeal abscess]]
* [[peritonsillar abscess]]
* [[tonsilitis]]
* [[EBV infectious mononucleosis|mononucleosis]]
* [[strep throat]]
* obstructive diseases ([[tumor]]s, [[stenosis]])
* inability to swallow due to neurodegenerative diseases ([[amyotrophic lateral sclerosis]])
<!-- Another form of ptyalism is associated with pregnancy, most common in women with a condition known as '''Hyperemesis Gravidarium''', or uncontrollable and frequent nausea and vomiting during pregnancy which is far worse than typical "[[morning sickness]]". With Hyperemesis, ptyalism is a side-effect, which is a natural response to uncontrollable vomiting. With normal vomiting, salivary glands are stimulated to lubricate the oesophagus and mouth to aid in expelling of stomach contents. During a hyperemetic pregnancy, many woman complain of excessive saliva and an inability to swallow this saliva. Some women note having to carry around a "spitoon" or using a cup to spit. Swallowing their own saliva has been noted to gag and further nauseate the women making the hyperemesis that much worse. There are several theories as to the causes of hyperemesis and related symptoms such as ptyalism. Although hyperemesis was once considered a psychological disease, the medical community now considers hyperemesis as a real and serious physiological condition. Some pregnant women who are affected end up terminating the pregnancy.  Others refuse to carry another child. The most frequent act is preparing for the onset of hyperemesis if a subsequent pregnancy is expected. -->

==Treatment==
A comprehensive treatment plan depends on the cause and incorporates several stages of care: Correction of reversible causes, [[behavior modification]], medical treatment, and surgical procedures.{{citation needed|date=December 2021}}

[[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.<ref name="Laryngoscope">{{cite journal |title=Reduction of salivary flow with botulinum toxin: Extended report on 33&nbsp;patients with drooling, salivary fistulas, and sialadenitis |doi=10.1097/00005537-200410000-00033 |pmid=15454785 |volume=114 |issue = 10|journal=The Laryngoscope |pages=1856–1860 |author=Ellies Maik|year = 2004|s2cid=8507758 }}</ref><ref name="Neurology">{{cite journal |url=http://www.neurology.org/content/61/9/1279.short |title=A randomized trial of botulinum toxin A for treatment of drooling |journal=Neurology |volume=61 |issue=9 |pages=1279–1281 |access-date=2013-10-02|doi=10.1212/WNL.61.9.1279 |year=2003 |last1=Lipp |first1=A. |last2=Trottenberg |first2=T. |last3=Schink |first3=T. |last4=Kupsch |first4=A. |last5=Arnold |first5=G. |pmid=14610139 |s2cid=42377134 |url-access=subscription }}</ref><ref name="jamanetwork">{{cite journal|url=http://archpedi.jamanetwork.com/article.aspx?articleid=352611|title=Treatment of Sialorrhea With GlycopyrrolateA Double-blind, Dose-Ranging Study |journal=Archives of Pediatrics & Adolescent Medicine |volume=154 |issue=12 |pages=1214–8 |access-date=2013-10-02|doi=10.1001/archpedi.154.12.1214 |year=2000 |last1=Mier |first1=Richard J. |last2=Bachrach |first2=Steven J. |last3=Lakin |first3=Ryan C. |last4=Barker |first4=Tara |last5=Childs |first5=Judith |last6=Moran |first6=Maria |pmid=11115305 |doi-access=free |url-access=subscription }}</ref>

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 (surgery)|resection]] of salivary glands.{{citation needed|date=December 2021}}

==Popular culture==
The scope of the meaning of the term ''drool'' in popular use has expanded to include any occasion wherein someone highly desires something.<ref>{{Cite web|title=Definition of DROOL|url=https://www.merriam-webster.com/dictionary/drool|access-date=2020-06-13|website=www.merriam-webster.com|language=en}}</ref><ref>{{Cite web|title=DROOL {{!}} meaning in the Cambridge English Dictionary|url=https://dictionary.cambridge.org/dictionary/english/drool|access-date=2020-06-13|website=dictionary.cambridge.org|language=en}}</ref>

==See also==
* [[Slobbers]]
* [[Salivary microbiome]]

==References==
{{Reflist}}

== External links ==
{{Medical resources
| ICD10          = {{ICD10|K|11|7|k|00}}
| ICD9           = {{ICD9|527.7}}
| ICDO           =
| OMIM           =
| MedlinePlus    = 003048
| eMedicineSubj  = 
| eMedicineTopic = 
| DiseasesDB     = 20764
| MeshID         = D012798
}}
{{Wiktionary|drool}}
* [https://www.nlm.nih.gov/medlineplus/ency/article/003048.htm NIH site on drooling]

{{Oral pathology}}

[[Category:Ethology]]
[[Category:Diseases of oral cavity, salivary glands and jaws]]
[[Category:Symptoms]]
[[Category:Excretion]]
[[Category:Saliva]]