Causes of thick saliva in the mouth. How to relieve the condition when saliva is viscous and viscous

Saliva is one of critical components digestive system. It not only moistens food while eating, but also triggers the mechanism of its digestion. In addition, saliva has bactericidal properties that provide reliable protection of the body from various infections.

True, all of the above is relevant only if saliva is produced as much as necessary. But if a person has increased salivation, then this is already becoming a serious problem that needs to be dealt with.

Hypersalivation in adults

The causes of this disease can be very different, but the result is always the same - severe discomfort. The fact is that men and women in the modern world are forced to communicate a lot with other people. Normal communication is impossible if you do not make a good impression on the interlocutor. Increased salivation does not allow you to look good. A sick person is forced to avoid communication with other people. A psychological complex develops when it seems to the patient that everyone around is paying attention to his problem. This is followed by a decrease in self-esteem, and depression sets in.

Increased salivation due to increased work salivary glands. There are 3 pairs of them in the human oral cavity. The main task of these glands is the secretion of saliva in the required volumes. However, if their function is impaired, saliva is produced in excess. It literally floods the oral cavity, because of which the patient is forced constantly spitting or swallowing it. At the same time, he has a completely unattractive appearance. In addition, a person cannot eat normally: there are problems with swallowing.

Increased salivation in medical practice called hypersalivation. This problem in adults is caused by various pathological changes in the body. Often, increased salivation provokes various diseases of the digestive system. Also, drooling may begin to flow profusely after taking certain medicines. The cause of hypersalivation may be excessively hot or spicy food etc. In any case, the problem cannot be dealt with unless the exact source of the disease is identified.

About excessive salivation the following signs show that can't be overlooked:

It is worth noting that increased salivation is of two types: true and false. It's easy enough to tell them apart. In the first case, salivation is really redundant. In the second, saliva production volumes are within the normal range, but since the swallowing mechanism is disturbed in the patient, there is a feeling of excess fluid in the mouth.

Causes of increased salivation

True salivation occurs as a result of the development of various pathologies in the body. internal organs, infectious and neurological diseases. Only an experienced clinician can accurately determine the cause of hypersalivation. On the whole, it is possible highlight the following reasons persistent increased salivation in adults:

Increased salivation in women

All of the above causes of excessive salivation can occur in both men and women. But the latter have one condition which occurs only in them. It's about pregnancy.

body of pregnant women changes greatly. These changes mainly affect the endocrine system. There is a global hormonal changes, which causes hypersalivation in the early stages. We are talking about the first 3 months of pregnancy.

Excessive salivation during pregnancy is not normal. It is a sign early toxicosis. The woman begins to feel severe nausea, sometimes vomiting follows. In such a situation, the likelihood of increased salivation is high.

Sometimes the glands continue to function normally, but the pregnant woman afraid to swallow saliva as it may cause vomiting. In this case, a feeling of hypersalivation is created.

Often, drooling in pregnant women begins to flow strongly due to heartburn. The body tries to put out the "fire" in the esophagus due to more saliva. As you know, it has bicarbonate, which is an alkaline agent.

Also, as a cause of excessive salivation in women, it should be noted diseases thyroid gland . The fact is that pathologies of the thyroid gland are found mainly in women.

Treatment for increased salivation

The basis of the treatment of hypersalivation is the fight against the cause that caused the excess production of saliva. Sometimes it is enough to relieve the irritation of the mucous membranes in the mouth to get the desired result. The same psychotherapy gives excellent results in the treatment of patients with hypersalivation on the background of neuroses.

Also for the treatment of severe salivation the following methods are used:

Conclusion

Hypersalivation can occur at any age. It is not worth waiting for the pathology to disappear by itself. Should be sure to see a doctor to be examined and receive appropriate treatment.

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The human salivary glands work constantly, but the amount of fluid they secrete usually does not exceed 12 mg per hour. From time to time, the level of saliva may increase, for example, as a response of the body to tasty, beautiful or fragrant food. Also, the amount of fluid in the mouth becomes larger when the mucous membrane is irritated - an example of this may be the desire to constantly spit out the accumulated saliva during dental treatment. However constant allocation a large number saliva signals health problems.

Causes of excessive salivation

So, increased salivation or hypersalivation may occur as a result of accumulation in oral cavity a large number of bacteria. That is why profuse salivation often accompanies diseases such as gingivitis, stomatitis or tonsillitis.

The secretion of large amounts of fluid by the salivary glands can also occur with pesticide poisoning or mercury vapor, oversaturation with iodine, or as a side effect of taking certain medications.

The reasons for the strong secretion of saliva can also be deviations in the activity of the central nervous system, violation cerebral circulation, defeat vegetative centers and certain types paralysis. Especially often saliva can be released after a stroke. In some cases, the amount of saliva increases under the condition of toxicosis during pregnancy.

Also, hypersalivation can be a signal for the development of cerebral palsy. That is why it is especially important for parents of young children to pay attention to this symptom and immediately tell the doctor about it.

How to get rid of increased salivation

To recover from hypersalivation, you need to contact a therapist. He will complete medical examination based on specific symptoms. And then he will prescribe a course of treatment or refer him to a specialist of a narrower profile, for example, a neuropathologist or gastroenterologist.

Usually to get rid of increased excretion saliva, the patient is advised to first treat all acute and chronic diseases that can cause hypersalivation. He may be prescribed drugs with an anticholinergic effect, aimed at reducing the amount of saliva. In some cases, surgical treatment is also used.

How to get rid of excess saliva in the mouth?

People who are faced with the problem of hypersalivation are interested in the causes of increased salivation, both in adults and in children.

This not only causes serious discomfort, but also indicates dangerous changes in the body and oral cavity, which must be addressed immediately. In this article, we will tell you about the causes of the problem and what needs to be done in this case.

The salivary glands of adults and children can produce either too much or too little saliva. It happens by different reasons, but there are several main symptoms:

• too much liquid is always felt in the mouth. This happens if the allocation rate is exceeded at least twice;
• due to an unnaturally large amount of secretion in the mouth, there is a constant reflex desire to swallow the accumulated saliva;
• are changing taste sensations mouth, sensitivity to palatability food can be either too strong or not enough.

Why is there a lot of saliva in adults?

There are several reasons why the problem can be associated not only with a disorder of the oral cavity, but also with other dysfunctions of the body.

1. Disorders of the digestive system - hyperacidity in the stomach, disorders of the liver and pancreas, gastrointestinal tract, ulcers and others most often contribute to the appearance of hypersalivation.
2. Pathologies of the thyroid gland are disorders of the hormonal balance in the body.
3. Pregnancy - in women, hypersalivation can occur during this period due to toxicosis. Nausea during pregnancy makes it difficult to swallow saliva, which contributes to its accumulation.
4. Taking medication - for both men and women, the problem can be caused by taking certain medications. medicinal products. In this case, you need to make sure that the cause of the disease is in taking the drug, and reduce its dosage.
5. Inflammatory processes in the oral cavity - with diseases such as tonsillitis or stomatitis (for example, aphthous), the release of secretion will increase significantly, but will be more likely defensive reaction organism.
6. Diseases of the nervous system - cerebral palsy, Parkinson's, lateral sclerosis, neuralgia trigeminal nerve etc.;
7. During sleep can be caused by:

• mouth breathing;
• irregular structure of the dentoalveolar system;
• sleep disturbance.

A person suffering from hypersalivation in sleep usually does not experience its symptoms during the day.

Increased salivation is more a symptom of other, more serious diseases than a single oral problem. It is because of this, if you find the appropriate symptoms in yourself, you need to consult a doctor.

Causes of increased salivation in children

Children are more likely than adults to suffer from hypersalivation, mainly due to the peculiarities of human development in childhood. The main reasons are:

• reflex factor - in children in the first year of life, hypersalivation is not a pathology, it is caused by reflective features and should be perceived as inevitable. Teething in a child often causes elevated compartment saliva, since a serious load falls on the gums and the oral cavity as a whole;
• worms - this is due to the child's habit of pulling dirty objects into his mouth, with helminths, increased salivation will be observed more often at night than during the day;
• infection or disorder gastrointestinal tract in infants - a situation may occur when the secretion is normal, but the saliva is not swallowed by the baby due to disorders with the function of swallowing;
• mental disorders - occurs in older children. In this case, you should immediately contact the pediatrician, who will determine exact reason the occurrence of a symptom and refer you for a consultation with another specialist or prescribe the necessary course of treatment.

Important! If an older child persistent problems with increased salivation, this can cause speech defects, since in this case it is rather difficult for children to pronounce words correctly and quickly.

Hypersalivation during pregnancy

Due to failures in hormonal balance the body of a woman caused by pregnancy may experience hypersalivation, most often its symptoms appear in the first 2-3 months after conception.

Toxicosis in the early stages leads to gag reflexes and frustration swallowing functions. As a result, women during pregnancy can experience not only hypersalivation, but also salivation.

At the same time, it is not at all necessary that the glands began to secrete large quantity saliva, just the process of swallowing is less frequent, respectively, it lingers in the oral cavity.

Video: saliva study

During sleep

Frequent salivation in dark time days can be caused by several factors:

• salivary glands “wake up” earlier than a person - during sleep, their work is much slower, but sometimes they resume their work process long before the moment when a person begins to wake up;
• sleep with open mouth- if a person, for some reason, sleeps with his mouth open, then in a dream he will be prone to hypersalivation. In this case, it is necessary to turn to the ENT, because the problem is most often within his competence, but it is also necessary to consult a dentist, since the mouth may not close due to the incorrect structure of the dentoalveolar system;
• sleep disturbance - if a person sleeps too soundly, then he actually does not control some processes in his body. The human brain is not able to control the release of secretion, as a result of which hypersalivation occurs.

If the facts increased appearance saliva in the oral cavity during sleep is not too frequent, and it is not secreted too abundantly, then there are few reasons for concern.

How to reduce salivation?

Increased salivation, and the discomfort it causes, causes people desire get rid of this problem as soon as possible. Treatment, in turn, depends on the causes of its occurrence.

The process of diagnosing a disease is no less important than the treatment itself. First of all, you need to contact the doctors: it can be a dentist or a therapist. If the problem of hypersalivation is beyond their competence, they can redirect the patient to an ENT or dentist.

1. If the production of a large amount of saliva needs to be stopped, doctors may prescribe drugs to suppress overactive salivary glands (for example, ribal). But if the cause is not specifically in them, but in diseases of other organs or systems, then this will not be the treatment of the disease, but the suppression of its symptoms. You can completely get rid of this problem only after the final elimination of its source.
2. If the salivary glands themselves are the source of the disease, doctors can remove them, but this happens only as a last resort. Most often, a course of treatment is prescribed, for example, cryotherapy, which stimulates the swallowing reflex. Some drugs may be injected into the salivary glands to slow down the secretion.

There are also folk remedies that can be used at home. So, rinsing the mouth with a decoction of chamomile or nettle can temporarily reduce annoying symptoms. But such treatment is in the form of an auxiliary, and in case of serious problems of the body, the methods will be completely ineffective.

• we take viburnum berries and trample them in a mortar;
• pour the mixture with water (approximate proportion: 2 tablespoons of viburnum per 200 ml of water) and let it brew for 4 hours;
• rinse your mouth with a remedy 3-5 times a day.

Additional questions

Increased salivation with angina

With a cold or inflammatory processes in the oral cavity, including tonsillitis, hypersalivation may indeed appear, since during an illness an infection enters the mouth, which inflames the salivary glands. It is necessary to cure the underlying disease, after which the increased salivation, as one of its symptoms, will also disappear.

Before or during menstruation

Enough rare symptom, you can associate it with changes in the hormonal balance of a woman during this period. If the frequency and amount of saliva in the mouth causes discomfort, you should consult a doctor.

Salivation and nausea

Nausea can indeed be the source of this. During toxicosis in pregnant women, for example, the swallowing reflex- a person begins to swallow less often and an excess of saliva in the oral cavity is obtained.

After eating a lot of saliva in the mouth - what to do?

Most likely, the glands react this way to too spicy or sour food. This is not a very threatening phenomenon, but if it causes severe discomfort to you, then you should consult a doctor.

Increased salivation in men and women

Increased salivation, or hypersalivation, is normal during meals. But there are also pathological causes such a symptom that can signal a number of diseases.

Increased salivation - types and causes

The process of salivation is important for a person, and the salivary glands located in the mouth are responsible for it. Saliva production is constant - up to 2-5 ml of this liquid is produced in 5 minutes. In some cases, there is a stronger salivation, sometimes the oral cavity literally overflows. If in a child of 3-6 months (usually no more than one year of age) this is a normal phenomenon, then in adults it is considered a problem. In parallel, other unpleasant symptoms may occur, such as nausea.

Depending on the time of appearance of the cause of hypersalivation (or ptyalism), the following may differ:

Hypersalivation is true and false. In the first case, the abundant secretion of saliva in men and women is associated with an excess of its production, in the second it develops due to a violation of swallowing the liquid. False ptyalism is the norm in children during teething, in an adult it is somehow associated with pathologies of the brain or with problems of the jaw muscles.

Symptoms of increased salivation

Usually the main symptom of an unpleasant phenomenon is the sudden or regular release of copious amounts of saliva into the oral cavity, which leads to a desire to swallow it or spit it out. Sometimes the need for spitting causes a person nervous disorders drives him into depression.

Any amount of saliva in excess of 5 ml in 5-10 minutes is considered pathological.

If the patient has swallowing disorders, which happens with paralysis, after a stroke, and for a number of other reasons, saliva volume may be normal. But at the same time, a person feels its increased production, although there is none. Similar symptoms occur in people with mental disorders, obsessive states.

Since hypersalivation is almost always caused by health problems, it cannot do without other accompanying signs:

• change in taste up to its perversion;
• frequent occurrence of nausea, sometimes vomiting;
• heartburn, belching;

With regular swallowing of saliva, a person may experience liquid stool, because the amount of moisture in feces increases. In severe cases of ptyalism, even during the day, saliva can flow down the cheeks, drip if a person does not control himself. Often, without sufficient care, red spots, abscesses, and wounds may appear on the face.

Causes - diseases of the gastrointestinal tract

Diseases of the digestive tract never run without a trace, unless we are talking about oncological pathology(at an early stage develops without symptoms). But much more often the cause of hypersalivation are widespread diseases:

• acute and chronic gastritis;
• duodenitis;
• erosive gastritis;

An accurate diagnosis can only be made after fibrogastroduodenoscopy, because the symptoms of these diseases are similar. Salivation occurs on an empty stomach, combined with pain, nausea (with an ulcer), immediately after eating, along with heaviness, pain (with gastritis). Duodenitis leads to the same symptoms, but one or two hours after eating.

Also, profuse salivation in men and women often occurs with acute pancreatitis when the pancreas overproduces enzymes. If ptyalism is combined with bitter belching, especially in the morning, it is necessary to check the liver and gallbladder. With a spasm of the esophagus, scars or tumors, swallowing is difficult, so saliva accumulates in the mouth.

Oral diseases

Sore throat and excessive saliva is a sign of a sore throat, especially if pain syndrome aggravated on swallowing. On examination, you can notice a sharp swelling of one or two tonsils, their redness, the appearance of white dots - abscesses. With angina, the temperature necessarily rises, there is a general malaise.

During a sore throat, the body tries to alleviate the pain in the throat by hypersalivation.

Constant salivation is a likely sign of chronic gingivitis, stomatitis, oral candidiasis, periodontitis. In this case, there is inflammation of the gums or other tissues, which causes a similar reaction. You need to get rid of bacteria or fungi in your mouth, and the problem will go away. Foreign bodies can also cause unpleasant symptoms:

• ill-fitting dentures;
• braces;
• implants;
• crowns.

Inflammation of the salivary gland also provokes ptyalism, and the face and neck of the patient may swell, it will be painful to talk.

Nocturnal hypersalivation

If in the morning they mark wet spots on the pillow, this means the appearance of a large amount of saliva at night. A harmless cause can be called hunger - usually in this case, saliva flows closer to the morning, when sleep becomes superficial. If the aroma of food comes from the kitchen, you should not be surprised at this phenomenon. Occasionally, in adults, salivation occurs during especially sound sleep when the body is out of control.

ENT diseases can also be guilty of nocturnal hypersalivation:

• adenoids - in adults they occur only with re-growth or lack of surgery with very large vegetations in childhood;
• serious malocclusion, anomalies of the dentition;
• forced breathing through the mouth against the background of congestion with rhinitis, sinusitis, and other sinusitis.

All these diseases cause the need to breathe through the mouth, so saliva can be produced intensively to prevent the mucous membrane from drying out.

Neurological and endocrine causes

With strong excitement, stress, saliva in many people is produced uncontrollably. The reason is the release of cortisol into the blood - the stress hormone, which in excess can cause a variety of reactions.

After the person calms down, the amount of saliva immediately returns to normal.

In an adult or teenager who has suffered from cerebral palsy (infantile cerebral palsy) since childhood, a serious lesion of the central nervous system often occurs. This causes disturbances in the coordination of movements of the muscles of the face, pharynx. As a result, saliva flows from the mouth, and it seems that there is too much of it. Similar phenomena occur when the vagus nerve is damaged, which occurs with TBI, Parkinson's disease. Hypersalivation is also possible with:

• trigeminal neuritis;
• many mental illnesses;
• senile dementia;
• brain tumors;

Among endocrine problems diseases of the adrenal glands, diabetes mellitus are capable of provoking ptyalism. Sometimes increased salivation in women, along with sweating, occurs in menopause against the background of hormonal changes. In pregnant women, the cause of this phenomenon is toxicosis (then saliva is secreted in excess and nauseated).

Other possible causes

Worms - intestinal, liver and others - cause serious intoxication of the body. The body reacts to such changes in different ways, including the production of more saliva. This is usually combined with a number of other symptoms:

• stomach ache;
• frequent diarrhea;

Among the signs of poisoning the body with chemical agents, heavy metals, pesticides, hypersalivation also occurs. As a harbinger of acute kidney failure in seriously ill patients, uremia, or self-poisoning of the body, often occurs, and this condition is also sometimes combined with abundant production of saliva.

Ptyalism is characteristic of a serious infectious disease - rabies, however, it is very rare. Some drugs when taken give a similar side effect - you should read the instructions carefully.

This effect is different drugs for pressure, cardiac glycosides, alkaloids. In male and female smokers, due to mouth irritation from nicotine, saliva is also produced more strongly to flush harmful substances. After undergoing anesthesia, hypersalivation as a side effect is not uncommon - it disappears on its own in 1-2 days.

How to deal with dry mouth?

Thanks

General information

Causes

Possible causes of dry mouth:
1. Side effect of certain medications . This effect is not uncommon for both prescription and over-the-counter drugs. Dryness can be caused by cold medicines, allergies, antidepressants, painkillers, drugs prescribed for obesity, for the treatment of acne, mental disorders, enuresis, bronchodilators, diarrhea and vomiting. In addition, some sedatives and muscle relaxants have the same effect.
2. A number of infectious diseases, as well as diseases of internal organs including: HIV, diabetes, Parkinson's disease, anemia, stroke, Schergen's syndrome, mumps, hypertension, rheumatoid arthritis, Alzheimer's disease.
3. Side effects for a number of therapeutic methods . Decreased saliva production can be seen after head radiation or chemotherapy for cancer.
4. Violation of innervation . In the course of operations or injuries, the integrity of the nerves of the neck or head may be disturbed.
5. Dehydration . Drying of the mucous membranes can be with dehydration that accompanies fever, diarrhea, vomiting, thermal damage skin, blood loss, increased sweating.
6. Loss of salivary glands due to surgical intervention.
7. Some bad habits such as addiction to nicotine.
8. Mouth breathing .

signs

• strong desire to drink
• feeling of stickiness and dryness in the mouth,
• cracks in the corners of the mouth and on the red border of the lips,
• dry throat,
• the tongue itches, it is hard and red,
• it becomes uncomfortable to speak, it is difficult to swallow,
• decreased taste perception of food,
• voice becomes hoarse
• dry nose,
• throat may hurt
• stench in the mouth.

Effects

In the morning or at night

Dryness and bitterness in the mouth

Violation of the movement of bile through the biliary tract can be with gastritis, duodenitis, cholecystitis, pancreatitis.
Very often, similar symptoms are observed in patients with neurotic disorders, amenorrhea.

Often, dryness and bitterness in the mouth become the first symptoms of cholecystitis and gallstones. In this case, the patient complains at the same time of pain in the right side, which is activated after drinking alcohol or physical work.

violated motor function biliary tract and in diseases of the thyroid gland, so with hyperfunction, the release of adrenaline into the blood increases, which leads to spasm of the smooth muscles of the ducts.

Many diseases of the oral cavity are accompanied by dry mouth and bitterness. Inflammation of the gums can also cause an unpleasant metallic taste, burning of the gums or tongue.

Nausea and dryness occur with Helicobacter pylori gastritis

Most of the symptoms of IBS are related to the gastrointestinal tract, but when digestion is disturbed, the whole body suffers. Prolonged diarrhea provokes dehydration - so the patient feels dry mouth.

The main signs of IBS:

• pain in the epigastrium after eating, which disappears immediately after the excretion of feces,
• diarrhea, more often after eating before lunch,
• belching, sensation of "coma" in the stomach.

Usually the condition worsens after unrest or physical overexertion.

Side effect of taking antibiotics

Dry mouth may occur a few days after the start of the drug and disappear about a week after the end of treatment. Intensity discomfort depends on the following factors:

• drug quality,
• dosage,
• body reactions to the drug,
• duration of therapy
• dosage form.

• take the drug at certain hours, do not miss a dose and do not take it ahead of time, this will help to avoid jumps in the concentration of the drug in the tissues,
• drink only clean water or weak tea
• be sure to take probiotics for the entire course of antibiotic treatment. Many side effects of antibiotics are associated with a violation of the intestinal microflora, including dry mouth, which can be associated with diarrhea and dehydration. The use of probiotics will help to avoid dysbacteriosis,
• follow a diet. For the period of antibiotic treatment, a sparing diet should be observed: eat light food, do not drink alcohol, do not eat fried, fatty foods. Do not drink the drug with food, strictly follow the instructions.

For diabetes

In addition, the following symptoms are observed in diabetes:

• constant thirst
• profuse urination,
• a sharp change in weight in any direction,
• skin itch,
• migraine pain,
• "jams" in the corners of the mouth,
• lethargy.

With pancreatitis

At chronic pancreatitis the body does not absorb many useful substances from food. Lack of vitamins, iron and other microelements leads to the appearance of cracks in the corners of the mouth, dryness of the dermis, dullness of nails and hair. The chair in such patients is usually not formed.

Very often, patients suffer from pain in the left side of the abdomen that appears after eating. But pain may appear even a few hours after eating, especially if the patient's diet consisted of fatty or spicy foods.
Appetite drops, nausea and vomiting, belching, flatulence are often observed.
Dry mouth, weight loss and diarrhea are characteristic of an exacerbation of the chronic form of pancreatitis.
To prevent exacerbations, it is important to choose your diet very carefully.

With menopause

All these unpleasant symptoms are usually not too pronounced, so the vast majority of women get used to them and do not feel sick. However, if a woman has suffered severe stress, serious illness or injury, then menopause can be very painful and it is called in this case climacteric syndrome.

All mucous membranes are dried up: mouth, eyes, throat. Swelling, pain in the joints and heart may be observed. Very often the head hurts, the pain is activated after a bad dream, an emotional outburst.

Majority unpleasant symptoms passes or is facilitated with a balanced diet, physical education, sufficient rest. Fasting days are very useful, which should be done once a week, you can go hungry, but not more than once every 14 days and not longer than one day without a doctor's supervision.

Improve the condition of multivitamins containing complex B, C, A, E. You can drink them for 21 days, after which rest for 21 days and repeat again. Very well normalize the state of the vegetative-vascular system sedatives based on plants: motherwort, valerian. You can drink them completely without danger to health for a month, then take a break for the same period and repeat the treatment. Up to six courses of treatment can be carried out.

With HIV

Many, against the background of this symptom, begin to eat worse, but this should not be allowed - the body must receive enough nutrients. Saliva is necessary for the proper digestion of food, it also prevents the development of caries. With dry mucous membranes, the lips also feel bad - they dry, crack, itch. Dryness of the oral mucosa can be successfully dealt with, including with HIV.

Treatment with home remedies

How to increase saliva production?

• Drink more liquid
• Chewing gum or sucking on candy, but no sugar
• To clean the oral cavity, use fluoride-containing pastes and rinses,
• Eat less salty
• Quit smoking and alcohol
• Control nasal breathing: do not breathe through the mouth,
• In order for the air in the rooms to be sufficiently humid, you can use special humidifiers,
• Exist pharmaceutical preparations saliva substitutes.

Xerostomia (dry mouth) is the subjective complaint of dry mouth. Patients complaining of dry mouth often do not have objective evidence of decreased saliva production (SL) and their symptoms are rather secondary to qualitative and/or quantitative changes in the composition of the SL. Normally, the stimulated flow rate of Cl is 1.5-2.0 ml/min, while the unstimulated flow rate is approximately 0.3-0.4 ml/min. The diagnosis of hyposalivation (little saliva, decreased secretion) is made when the stimulated flow rate is 0.5-0.7 ml/min and the unstimulated flow rate (basal secretion) of saliva is ~0.1 ml/min. Xerostomia in patients with objective hyposalivation is diagnosed when the rate of saliva flow is less than the rate of absorption of fluid through the oral mucosa plus the rate of evaporation of fluid from the oral cavity.

Little saliva, reasons

Chronic xerostomia is a significant burden for many people. In particular, a condition in which there is little saliva affects speech, chewing, swallowing, wearing prostheses. Xerostomia secondary to hyposalivation (little salivation) can lead to rampant dental caries, fungal infections of the oral cavity (eg, candidiasis), changes in taste, bad smell from the mouth, burning sensation in the mouth. The most common cause of low saliva (hyposalivation) is the use of certain drugs (eg, anticoagulants, antidepressants, antihypertensive drugs, glucose-lowering antiretrovirals, levothyroxine, multivitamins, and nutritional supplements, non-steroidal anti-inflammatory drugs and steroid inhalers), radiation therapy to the head and neck, Sjögren's syndrome, depression, anxiety and stress or malnutrition.
The prevalence of xerostomia in the population ranges from 5.5% to 46% and increases with age. Little saliva remains an unresolved common complaint, especially among the elderly population.

Treatment of hyposalivation

Several approaches have been proposed to treat the condition of low saliva, but all of them are aimed at reducing the symptoms of dry mouth and increasing the flow of Cl. Simple available funds- Proper hydration of the body and oral cavity; increase in air humidity at night; avoidance of hard food products; the use of chewing gums without sugar, it is especially useful to chew gum (glue cherries, plums). Useful drugs include mucosal lubricants, Cl substitutes, and Cl secretion stimulants.

Systemic sialogens (stimulators of saliva secretion)

Pilocarpine and cevimelin (evoxac) two systemic drug approved for conditions that feel like there is little saliva in the mouth. Their effect depends on the presence of healthy salivary glands. Pilocarpine stimulates the parasympathetic nervous system. Cevimeline is a salivary gland stimulant with a more pronounced effect than pilocarpine. Both remedies are indicated when the mouth is dry. Pilocarpine is usually used at a dose of 5 mg three times a day for at least 3 months and cevimeline is prescribed at a dose of 30 mg three times a day for up to at least 3 months. Side effects drugs: excessive sweating, vasodilation of the skin, vomiting, nausea, diarrhea, persistent hiccups, bronchospasm, hypotension, bradycardia, increased frequency of urination and vision problems. Both pilocarpine and cevimeline are contraindicated in patients with uncontrolled asthma or chronic lung disease; beta-adrenergic blocker users. The drugs should be used with caution in patients with active peptic ulcer stomach or uncontrolled arterial hypertension. Pilocarpine is contraindicated in people with glaucoma and iritis.

Anethol trithion - choleretic drug, enhances the flow of Cl, improves salivation of the oral cavity.

Help yourself!

• Chew chewing gum without sugar and suck on candywithout sugar to stimulate saliva production.
• Drink water and drinks without sugar frequently throughout the day and with meals.
• Avoid sugary or starchy foods and drinks as they increase the risk of tooth decay.
• Cut down on coffee, tea, caffeinated sodas and alcohol.
• Don't use tobacco.
• If you're low on saliva, avoid salty or spicy foods, which can sting your mouth.
• Use a humidifier to humidify the air.
• Brush your teeth at least twice a day
• Visit the dentist two or three times a year.

When to See a Doctor

• If your mouth is constantly, chronically dry and sticky
• call emergency care if you suddenly have severe problems with swallowing or breathing.

Dry mouth is successfully treated with home remedies and herbal teas.

Hello. I am very much tormented by dryness in my mouth, a low amount of saliva produced, and, accordingly, stones form on my teeth rather quickly. Scares me terribly fat white coating on the tongue, enlarged papillae on the right side of the tongue and dryness. I will describe the situation in order. In January 2016, she cured 2 teeth in the clinic, put in domestic filling material. Of course, I did not appreciate the work of a specialist, I decided a little later to go to a paid clinic to correct the work of the previous doctor. And then everything began to spin, that I forgot about these teeth. January. sore throat. ENT prescribes rinsing with miramistin + tonsilgon tablets, the treatment did not help. February. ENT appoints chlorhexidine rinse + cefatoxime injections for 2 days a course of 7 days (6 days were put down, canceled due to deterioration of health immediately after the injection). The throat continues to hurt + fungi of the genus Candida glabrata 10 to the 4th degree and the golden staff instead of 10 to 3 became 10 to the 6th degree. March - dentist private clinic examining the cavity, he prescribed diflucan 150 mg and recommended that he contact the faculty clinic if the fungus does not go away. The fungus has not disappeared, the dentist of the faculty clinic prescribes rinsing with soda 3 times a day, rinsing until the plaque disappears. I rinsed for 10 days, the tongue cracked, the plaque appeared in the new. After a while, everything began to calm down. tongue became thick. A week later, I went back to the faculty clinic with the result of the seeding, which had been done a few weeks earlier. The dentist prescribed treatment: flucanazole 50 mg for 14 days, treatment of the tongue with iodinol 3 times a day for 14 days, treatment of the tongue with Candida for 14 days. plaque after given treatment began to appear again, but not in such quantities. I again went to the dentist for examination and treatment of teeth, they offered to clean the tartar and recommended rinsing the mouth for 7 days with the President rinse. The rinse aid did not suit me, my tongue ached. The tip burned, the papillae increased, the tongue. The clinic is located in a different area, and with a small child and a “burning” tongue I flew to the clinic, where I was told: “You can put out your fire by rinsing aqueous solution With butter tea tree 5-6 drops for half a glass of water. "The saliva became sticky, frothy, white. I called the doctor. The answer will pass. Nothing has changed. In the attachment of the photo, in the photo the tip is red from the candy, so the tongue would be covered all over with white bloom. In the last smears for flora, staphylococcus 10 grade 3, streptococcus group oralis 10 grade 5, no fungi were found. chronic diseases tonsillitis, pharyngitis, gastritis (I have chronic gastritis, and there has never been such a plaque, the therapist excludes the possibility of this plaque due to gastritis). By the way, at the end of August, the tonsils were sanitized with octinesept and bacteriophane for 5 days. Suffering from dry mouth white saliva, the amount of saliva secreted is low (I dissolve caramel without sugar). If I don’t drink, I don’t eat for 20 minutes, then a plaque appears, especially when I start talking. Blood for sugar handed over - normal. How to determine the cause of the raid? How to increase the amount of saliva produced? How to get rid of foamy saliva? Each doctor directs me to another, I'm tired of running around and looking for reasons. Could it be oral dysbiosis? I ask you to give a conjectural answer and recommendations.

Feeling of dry mouth - xerostomia, hyposalivation (terms more often used to refer to conditions decreased secretion without clear clinical manifestations detected experimentally) - or excess saliva (sialorrhea, hypersalivation) - possible both with a neurogenic violation of secretion (organic or psychogenic nature), and with various somatic diseases. Hypo- and hypersalivation may be permanent or paroxysmal; the severity of disorders, as well as the degree of salivation, normally depends on the functional states of the brain in the sleep-wake cycle. The volume of secretion during sleep is much lower, it also decreases with directed attention. When eating food, saliva production increases as a result of conditioned and unconditioned reflexes. Unconditioned reflexes arise from olfactory, gustatory and tactile receptors. Usually 0.5-2 liters of saliva is produced per day.

Brief physiology of salivation and pathogenesis of its disorders

Participation of sympathetic and parasympathetic innervation in the regulation of salivation is not the same, the leading role belongs to parasympathetic mechanisms. Segmental parasympathetic innervation is represented in the trunk by secretory salivary nuclei. (n.salivate rius sup. et inf.). From the brain stem, parasympathetic fibers come as part of VII and IX glossopharyngeal nerve, synaptically interrupted in the submandibular and ear ganglia, respectively. The submandibular and sublingual salivary glands receive postganglionic fibers from the submandibular ganglion, and parotid glands- from the ear ganglion. Sympathetic postganglionic fibers originate from the superior cervical ganglion and end in the vessels and secretory cells of the submandibular salivary glands only.

The sympathetic and parasympathetic innervation of the salivary glands does not have a reciprocal relationship, i.e., peripheral sympathetic activation does not cause peripheral suppression of secretion. Any suppression of secretion, for example during stress, is mediated by central inhibitory influences by reducing the activation of efferent pathways. Afferent fibers are part of the nerves that innervate the masticatory muscles, and taste fibers. Normally, reflex secretion of saliva is carried out with the predominance of parasympathetic impulses, which causes increased secretion of saliva and vasodilation as part of the secretory process. The mediators in the endings of the parasympathetic nerves are acetylcholine, vasoactive intestinal polypeptide (VIP) and substance P. protein composition saliva by increasing exocytosis from certain cells. Sympathetic fibers terminate mainly in those cells that receive parasympathetic innervation, which provides a synergistic effect. Although some sympathetic fibers regulate vascular tone, it is more dependent on independent central control and is not directly involved in reflex secretory mechanisms.

The reflex activity of the salivary glands can change if any part of the reflex (its afferent, central or efferent part) is disturbed, as well as if the effector organ is damaged.

Insufficient afferentation from the masticatory muscles explains xerostomia in old age and that occurs with a long sparing diet. In severe cases, atrophy of the salivary glands is possible.

Reflex salivation is under the complex control of the higher parts of the brain, the influence of which is realized, in particular, in changes in saliva secretion depending on functional state brain in the sleep-wake cycle. An example of suprasegmental influences on salivary function can also be psychogenic hypo- and hypersalivation, unilateral suppression of secretion in hemispheric tumors, the central effect of antihypertensive drugs, anorexigenic drugs.

Damage to the efferent autonomic pathways explains xerostomia in the syndrome of progressive autonomic failure; similarly, dry mouth is caused by pharmacological denervation with anticholinergics. The defeat of the effector organ, i.e., the salivary glands, is due to dry mouth in Sjögren's syndrome, post-radiation xerostomia. Dry mouth in diabetes mellitus is associated with a decrease in the secretion of the liquid part of saliva due to plasma hyperosmolarity, as well as in connection with polyuria.

Salivation is possible not only with increased secretion of saliva, but also when its normal outflow is disturbed. Thus, discoordination of the oral muscles causes salivation in children with cerebral palsy; subclinical swallowing disorders due to increased tone maximal muscles can lead to sialorrhea in parkinsonism (with this disease, however, another mechanism is also possible - activation of central cholinergic mechanisms); in patients with bulbar syndrome, salivation is caused by a violation reflex act swallowing.

Salivation

Salivation can be both with increased and with normal secretion of the salivary glands; at the same time, depending on the predominant activation of parasympathetic or sympathetic mechanisms, secretion of liquid or thick saliva respectively. The following most well-known forms of salivation can be distinguished.

Psychogenic hypersalivation

Rarely observed. Occurs without apparent reason, while there are no signs of organic damage to the nervous system. Salivation is sometimes dramatic; the patient is forced to carry a jar to collect saliva. What matters is the psychoanamnesis, the features of demonstrativeness in the presentation of the symptom, its combination with other functional neurological manifestations or stigmas.

Medicinal hypersalivation

Majority medicines that affect salivation cause xerotomy of mild or moderate severity. At the same time, some drugs may be accompanied by side effect in the form of salivation. Similar effect described when taking lithium, nitrazepam, an anticonvulsant used to treat various forms of epilepsy. In the latter case, salivation develops as a result of a violation of the reflex function of swallowing. Cancellation or dose reduction of the drug usually eliminates drug hypersalivation.

hypersalivation in parkinsonism

The most common form of hypersalivation, often combined with other autonomic disorders characteristic of parkinsonism (seborrhea, lacrimation), may be one of the early manifestations of the disease. Sialorrhoea in parkinsonism is most pronounced at night and in the supine position. As a rule, taking antiparkinsonian drugs (especially anticholinergics) reduces salivation.

Salivation in bulbar and pseudobulbar syndrome

With bulbar and pseudobulbar syndrome various etiologies(tumors, syringobulbia, poliomyelitis, vascular pathology, degenerative diseases) salivation may occur, the degree of which depends on the severity bulbar disorders. Salivation can be profuse (up to 600-900 ml/day); saliva is thick. Patients are forced to keep a handkerchief or towel at their mouths. Most authors explain sialorrhea as a violation of the reflex act of swallowing, as a result of which saliva accumulates in the oral cavity, although irritation of the boulevard center of salivation is also possible.

Salivation in patients with cerebral palsy

Associated with oral muscle discoordination and difficulty swallowing saliva; often it significantly complicates the life of patients.

Hypersalivation in somatic pathology

Increased secretion of saliva is observed with ulcerative stomatitis, helminthic invasion, toxicosis of pregnant women.

Xerostomia, or dry mouth

Xerostomia in Sjögren's syndrome

A pronounced constant dry mouth is one of the main manifestations of Sjögren's syndrome ("dry syndrome"). The disease refers to systemic autoimmune suffering, it is observed more often in women over 40 years of age. The parotid salivary glands periodically swell. In this case, xerostomia is combined with xerophthalmia, dryness of the mucous membrane of the nose, stomach and other mucous membranes, articular syndrome, changes in reactivity.

Drug xerostomia

Medication is the most common cause of salivary gland hypofunction. More than 400 drugs (anorexants, anticholinergics, antidepressants, sedatives and hypnotics, antihistamines, antihypertensives, diuretics, etc.) can cause a similar effect. Usually, mild or moderate dryness occurs in the mouth - depending on the dose, duration and mode of administration of the drug. The hypofunction of the salivary glands is reversible.

Post-radiation xerostomia

It is observed after irradiation of the salivary glands during radiation therapy of head tumors.

Psychogenic xerostomia

Transient feeling of dry mouth when agitated, stressful situations. Usually observed in anxious, emotionally labile individuals.

Dry mouth has also been described in depressive states(while dryness is not associated with taking medications).

Xerostomia in acute transient total dysautonomia

In 1970, a selective lesion of vegetative (sympathetic and parasympathetic) fibers of an infectious-aplergic nature was described for the first time, followed by recovery. Parasympathetic dysfunction, in addition to xerostomia, is manifested by a decrease in the secretion of tears, lack of pupillary response to light, a decrease in the activity of the gastrointestinal tract, detrusor Bladder, which leads to its insufficient emptying, etc. Sympathetic dysfunction is manifested by insufficient dilation of the pupils in the dark, orthostatic hypotension with fainting, fixed heart rate, lack of sweating, etc.

Xerostomia with glossodynia

Salivation disorders are observed in 80% of patients with glossodynia; most often these disorders are represented by hyposalivation, which may be the first manifestation of the disease (before the development of algic phenomena). Dry mouth is more common at night.

Xerostomia due to congenital absence of salivary glands

Congenital absence of salivary glands is a rare pathology, which is sometimes combined with a decrease in the production of tears.

Xerostomia with limited chewing

Insufficient salivation and a feeling of dry mouth may develop in individuals who are on a diet and consume only pureed and liquid foods, for example, after maxillofacial operations, in individuals old age. With prolonged adherence to such a diet, atrophy of the salivary glands is possible.

xerostomia in diabetes

Dry mouth may be one of the first manifestations of the disease; at the same time thirst arises, increased appetite, polyuria and other manifestations of diabetes mellitus.

Xerostomia in diseases of the gastrointestinal tract

Hyposalivation may occur with chronic gastritis, hepatocholecystitis.

Hyposalivation in some focal brain lesions

Salivary secretion in hemispheric tumors and brain abscesses decreases on the side of the focus, and in subtentorial tumors, bilateral inhibition of secretion is noted, more pronounced on the side of the tumor. The most pronounced inhibition of secretion was observed in patients in serious condition, apparently due to the influence of the tumor on the brainstem. Complete inhibition of secretion is an extremely unfavorable prognostic sign. However, it should be remembered that the experimentally detected decrease in saliva secretion in clinical picture occupies a very modest place against the background of gross neurological defects.

Treatment of salivation disorders

The choice of therapy for hypersalivation and its effect largely depend on the form of hypersalivation.

Drug hypersalivation usually requires only the abolition or reduction of the dose of the drug.

With psychogenic hypersalivation, pharmacological agents are used (tranquilizers, antidepressants - amitriptyline is preferable, since it has anticholinergic activity), various forms psychotherapy, in particular, improvement with hypnotherapy has been described.

Salivation in parkinsonism usually decreases markedly against the background of antiparkinsonian therapy (especially when using anticholinergics at doses usual for this disease), but sometimes difficult to treat.

To correct salivation in children cerebral palsy created special programs for teaching children. In severe cases, surgical treatment is indicated. Various ways Surgical treatment includes removal of the salivary glands, dosing of the ducts, their transposition, various procedures for denervation of the salivary glands.

Treatment of xerostomia can be directed:

1. to eliminate the cause of hypofunction of the salivary glands (treatment of the underlying disease in Sjögren's syndrome; dose reduction, changing the regimen of taking drugs or canceling them; insulin therapy for diabetes mellitus; diet expansion, exercises involving masticatory muscles with deafferent xerostomia);
2. to stimulate the function of the salivary glands: pilocarpine (capsules 5 mg 1 time per day sublingually: at this dosage there are no noticeable effects on blood pressure and heart rate); a nicotinic acid(0.05-0.1 g 3 times a day), vitamin A (50,000-100,000 IU / day), potassium iodide (0.5-1 g 3 times a day in the form of a mixture);
3. to change the consistency of saliva: bromhexine (1 tablet 3-4 times a day).

As replacement therapy use: various formulations of artificial saliva when other forms of treatment are ineffective (mainly for Sjögren's syndrome, severe forms postradiation xerostomia).