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Saliva is a clear liquid produced by several glands in the mouth. It is essential for lubricating food, aiding digestion, and maintaining oral health. The human body produces up to 1.5 litres of saliva daily, and this process is regulated by the parasympathetic and sympathetic nervous systems. While salivation is a natural and necessary bodily function, excessive salivation, or hypersalivation, can lead to drooling, which may be a symptom of an underlying medical condition or the result of certain medications. In this context, the question of whether salivation involves muscle action arises, particularly concerning the role of muscle control in managing drooling.
| Characteristics | Values |
|---|---|
| Saliva production | 1.5 litres of saliva is produced by the human body every day |
| Saliva composition | Saliva is mostly made of water but also contains substances that aid digestion and protect the teeth |
| Saliva stimulation | Chewing, sucking on candy or cough drops, and the presence of food stimulate saliva production |
| Saliva regulation | The parasympathetic and sympathetic nervous systems regulate saliva production |
| Excessive salivation | Hypersalivation, sialorrhea, or drooling can be caused by certain diseases, medications, or dietary factors |
| Excessive salivation treatment | Anticholinergic medications, botulinum toxin injections, surgery, or radiation may be used to reduce saliva production |
| Poor muscle control | Conditions affecting muscle control, such as cerebral palsy or Parkinson's disease, can lead to drooling due to difficulty swallowing |
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What You'll Learn
Saliva is produced by salivary glands in the mouth
Saliva is a clear liquid produced by the salivary glands in the mouth. It is mostly made of water but also contains other important substances that aid digestion and keep the teeth strong. The human body produces up to 1.5 litres of saliva every day, with the highest production typically occurring in the late afternoon and the lowest at night.
The salivary glands are located inside each cheek, at the bottom of the mouth, and near the front teeth by the jawbone. There are six major salivary glands and hundreds of minor ones. The major glands include the parotid, submandibular, and sublingual glands, which produce approximately 70%, 20% to 30%, and 5% of saliva, respectively. The remaining saliva is produced by the minor salivary glands located on the palate, buccal mucosa, and tongue.
The production of saliva is regulated by the parasympathetic and sympathetic nervous systems. Increased parasympathetic stimulation, through the facial and glossopharyngeal nerves, leads to increased salivation. This occurs particularly in the presence of food. On the other hand, sympathetic stimulation results in the release of noradrenaline, which has a less significant impact on saliva production.
Saliva plays a crucial role in oral health. It helps clear food particles from the teeth, reducing the risk of cavities and protecting against tooth decay. Additionally, saliva lubricates food, aiding in digestion. A lack of saliva can lead to dry mouth (xerostomia), causing swollen and uncomfortable mouth tissues and creating an environment where germs thrive, leading to bad breath and an increased risk of gum disease.
Excessive salivation, or hypersalivation, can lead to drooling, which can be socially embarrassing and, in some cases, cause serious medical complications such as choking or pneumonia. Drooling is commonly observed in individuals with neurological impairments, such as cerebral palsy or Parkinson's disease, due to weak muscles around the mouth or difficulty swallowing. Treatment for excessive salivation may include prescription medications that reduce saliva production, oral motor therapy, surgery, or radiotherapy.
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The parasympathetic nervous system controls the secretion of saliva
Salivation, or the secretion of saliva, is a complex process involving multiple parts of the human body. The human body produces around 1.5 litres of saliva every day, and this plays a vital role in lubricating food, aiding digestion, and maintaining oral hygiene. The production and composition of saliva are under neural control, with the parasympathetic nervous system playing a key role in its regulation.
The parasympathetic nervous system is one of two parts of the autonomic nervous system, which is a subsystem of the peripheral nervous system. This system is comprised of nerves that connect directly to the brain, with four of the twelve cranial nerves being part of the parasympathetic nervous system. These nerves are connected to the eyes, nose, mouth, and other vital internal organs. The vagus nerve, for example, makes up about 75% of the parasympathetic nervous system and connects to the heart, lungs, and abdomen, in addition to the mouth.
In the context of salivation, the parasympathetic nervous system stimulates the production of saliva when food is present in the mouth. This stimulation results in the release of acetylcholine (ACh) onto M3 muscarinic receptors, leading to an increased flow of saliva. This process is coordinated via centres in the medulla and occurs through the facial and glossopharyngeal nerves.
While the parasympathetic nervous system increases salivation, it is important to note that the sympathetic nervous system also plays a role in salivary production. The sympathetic control of salivary production is mediated through the superior cervical ganglion, resulting in the release of noradrenaline. However, the parasympathetic system is considered more important in regulating saliva production overall.
Excessive salivation, or sialorrhea, can occur due to a lack of swallowing or increased secretion of saliva. In cases of sialorrhea, anticholinergic medication can be used to reduce saliva secretion. Additionally, botulinum toxin injections or surgical interventions may be considered as alternative treatments.
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Drooling is a symptom of excess salivation
Drooling, or excess salivation, is when saliva unintentionally flows out of the mouth. This can be caused by either an excess of saliva or weak muscles around the mouth.
Excess salivation typically occurs due to neuromuscular dysfunction, such as cerebral palsy, Parkinson's disease, or Motor Neurone Disease. It can also be caused by certain medications, such as anti-cholinesterases, which are used in the treatment of Alzheimer's disease and myasthenia gravis. In addition, sleeping position can be a factor, as those who sleep on their side or stomach are more likely to drool. Drooling is also common in newborns and babies up to two years old, with excess saliva production typically peaking around three to six months of age and during teething.
There are two main types of sialorrhea, or excess salivation: anterior and posterior. Anterior sialorrhea occurs when there is excessive anterior or forward spillage of saliva from the mouth, resulting in saliva flowing onto the face and clothes. This can cause difficulties with cleanliness, skin care, and socialization. Posterior sialorrhea, on the other hand, involves excessive posterior spillage of saliva down the trachea, rather than being swallowed normally. This can lead to chronic lung irritation called aspiration which can sometimes progress to pneumonia.
Treatment for drooling is not always necessary, but severe cases may require intervention. Lifestyle strategies such as sucking on hard candy or chewing gum can help activate the jaw and automatic swallowing reflex, providing temporary relief. Physical therapy can also be beneficial for strengthening and developing the muscles around the mouth. In more severe cases, anticholinergic medications, such as glycopyrrolate, can be used to reduce saliva production. Botulinum toxin injections, such as Botox, are another option for reducing the flow of saliva from the salivary glands. In children, a procedure called salivary gland ablation has been developed to treat sialorrhea, as operative interventions can be risky and may not completely eliminate the condition.
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Anticholinergic medication can reduce salivation
Salivation is a muscle action that can be controlled by the brain. Drooling, or excess salivation, can be caused by neuromuscular dysfunction, such as cerebral palsy, Parkinson's disease, or Motor Neurone Disease. Anticholinergic medication can be used to reduce salivation in such cases. Anticholinergics inhibit activation at muscarinic receptors, thereby decreasing the volume of drooling. Anticholinergic drugs are also used to treat hypersalivation caused by the use of antipsychotics or neuroleptics.
Anticholinergic medication can be administered orally or through injections. Oral anticholinergic medications include trihexyphenidyl, benztropine, and hyoscyamine, which can ease involuntary muscle movements and tremors. Glycopyrrolate, which is also available as an oral medication, has been found to reduce drooling with fewer side effects compared to other anticholinergics. Anticholinergic medication is also given as 1-2 drops under the tongue per day to dry the mouth.
Botulinum toxin injections are another option for treating excess salivation and drooling. These injections cause partial or complete muscle paralysis by inhibiting the release of acetylcholine at the neuromuscular synaptic end plate. IncobotulinumtoxinA and rimabotulinumtoxinB have been approved by the FDA for the treatment of chronic sialorrhea in adults. Botulinum toxin injections can also be administered to the salivary glands in the cheek and jaw area to decrease saliva production.
While anticholinergic medication can be effective in reducing salivation, it is important to consider potential side effects. At tolerable doses, drooling may not completely cease, and side effects such as dry mouth, difficulty swallowing, and muscle weakness may occur. In some cases, anticholinergic medication may need to be discontinued due to these side effects. Additionally, the use of anticholinergics to treat hypersalivation caused by antipsychotics or neuroleptics requires further research to guide clinical practice.
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Salivation is stimulated by chewing and sucking
Salivation, or the production of saliva, is primarily stimulated by the parasympathetic nervous system, with the parasympathetic outflow coordinated via centres in the medulla and innervation occurring via the facial and glossopharyngeal nerves. The presence of food prompts parasympathetic stimulation, which results in the release of acetylcholine onto M3 muscarinic receptors, increasing the flow of saliva.
Chewing and sucking are therefore key stimulators of salivation, as they indicate the presence of food. Chewing gum or sucking on candy, for example, can help to clear saliva and provide temporary relief from drooling. This is because chewing and sucking activate the jaw and the automatic swallowing reflex.
The act of chewing and sucking is particularly important for people with certain medical conditions, such as Parkinson's disease, who may experience drooling due to swallowing issues. In such cases, sucking on hard candy or chewing gum can help to manage this symptom. Anticholinergic medications, which reduce saliva production, may also be used to treat excessive drooling in such cases, although they can have undesirable side effects.
The importance of saliva for oral functions cannot be overstated. Saliva is a lubricating agent, smoothing the passage of food through the mouth and reducing damage to the oral mucosa. It also plays a role in digestion, containing amylase and lingual lipase, which break down starch and lipid molecules, respectively. Additionally, saliva helps to clean the mouth of food particles and stimulates the taste buds.
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Frequently asked questions
Salivation is the production of saliva, a clear liquid made by several glands in the mouth area. Saliva is essential for lubricating food, digestion, and protecting oral health.
Excessive salivation, or drooling, can be caused by several factors, including:
- Increased saliva production, which may be stimulated by the presence of food or certain medications.
- Impairment of swallowing, often due to neuromuscular dysfunction or neurological conditions such as Parkinson's disease or cerebral palsy.
- Diets high in acidic content.
- Certain medical conditions, such as amyotrophic lateral sclerosis (ALS) or stroke, which can cause muscle weakness around the mouth.
The treatment for excessive salivation depends on the underlying cause. Some common treatments include:
- Lifestyle changes, such as sucking on hard candy or chewing gum to stimulate the swallowing reflex.
- Prescription medications, such as glycopyrrolate, that reduce saliva production.
- Botulinum toxin injections, such as Botox, that decrease saliva production by tightening facial muscles.
- In severe cases, surgery may be considered to reroute the salivary ducts or remove the salivary glands.
Decreased salivation, or dry mouth (xerostomia), can be caused by various factors, including:
- Aging.
- Certain diseases, especially systemic disorders.
- Poor nutrition.
- Use of certain medications.
