Excess saliva pregnancy

Excess saliva pregnancy

Excessive saliva during pregnancy is also known as ptyalism gravidarum, hypersalivation or sialorrhea gravidarum, is common during the first trimester of pregnancy 1. Excessive saliva during pregnancy is usually associated with nausea and vomiting (emesis or hyperemesis) during the first trimester of pregnancy. You might need to spit out some saliva into a tissue quite often, and the bitter taste of the saliva can cause nausea and vomiting. The good news for most women is that it should ease after the first trimester. In rare cases, the increased salivation associated with hyperemesis (severe nausea and vomiting) does not abate at the end of the first trimester but continues, or even increases in amount, until delivery 2.

Using gum or ice may be temporary coping strategies; however, some pregnant women always complain of bad taste and maintain that swallowing the excessive or thickened saliva perpetuates the sense of nausea 3. Excessive saliva during pregnancy may diminish during sleep, however the patients may complain of excessive secretions as one cause of nocturnal wakening 4. In addition, social encounters may be limited during pregnancy 4.

Excessive saliva during pregnancy causes

As with most things in pregnancy, your hormones are to blame for excessive saliva. It can also be caused by pregnancy sickness, as nausea can make women try to swallow less, especially in those with hyperemesis gravidarum (extreme morning sickness).

Other causes include heartburn, which is common in pregnancy, and irritants like smoke, toxins and some medical conditions.

Some researchers consider that increased saliva during pregnancy (ptyalism gravidarum) has a physiologic, not psychologic origin 1. It is generally agreed that salivary secretion is under neural control and that stimulation of the parasympathetic nerve supply of the salivary gland causes a profuse watery secretion with very little organic content 2.

Excessive saliva during pregnancy treatment

While there is no medical treatment for excessive salivation during pregnancy, you may be able to ease symptoms by:

  • eating smaller but more frequent meals
  • brushing your teeth and using mouthwash several times a day
  • chewing sugarless gum or sucking hard sweets
  • taking frequent, small sips of water.

To date, some medical literature has recommended the use of central nervous system depressants such as barbiturates, anticholinergics such as belladonna alkaloid, or phosphorated carbohydrate 1. In addition, Japanese patients sometimes use alpinia oxyphylla (a medicinal plant in China used for digesting, antidiuresis and/or salivation restraint) for the treatment of excess saliva in early pregnancy; however, individual differences in the effects of alpinia oxyphylla seem to be large. Therefore, there is no satisfactory treatment currently available for this complication during pregnancy.

References
  1. Suzuki S, Igarashi M, Yamashita E, Satomi M. Ptyalism gravidarum. N Am J Med Sci. 2009;1(6):303-304. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3364630
  2. Freeman JJ, Altieri RH, Baptiste HJ, Kao T, Crittenden S, Fogarty K, Moultrie M, Coney E, Kangis K. Evaluation and management of sialorrhea of pregnancy with concominant hyperemesis. J Natl Med Assoc. 1994;86:704–708.
  3. Erick M. Ptyalism gravidarum: an unpleasant reality. (Letter to the editors) J Am Diet Assoc. 1998;98:129.
  4. Van Dinter MC. Ptyalism in pregnant women. J Obstet Gynecol Neonatal Nurs. 1991;20:206–209.
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