Sialorrhea may have a significant negative impact on quality of life for both the patient and caregiver. The psychosocial complications include isolation, barriers to education (such as an inability to share books or computer keyboards), increased dependency and level of care, damage to electronic devices, decreased self-esteem, and difficult social interaction. People with drooling are also at increased risk for aspiration of saliva, food, or fluids into lungs, particularly when the normal reflex mechanisms such as gagging or coughing are impaired. Physical complications include maceration of the skin around the mouth with secondary infection, bad odor, dehydration, speech disturbance, and interference with feeding. Whatever the cause is, drooling is bothersome, resulting in physical and psychosocial complications. In adults, the most common cause of sialorrhea is PD with a rate of 70–80%. In children, the most common cause of sialorrhea is CP, which persists in 10–38% of these patients. Pathologic sialorrhea may develop due to hypersalivation, together with numerous neurologic disorders including cerebral palsy (CP), Parkinson’s disease (PD), and amyotrophic lateral sclerosis (ALS), or as an adverse effect of medications. Sialorrhea after 4 years of age is generally considered pathologic. Drooling is common in normally developed babies but subsides between the ages 15 and 36 months with the establishment of salivary continence. The underlying etiology is the excessive production of saliva or inability to retain saliva within the mouth due to reduced neuromuscular control of the tongue, oral tissues, and impairment in the swallowing mechanism, all of which are necessary to move saliva from the oral cavity to the oropharynx and beyond. Anterior sialorrhea results in salivary incontinence or involuntary spillage of saliva over the lower lip, known as drooling. Posterior sialorrhea is the flowing of saliva from the tongue to the pharynx. Sialorrhea can be classified as anterior and posterior both can occur separately or simultaneously. Sialorrhea, also known as hypersalivation or ptyalism, is excessive salivation associated with neurological disorders or localized anatomical abnormalities in the oral cavity.
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