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Excessive salivation during pregnancy is common, especially at the early stages. You may salivate more and, at times, even drool when pregnant. Hypersalivation is also known by other medical terms such as ptyalism gravidarum and sialorrhea (1).
The condition may occur along with nausea and vomiting. Read this post as we tell you whether or not it is normal for pregnant women to salivate more and how to manage the condition with or without medications.
Increased Salivation In Pregnancy: Is It Common?
Excess salivation is common during the first stage of pregnancy, although it reduces as the months pass by. However, if you have nausea, it may continue in the second trimester as well, and sometimes lasts until the delivery.
An average person produces around 60 ounces of saliva in a day (2). When pregnant, this amount goes up. You may notice the change if you are salivating more than usual or have difficulty swallowing the saliva because of vomiting and nausea during pregnancy. Either way, it is normal.
Quick factWhen In Pregnancy Does Hypersalivation Usually Start?
Increased saliva production begins in the first trimester of pregnancy, usually in the second or third week (1). For some women, it reduces by the beginning of the second trimester. But for others, the condition persists throughout their pregnancy and disappears after childbirth or delivery.
The graph below presents the typical onset and resolution time of Ptyalism gravidarum symptoms in pregnant women. According to the data, the symptoms began to appear during gestational weeks 4 or 5-6 in 37% of the pregnancies. In 55% of pregnancies, symptoms manifested at week 8, and in 8% of cases, they occurred at week 13.
Regarding resolution time, 20% of the women experienced symptom relief at 20-21 weeks gestation, 14% shortly before delivery, and 53% immediately after giving birth.
Appearance and resolution of Ptyalism gravidarum symptoms in pregnant women
Source: Characteristics and Outcomes of Ptyalism GravidarumThe origin or exact cause of excessive salivation during pregnancy is unknown, although it is most likely due to the hormonal changes. In any case, there is absolutely no need to worry about this condition.
Research findsCauses Of Hypersalivation In Pregnancy
Some of the causes that might lead to excessive saliva during pregnancy are:
- Nausea: This is a common symptom that you will experience in the first few weeks of pregnancy. Nausea may prevent you from swallowing, leading to an excessive build-up of the saliva. Morning sickness that is severe and lasting longer than usual is called hyperemesis gravidarum (3) (4).
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- Medications: One of the side effects of certain medicines is the excessive production of saliva. AnticonvulsantsiDrugs used to treat or prevent seizures or convulsions by controlling abnormal activity in the brain. , tranquilizers, and anticholinergic medicinesiDrugs that block and inhibit the activity of the ACh neurotransmitter at the central and peripheral nervous system. intervene with the functioning of the salivary glands and block parasympathetic innervationiResponsible for the simulation of rest-and-digest activities that occur when the body is at rest. , resulting in more saliva production (5).
- Heartburn: Acid reflux or heartburn is a condition when the valve between the stomach and the esophagus opens, allowing the stomach acid to move into the esophagus. When it occurs during pregnancy, women experience throat irritation or a burning sensation in the chest. The acid activates the salivary glands, which increases the production of saliva (6). Even if you have certain allergies, you may experience ptyalism (7).
- Hormonal changes: Excessive saliva is produced more during early pregnancy and the third trimester. Doctors say it could be due to hormonal changes, but there is no proper scientific evidence to prove it.
- Oral infection: Optimal dental health is essential for pregnant women. But healthy pregnant women can also have oral cavity problems that might increase the risks of oral infection. This may lead to ptyalism, too (8).
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- Irritants or chemicals: Exposure to certain toxins and chemicals could be responsible for ptyalism during pregnancy. Also, certain medications for oral infections or any vulnerability to pesticides could result in increased salivation. This usually occurs when mercury is present in the medications/substances you are exposed to (9).
- Maternal anxiety: Pregnancy is a time when women experience physical discomfort, mental anxiety, and stress. They tend to swallow less saliva when they are anxious, and this feels like excess saliva is being produced (10).
- Gag reflex: This reflex occurs in the back of the throat to prevent swallowing something foreign. Drooling or hypersalivation can be caused if a person has some problems with reflexes like gagging or coughing.
- Sleep deprivation: Excess salivation or drooling is more likely to happen when you are sleeping as you are not conscious. Sleep apnea is caused when the airway is blocked while you are asleep which leads to excess saliva or drooling due to irregular breathing.
Irrespective of what is causing excessive saliva in pregnancy, you shouldn’t be worried, for it is a common symptom and will subside eventually. Increased salivation could even be good for you sometimes.
Point to considerAre There Any Benefits Of Excess Saliva?
Yes, hypersalivation helps manage a few concerns that are common during pregnancy.
- Helps in digestion: Indigestion is pretty common in pregnancy. Increased salivation helps to break down starch into maltoseiSugar formed by two molecules of simple sugar glucose bonded together. and then into glucose, ensuring proper digestive system functioning (11).
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- Neutralizes acids: Saliva contains phosphorus and calcium and is considered a relative of blood. It neutralizes the acids and maintains gastroesophageal reflux, and eventually soothes heartburn, which is a common symptom of pregnancy (6).
- Lubricates mouth: Dry mouth is one of the common symptoms during early pregnancy (12). The production of mucus with increased salivation lubricates the mouth and prevents food from sticking to the gums and teeth (13).
- Oral hygiene: Nausea and vomiting during pregnancy are likely to increase the risks of oral infections. However, excessive saliva moistens the mouth, keeps away germs and bad breath during pregnancy, and prevents gum diseases and tooth decay (14).
- Natural defense against bacteria: Oral infections and bacteria may form plaqueiA thin film of bacteria that constantly forms on the teeth. in the mouth (15). The salivary glands collect nitrate (from blood) and help in fighting bacteria, hence acting as a natural defense against agents that could harm gums and teeth.
Although excessive salivation is good, it becomes irritating when accompanied by nausea and morning sickness. There are, however, ways to treat it.
How Do You Get Rid Of Excess Saliva During Pregnancy?
Dr. Michael Green, a board-certified obstetrician-gynecologist from Lake Arrowhead, California, says, “Some ways to reduce excess saliva are to chew or suck on sugarless candies or gum, stay hydrated, and avoid any trigger foods that worsen the sensation. Typically, salivation is more excessive in the first trimester and peters off by the second. It may gradually improve for some women as their pregnancy develops.”
Here are several practical tips and home remedies you can try to get relief from hypersalivation.
- Keep a note of your water intake. Always keep a bottle of water at your side and stay hydrated at all times to prevent dehydration. Hypersalivation if not managed well can sometimes lead to dehydration.
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- Brush your teeth twice a day. Also, rinse using a mouthwash as many times as you can during the day, to get rid of the excess saliva.
- Reduce the amount of starchy food in your diet and eat well-balanced meals to ensure optimum prenatal care. Try to have small meals at regular intervals throughout the day. Also, you can add fibrous vegetables and fruits to your diet.
- Suck on sugarless chewing gum or candy to swallow the extra saliva. While this won’t bring down the production of saliva, it will make swallowing a lot easier. Sucking on ice cubes is another trick that makes your mouth numb for a while and pauses the secretion of saliva.
- Munch on dry biscuits, it can help soak the extra saliva in your mouth.
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- If you have difficulty swallowing the excessive saliva, spit out in a cup, tissue, or washcloth, and then throw it.
Starr Andrews, a mother, shares her experience managing excess saliva due to hyperemesis gravidarum during her pregnancy. She says, “I couldn’t even swallow my own saliva without vomiting! I never had this saliva problem so it really bothers me and nothing works but having my bucket to puke in and paper towels soak it up. I would carry a cup to puke with paper towels or a zip-lock baggie. I had a towel on my pillows and put Gauze to soak up the saliva (i).”
- Treating ptyalism with drugs is considered challenging, as the exact cause is not known. Medications such as belladonna and phenothiazine can be taken, although they have certain side-effects such as constipation and dry mouth during pregnancy (16).
Some more questions related to saliva during pregnancy are answered next.
Frequently Asked Questions
1. Can I prevent excessive saliva in pregnancy?
No, increased secretion of saliva is a natural, short-term condition in pregnancy and cannot be prevented. There is no need to worry about it since it doesn’t affect your baby in any way (17). Keep calm, use natural remedies that offer relief, and try distracting yourself.
2. When does the production of excess saliva end?
Just like the other symptoms of pregnancy, increased salivation is unpleasant and disturbing but tends to go away after the first trimester. However, for some women, it may continue into the second and third trimester as well, fading completely after the delivery.
3. Is it necessary to visit the doctor?
If the condition is not causing problems other than discomfort, then minor lifestyle changes, such as drinking enough water, may help. However, if it is becoming intense and resulting in excessive vomiting, you should consult your doctor to know how to manage the condition better and look for other contributing causes.
4. Are there any health concerns associated with excessive saliva during pregnancy?
Excessive salivation during pregnancy is not harmful to the developing fetus and has not been associated with any serious health complications (19).
5. Are there any medical treatments available for excessive saliva during pregnancy?
A study has reported clonidine hydrochloride to be effective in treating excessive salivation in pregnant women. However, the treatment is subject to further research (20).
Excessive saliva during pregnancy is common, and it is mostly caused by nausea and vomiting, especially in the early stages. Therefore, there is no need to be concerned about this condition. In fact, it may even help address other common pregnancy issues such as indigestion, heartburn, and mouth infections. However, if it irritates you and interferes with your daily life, you could try some helpful salivation prevention and reduction measures. For example, staying hydrated, brushing your teeth, using mouthwash, and avoiding starchy meals might be beneficial.
Infographic: Causes Of Hypersalivation In Pregnancy
During pregnancy, increased hormones, such as progesterone, can cause the glands in the mouth to produce more saliva. This can result in ptyalism or excessive saliva production, also known as hypersalivation. Other factors that can contribute to hypersalivation during pregnancy are illustrated in the following infographic. Take a look and share with others as well. Illustration: Momjunction Design Team
Key Pointers
- Hypersalivation during pregnancy is a common condition that typically decreases as pregnancy progresses, but it may persist until delivery in some women.
- Hormonal changes are the most likely cause of hypersalivation during pregnancy. Other potential causes include nausea, anxiety, certain medications, heartburn, and oral infections.
- Hypersalivation during pregnancy may serve several beneficial functions, including aiding in digestion, neutralizing acid, lubricating the mouth, and protecting against bacterial infections.
- Women experiencing hypersalivation during pregnancy may benefit from staying well hydrated, practicing good oral hygiene, reducing their intake of starchy foods, and chewing sugarless gum.
Illustration: Excessive Saliva During Pregnancy: Causes And Tips To Control
Image: Dalle E/MomJunction Design Team
Pregnancy can bring about many changes, including excessive saliva production in the mouth. Learn more about gravidic ptyalism and how to manage this condition during pregnancy.
Personal Experience: Source
MomJunction articles include first-hand experiences to provide you with better insights through real-life narratives. Here are the sources of personal accounts referenced in this article.
i. Hyperemesis gravidarum (hg) how my pregnancy-almost kill us . My nine months of hell . This is the dark side of pregnancy you haven’t seen …..;https://hgbeforeduringandtheaftermath.wordpress.com/2020/12/01/hyperemesis-gravidarum-short-story-of-my-nine-months-of-hell/
References
1. S. Suzuki, M. Igarashi, E. Yamashita & M Satomi; Ptyalism gravidarum; North American Journal of Medical Sciences (2009)
2. D. Harris; Spit it out: 4 things saliva reveals about your health; Augusta University (2017)
3. Hyperemesis Gravidarum; American Pregnancy Association (2018) Nausea (Morning Sickness) During Pregnancy; PregMed
4. N. G. Hockstein, D. S. Samadi, K. Gendron & S. D. Handler; Sialorrhea: A Management Challenge; American Family Physician Foundation (2004)
5. Ptyalism; PregMed (2016)
6. Dental Carries; Microbial Diseases of the Mouth and Oral Cavity;
7. J. A. Giglio, S. M. Lanni, D. M. Laskin & N. W. Giglio; Oral Health Care for the Pregnant Patient; Pratique Clinique (2009)
8. T. G. Jayakaran; The Effect of Drugs in the Oral Cavity – A Review; Journal of Pharmaceutical Sciences and Research (2014)
9. H. S. Kane, C. D. Schetter, L. M. Glynn, C. J. Hobel & C. A. Sandman; Pregnancy anxiety and prenatal cortisol trajectories; Journal Biological Psychology (2014)
10. A. Preciado; The Role of Acculturative Stress on Maternal Anxiety and Cortisol Levels during Pregnancy; California State University
11. Rio R, Azevedo A, Simões-Silva L, Marinho J, Silva MJ, Sampaio-Maia B; The biochemistry of saliva throughout pregnancy; MedicalExpress (São Paulo, online). 2015;2(5):M150506.
12. Dry Mouth During Pregnancy; PregMed (2015)
13. Increased Saliva in Early Pregnancy; New Health Guide
14. Reddy RS, Amara SL, Tatapudi R, Koppolu P, Nimma VL, Reddy RL. Awareness and attitude towards maintenance of oral health during pregnancy among patients and clinicians attending obstetrics and gynecology ward. J NTR Univ Health Sci 2013;2:102-8
15. E. Hajikazemi and F. Haghdoost Osquei (2012). Oral and Dental Health in Pregnancy, Oral Health Care – Pediatric, Research, Epidemiology and Clinical Practices, Prof. Mandeep Virdi (Ed.), ISBN: 978-953-51-0133-8, InTech, Available from:
16. Z. Beevi, W. Y. Low & J. Hassan (2015) Successful Treatment of Ptyalism Gravidarum With Concomitant Hyperemesis Using Hypnosis, American Journal of Clinical Hypnosis, 58:2, 215-223, DOI: 0.1080/00029157.2015.1013186. Available from:
17. Moshe Bronshtein et al.; Characteristics and Outcomes of Ptyalism Gravidarum; IMAJ; (2018)
18. Shunji Suzuki and Yukiko Fuse; Clinical significance of ptyalism gravidarum; NCBI; (2013)
19. Excessive saliva in pregnancy; National Childbirth Trust, UK
20. Victoria De Braga et al. (2022); Successful treatment of ptyalism gravidarum with clonidine hydrochloride: A case report; Case Reports in Women’s Health
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Read full bio of Dr. Kofi Kwaw-Asante
Dr. Michael Green is a board-certified OB/GYN living in Lake Arrowhead, CA. He studied medicine at St. Louis University of Medicine and completed a Family Medicine Residency at the Ventura County Medical Center. Dr. Green did a second residency in Obstetrics and Gynecology at The Carolinas Medical Center in Charlotte, NC. In addition, he holds a masters degree in Chemistry from the California State University Northridge. With over 17 years experience, Dr. Green currently works as a site director for OBHG at Northridge Medical Center in Northridge, CA.Dr. Michael Green is a board-certified OB/GYN living in Lake Arrowhead, CA. He studied medicine at St. Louis University of Medicine and completed a Family Medicine Residency at the Ventura County Medical Center. Dr. Green did a second residency in Obstetrics and Gynecology at The Carolinas Medical Center in Charlotte, NC. In addition, he holds a masters degree in Chemistry from the California State University Northridge. With over 17 years experience, Dr. Green currently works as a site director for OBHG at Northridge Medical Center in Northridge, CA.
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