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What Is Ptyalism In Pregnancy?

It's quite common to experience a slight increase in salivation during pregnancy; this is simply one of those "weird and wonderful" things that can happen while you're cooking a baby, along with increased blood flow, that linea negra on your tummy, and the so-called "pregnancy mask". These things are ultimately caused by pregnancy hormones. (Those things have a lot to answer for!)

A small subset of pregnant women develops really rather excessive salivation, however. This is called ptyalism, from the Greek word for "spit much", and it can even involve frothing at the mouth like you have rabies. 

What Causes Excess Saliva In Pregnancy?

Ptyalism in pregnancy was described in the medical literature as early as the 1950s. It is usually associated with morning sickness (pregnancy nausea), and especially the extreme form of morning sickness called hyperemesis gravidarum. It is not, however, known what causes this condition. 

Symptoms of hyperemesis gravidarum include:

  • Vomiting often — sometimes more than 50 times a day — and often to the point where you find it very hard to keep any food or beverage down. This extreme form of pregnancy nausea may also last well beyond the first trimester, some women experiencing it for the duration of their pregnancies. 
  • Dehydration. 
  • Weight loss. 
  • Low blood pressure. 
  • An extremely sensitive sense of smell and taste, even beyond what other pregnant women experience. 

Then there is ptyalism, potentially. If you have it, your saliva is likely to be completely normal in the sense that it won't have an unusual odor, color, or taste — but the amount is severely increased. Women with ptyalism in pregnancy may find that, on top of the morning sickness they are already experiencing, swallowing also causes you to gag or vomit. Your excessive saliva may interfere with sleep and speaking, and it may interfere with your mental health, as well. 

Is There Any Treatment For Excess Saliva In Pregnancy?

Because ptyalism in pregnancy is a rare condition, because it has been poorly researched, because its causes are not known yet, and because it isn't thought to lead to adverse pregnancy outcomes, treatment may be hard to come by. 

One case in which a pregnant woman was cured of ptyalism gravidarum by way of hypnosis was described in the medical literature, and there are also known cases where the condition spontaneously went away at some point during pregnancy. Even without a cure, it may be helpful to know that your ptyalism will be resolved after you give birth. 

In the meantime, most medical professionals will suggest that you brush your teeth often and use mouthwashes. Both these acts have a drying effect on the mouth, which may offer you some relief. There are medications that dry the mouth, but their safety has not been established for use during pregnancy so it is unlikely that you will be prescribed these. 

If you are suffering from hyperemesis gravidarum (extreme morning sickness) at the same time, you will be treated with IV fluids for dehydration, anti-nausea medications, and multivitamins as necessary. You may also be hospitalized. 

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