Salivary changes are a common, though often unpublicized, experience during pregnancy. While the focus is often on morning sickness or fatigue, shifts in both the volume and texture of saliva are frequent symptoms that can begin early in the first trimester. These alterations in oral fluid production are generally temporary, typically resolving after the baby’s birth. Understanding this physiological shift helps demystify what is a confusing and sometimes distressing symptom for expectant individuals.
Ptyalism: When Saliva Becomes Excessive
The medical term for excessive saliva production is ptyalism, or sialorrhea, and in pregnancy, it is often referred to as ptyalism gravidarum. This condition involves a dramatic increase in the amount of saliva produced daily, sometimes reaching up to 1.5 to 2 liters, which is a significant jump from the typical non-pregnant volume of about 0.5 to 1.5 liters per day. This substantial volume makes it difficult to swallow the fluid quickly enough, leading to the sensation of pooling or constant drooling.
The appearance of the saliva can vary from its normal thin, watery state to a noticeably different consistency. Because the fluid is produced in such excess, it can become foamy, thick, or ropey as it sits in the mouth and mixes with air. This altered texture is often accompanied by a sensory change known as dysgeusia, where individuals report a distinctly bitter or unpleasant metallic taste in their mouth.
The excess fluid often feels thicker, more copious, and can have a bitter quality that makes swallowing difficult. This difficulty in swallowing, combined with the bitter taste, can contribute to or worsen feelings of nausea. The constant need to manage the flow often requires carrying tissues or a small cup for frequent expectoration.
Physiological Triggers for Saliva Changes
The sudden increase in fluid production is related to several physiological changes occurring during gestation. Hormonal fluctuations are thought to be a primary factor, with the surge in hormones like estrogen and human chorionic gonadotropin (hCG) potentially signaling the salivary glands to increase activity. These hormonal shifts play a significant role in many early pregnancy symptoms.
A strong connection exists between ptyalism and the experience of nausea and vomiting. Individuals who feel intensely nauseated often instinctively swallow less, attempting to minimize the gag reflex, which causes saliva to simply accumulate in the mouth. This reduced swallowing contributes to the perceived feeling of having too much saliva.
Another significant trigger is the common occurrence of gastroesophageal reflux, or heartburn, during pregnancy. Stomach acid can irritate the lower esophagus, which then triggers a protective reflex in the body. This reflex stimulates the salivary glands to produce more saliva, which is naturally alkaline, to help neutralize the acid and protect the lining of the throat and mouth. The increased flow of saliva acts as a natural buffer against the corrosive effects of stomach contents.
Coping Strategies for Managing Saliva Flow
While there is no single treatment to stop the flow, several practical strategies can help manage the discomfort of excessive saliva. Maintaining frequent hydration by taking small, regular sips of water can help dilute the saliva, making it easier to swallow without triggering nausea. Sucking on ice chips or sugar-free hard candies also encourages more frequent, yet comfortable, swallowing.
Adjusting dietary choices can also provide some relief. Starchy items like white bread, rice, and pasta can sometimes stimulate increased saliva production for digestion, so reducing their intake may be helpful. Conversely, sucking on sour flavors, such as a slice of lemon or a sour sugar-free candy, can help manage the unpleasant taste and encourage swallowing.
Good oral hygiene is important, as frequent brushing with a minty toothpaste and using an alcohol-free mouthwash can provide a fresher feeling in the mouth. Chewing sugarless gum is another simple method, as the act of chewing makes it easier to manage and swallow the excess fluid. While the condition is harmless to the baby, persistent and severe symptoms that cause significant distress or lead to dehydration warrant a discussion with a healthcare professional.