1/9. The management of drooling problems in children with neurological dysfunction: a review and case report.Drooling in children with neurological dysfunction indicates neurogenic failure to coordinate the muscles of the tongue, soft palate, and face which act in the first stage of swallowing. This causes excessive pooling of saliva in the anterior part of the mouth and consequent overspill. Treatment for drooling includes behavioral, pharmacological, and surgical modalities. Correcting a malocclusion has also been reported to help eliminate drooling. This paper describes the treatment of a child with neurofibromatosis, psychomotor, developmental, and neurologic retardation, and difficulty with speech. The patient was referred to our clinic to correct his drooling. Simple orthodontic treatment succeeded in eliminating the drooling and improving his speech.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
2/9. The use of a removable appliance to improve oral continence in an elderly dentate patient.Challenges in the treatment of our older dentate patients are arising more frequently, and novel solutions may be required to overcome them. This case report describes the treatment given to an elderly dentate female patient, whose lax peri-oral musculature was preventing a satisfactory oral seal from being achieved. This resulted in constant "drooling" and much social disability in an otherwise fit and gregarious lady. A simple removable appliance was provided to increase support to the tissues at the angles of the mouth. An immediate relief of the salivary leakage was achieved and maintained. Simple solutions may be available to problems which may cause great distress to our patients reducing the quality of their lives. This solution to the problem of peri-oral leakage, of a normal volume of saliva, may be useful for many other patients with similar problems, following loss of peri-oral muscle tone with age.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
3/9. Surgical management of drooling. Case report.Drooling occurs when excessive quantities of saliva dribble from the opened mouth. This distressing condition affects many mentally handicapped patients who are unable to effectively clear their normal salivary flow by swallowing. Any method employed for the control of drooling must still allow a sufficient volume of flow for mastication, deglutition and oral hygiene. Surgery is generally indicated for marked or severe cases of drooling and Wilkie's operation involving redirection of the parotid flow into the oropharynx is the most commonly performed surgical procedure. This operation may be combined with bilateral removal of the submandibular salivary glands if the problem is severe.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
4/9. Sudden drooling and supine gagging: an important emergency?We describe a case of an eupnoeic patient complaining of a foreign body sensation in his mouth and throat, with sudden drooling and supine gagging. This condition was caused by an isolated uvular angioedema (Quincke's oedema). As this uvular hydrops did not decrease with initial standard therapy for angioedema, epinephrin was applied directly on the swollen uvula, causing it to shrink very rapidly. Isolated uvular oedema is a potentially life-threatening condition with risk of sudden upper airway obstruction, and should therefore be recognized and treated as soon as possible. As described in this case, its initial presentation can consist of gagging and drooling without dyspnoea, thus causing a real challenge for triage and diagnosis.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
5/9. Hypersalivation induced by olanzapine with fluvoxamine.Hypersalivation has been reported as a side effect of atypical antipsychotics such as clozapine and olanzapine. As it is very common for antipsychotics to cause dry mouth due to anticholinergic effects, hypersalivation seems to be paradoxical. We present the case of a 34-year-old Japanese man with delusional disorder, somatic type (DSM-IV). He had chronic neck pain as well as somatic hallucination with hypochondriacal delusion for 4 years. Since combination therapy with atypical antipsychotics and selective serotonin reuptake inhibitors (SSRIs) has been introduced in the treatment of refractory psychiatric disorders such as schizophrenia, olanzapine (10 mg/day) was added to fluvoxamine treatment (200 mg/day) in this case. Subsequently, hypersalivation was induced without any extrapyramidal symptoms. It is suggested that hypersalivation was an adverse effect of olanzapine. Possible interaction olanzapine with fluvoxamine might increase the risk of the adverse effect. When combination therapy of atypical antipsychotics and SSRI is introduced, it should be used cautiously with careful observation. Underlying pharmacological and clinical problems will be discussed.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
6/9. The effect of mouth closure on drooling and speech.The efficacy of a feeding program to decrease drooling and increase vocalizations by promoting mouth closure was explored in two boys with cerebral palsy through the use of oral facilitation techniques. A single-subject ABA design was repeated across subjects. Baseline 1 consisted of 5 (Subject 1) and 10 (Subject 2) half-hour sessions during which the subjects were fed applesauce and apple juice without treatment. A 1-hr play session followed, during which saliva was collected on an absorbent bib and weighted. Bilabial vocalizations produced by the subjects were recorded and counted. A 12-session intervention phase followed, which was identical to the baseline phase except that treatment was implemented. Treatment consisted of techniques to reduce tactile hypersensitivity before feeding and the application of jaw control during feeding. Baseline 2 consisted of 7 sessions identical to baseline 1. The results suggest that this intervention decreases drooling but does not increase bilabial vocalizations. Longer treatment and follow-up may be needed in future efficacy studies.- - - - - - - - - - ranking = 5keywords = mouth (Clic here for more details about this article) |
7/9. Decreasing drooling through techniques to facilitate mouth closure.A single case ABA experimental design is presented in which techniques to facilitate mouth closure were hypothesized to decrease drooling. The subject was an 11-year-old male with mental retardation and cerebral palsy. Baseline 1 consisted of 10 half-hour sessions of play, followed by 1-hour periods during which the amount of saliva collected on an absorbent bib was measured and recorded. The subsequent treatment phase of 4 weeks was identical to the baseline except that a half-hour period of intervention was substituted for the half-hour of play. Intervention involved providing jaw control with intermittent tapping and jiggling, stroking the upper gum, and giving juice with jaw control. Baseline 2 consisted of 10 sessions identical to baseline 1. Results indicate that the amount of saliva leaving the mouth was a function of the presence or absence of intervention.- - - - - - - - - - ranking = 6keywords = mouth (Clic here for more details about this article) |
8/9. Use of complete dentures to stabilize a segmentally resected mandible: a clinical report.Although edentulous patients with a midline segmental resection of the mandible can rarely be treated prosthodontically, this patient's dental condition was managed with some success. This success may be related to preservation of the floor of the mouth with graft. By maximum extension of the denture borders and an interlocking occlusion, a mutual stabilization of the residual segments and the denture was achieved in the static condition, which improved swallowing, control of drooling, and self-esteem. Because of the independent muscle function of each side of the mandible, mastication could not be restored adequately.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
9/9. Moebius syndrome: report of case.This is a review of diagnosis, etiology and abnormalities of Moebius syndrome. The Moebius syndrome is rare and the cause is still unclear. It presents a case of a premature newborn baby with Moebius syndrome, showing unilateral facial nerve palsy, asymmetry of facial expression, inability to tightly close the right eyelids, asymmetry of the angles of the mouth with frequent drooling, poor sucking ability, dysphagia, extremity abnormalities and other cranial nerve involvement (VIII, IX, X, XI). He also had hypoplasia of the pons, a heart defect, and bilateral cryptorchism. The baby died of apnea on the 41st day after birth.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |