What is drooling?
Drooling (or dribbling) is the unintentional loss of saliva from the mouth. It occurs naturally in infants, but as the infant gets older it usually decreases. Daytime drooling stops within the first few years of life, though it may still occur in the older child during sleep. Drooling beyond the age of about four years is unusual, unless there is an underlying medical problem.
Why does drooling occur?
Drooling beyond infancy may occur in some medical conditions such as when there is inflammation of the mucous membranes of the mouth or as a reaction to some medications, which cause an increase in the amount of saliva produced.
In some conditions including cerebral palsy, drooling is usually related to:
- abnormalities in swallowing (rather than to absence of swallowing)
- difficulties moving saliva to the back of the throat
- poor mouth closure
- jaw instability
- tongue thrusting
Drooling is not usually caused by an excess of saliva as may be thought. Instead it has been found that there is a tendency to swallow less frequently than normal.
Drooling can be made worse by a lack of head control and poor posture, lack of sensation around the mouth, breathing through the mouth, excitement and impaired concentration.
Who is vulnerable to drooling?
Drooling can occur in many children with a motor or neurological impairment; in cerebral palsy it can affect about one third of people. It may also occur in people with acquired brain damage, learning disabilities, Parkinsons disease, during epileptic seizures, in facial paralysis, speech disorders, in nasal obstruction and when consciousness has been interrupted for a short time. Drooling can therefore be present in children and adults.
Drooling, health and hygiene
There are health and hygiene implications for people who drool most of the time and to excessive degrees. The skin around the mouth, chin and neck can become red and sore, dehydration may occur because of fluid loss, there may be problems with eating, infections may be more easily transmitted, and choking is more likely, as are chest infections.
Treatments for drooling
A variety of techniques have been used to treat drooling. Some are more successful than others, but the treatment prescribed will depend upon the cause of the drooling. For example, someone with a severe learning disability is not likely to benefit from a training programme that demands a high level of co-operation and personal input. Equally, surgery for removal or re-siting of salivary glands would not be appropriate for someone who may have a nasal obstruction, which is a major contributor to the drooling. It is necessary, therefore, for the causes of drooling to be identified, usually by an ENT (ear, nose and throat) examination before treatment can be considered.
Treatments may include:
- reward or prompting to encourage swallowing
- surgery, where salivary glands are usually turned towards the back of the mouth so that saliva runs towards the back rather than the front of the mouth
- exercises to increase muscle tone, improve oral-motor function and improve sensory awareness
- medication, where drugs might be used to dry up salivary secretions
- removal of a salivary gland may be considered in extreme cases
- Botulinum toxin injections to help prevent and control drooling
Drooling: how to find help
Your family doctor can make referrals to specialist services. You can also contact speech and language therapy departments in hospitals or clinics without a referral. Such services can also be accessed through the private sector. More detailed information about speech and language therapy services can be obtained from:
The Royal College of Speech and Language Therapists
Tel: 020 7378 1200
For more information on Scope
Contact Scope Response for information, advice and support on cerebral palsy and disability issues.
This information was last reviewed May 2013.
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