Drooling, or dribbling, is the unintentional loss of saliva from the mouth.

It occurs in infants, but as the infant gets older it usually decreases. Daytime drooling stops within the first few years of life, though older children may still drool during sleep. Beyond the age of about 4 years, it is unusual, unless there is an underlying medical problem.

Why drooling occurs

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 saliva

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 is sometimes thought. Instead it has been found that there is a tendency to swallow less frequently than normal. It 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 (it can affect one third of people with Cerebral Palsy)
  • people with acquired brain damage
  • people with Parkinson's disease
  • during epileptic seizures
  • in facial paralysis
  • speech disorders
  • in nasal obstruction
  • and when consciousness has been interrupted for a short time.

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.
  • Fluid loss may lead to dehydration.
  • There may be problems with eating.
  • Infections may be more easily transmitted.
  • Choking and chest infections are more likely.

Treatments for drooling

A variety of techniques can treat drooling. Some are more successful than others, but treatment will depend upon the cause. For example, someone with a severe learning difficulty 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 work for someone who may have a nasal obstruction, which is a major contributor. A ENT (ear, nose and throat) examination is necessary to identify the causes before choosing a treatment.

Treatments can include:

  • rewarding 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
  • drugs that dry up salivary secretions
  • removal of a salivary gland 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 or through the private sector.

You can get more detailed information about speech and language therapy services from The Royal College of Speech and Language Therapists.

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