Drooling and cerebral palsy

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.

Older children may still drool during sleep. Beyond the age of about 4 years, it's unusual, unless there is an underlying medical reason, such as cerebral palsy.

Why drooling occurs

Drooling beyond infancy may occur in some medical conditions such as:

• when there is inflammation of the mouth
• or as a reaction to some medications, which cause an increase in saliva

Drooling is usually related to:

• difficulties moving saliva to the back of the throat
• difficulties with swallowing
• poor mouth closure
• jaw instability
• tongue thrusting

Some people think an excess of saliva causes drooling. But it's more likely to be a tendency to swallow less.

The following can make it worse:

• lack of head control
• poor posture
• lack of sensation around the mouth
• breathing through the mouth
• excitement
• impaired concentration

Health and hygiene

There are health and hygiene implications for people who drool a lot:

• The skin around the mouth, chin and neck can become red and sore.
• Loss of fluid may lead to dehydration.
• There may be problems with eating.
• Infections and choking 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 individual. You will need an ear, nose and throat examination before choosing a treatment.

Treatments can include:

• rewarding or prompting to encourage swallowing
• exercises to increase muscle tone, improve oral-motor function and sensory awareness
• drugs that dry up saliva
• Botulinum toxin injections to help prevent and control drooling
• surgery to move the gland so that saliva moves towards the back rather than the front of the mouth
• in extreme cases, removal of a salivary gland

Speech and language therapy

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.

Finding speech and language therapy services (The Royal College of Speech and Language Therapists)