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When is drooling a problem?

Drooling is a normal behavior in infants and young children. As babies, they explore their world through the use of their mouths. But, excessive drooling can be a cause for concern. Especially, if it persists as your child grows older. Read more to know when you should be worried about your child’s drooling habits, and what you can do about it.


In this article we will discuss:


Excess Saliva

But first, let’s talk about swallowing!

Saliva production is controlled by the autonomic nervous system. It is involuntary. This means that excessive saliva production can occur without us even realizing it! It usually happens when we experience stress or strong emotions like anger or excitement. It even occurs when we see or smell something that we like!

Normal swallowing is an important reflex that allows us to eat and drink without excessive saliva production. In order for us to swallow, there is a lot of voluntary and involuntary activity going on. It involves both the mouth and the throat. First, the lips close around the food or drink. Second, the tongue moves the food or liquid toward the back of the mouth. Third, the soft palate (roof of the mouth) elevates and blocks off the nasal cavity. Finally, muscles in the throat contract to push the food or liquid down into the stomach. Drooling in children can be caused by a number of factors. Children need good lip closure, tongue strength, and the ability to swallow in order to prevent excessive mouth drooling.


What is drooling?

Drooling is excessive saliva production. This typically happens in the mouth. It is also often caused by a tongue that protrudes constantly.

Drooling can be normal for infants as they explore their world using their mouths. This is because, at this age, children do not have well-developed muscles. Their mouths and throats need extra help to keep saliva swallowed. As lip closure and tongue strength improves, drooling usually reduces in time. But, excessive drooling can be cause for concern! Especially, if it persists as your child grows older.


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Why does drooling happen?

If any one of your child's reflexes is not functioning properly, excessive drooling can occur. Children with excessive tongue protrusion or weak lip closure will often drool continuously. Excessive drooling can also be caused by a variety of factors including:

  • poor mouth and/or throat muscle tone

  • excessive salivation from teething

  • overproduction of saliva by the salivary glands

  • nerve issues that control facial and oral muscles.

Medical problems as well as certain medications might also contribute to this condition.


What causes drooling?

There are many potential causes of excessive mouth drooling, including:


Anatomical abnormalities such as:

  1. Cleft lip. A cleft lip is a defect in the upper lip that can cause excessive drooling due to insufficient lip closure.

  2. Cleft palate. A cleft palate is a defect in the roof of the mouth. It can cause excessive drooling due to not enough tongue strength to push bolus and liquid through the mouth.

  3. Macroglossia. Macroglossia is an abnormally large tongue. It can cause excessive drooling due to insufficient tongue control.

Neurological conditions such as:

  1. Cerebral palsy is a disorder that affects body movement and muscle coordination. This is due to brain damage that occurs during fetal development, infancy, or early childhood.

  2. Muscular dystrophy is a group of inherited disorders that weaken and break down muscles over time.

  3. Myasthenia gravis is an autoimmune disease that causes muscle weakness and fatigue.

Developmental disorders such as:

  1. Down syndrome is a genetic disorder that causes physical and developmental delays.

  2. Autism spectrum disorder is a group of neurodevelopmental disorders. It affect communication, social interaction, interests, and activities.

Psychological conditions such as:

  1. Anxiety. Anxiety can cause excessive mouth drooling due to increased production of saliva and dry mouth.

  2. Nasal allergies. Allergies can cause excess saliva due to excessive mucus production and difficulty swallowing.

Cerebrovascular diseases such as:

  1. Stroke. A stroke can cause excessive drooling due to damage to the nervous system (including cranial nerves). It can paralyze the muscles in the face, tongue, and larynx that are needed for swallowing.

In some cases, excessive drooling may be caused by certain medications or medical treatments. It includes medications such as radiation therapy to the head or neck area. If excess saliva persists even after treating these underlying disorders or conditions, it may be a sign of an issue with muscle control in your child’s mouth and throat.


When is drooling a problem?


If excessive drooling is accompanied by other symptoms, such as difficulty swallowing, it may be indicative of a more serious underlying condition and medical help should be sought. If excessive drooling persists even after treating the underlying disorder or condition, it may be a sign of an issue with muscle control in your child’s mouth and throat. In this case, consulting with a speech pathologist or other healthcare professional may help to determine the cause and appropriate treatment.


Speech Therapy can help with drooling


If excessive drooling is due to a lack of muscle control, speech therapy can help to improve muscle strength and coordination. During the assessment, the speech pathologist will look at your child’s oral motor skills and determine the best way to help.


Assessment includes:


1. Case History

The speech pathologist will ask you questions about your child’s medical history, development, and current symptoms. This will help them to determine the underlying cause of excessive mouth drooling.

Excessive saliva

2. Oral Motor Assessment

The speech pathologist will assess your child’s oral motor skills, including muscle strength and coordination, range of motion, and drooling.


3. Swallowing Assessment

The speech pathologist will assess your child’s ability to swallow safely and effectively.

Based on the assessment, the speech pathologist will develop a treatment plan to address your child’s specific needs.



Treatment for drooling may include:


1. Lip strengthening exercises


These exercises include activities to improve the strength and coordination of the muscles around the lips. This can be done by blowing bubbles, puckering up, or making funny faces. This will help improve lip closure which will then reduce the escape of excessive saliva or drooling. The lip is very important in reducing excessive drooling as it acts as a seal to keep saliva from escaping.


2. Tongue strengthening exercises


These exercises help to improve tongue control and strength, which can help with excessive drooling as it will help your child to swallow saliva more effectively. This may include activities such as sticking out the tongue and moving it side to side or up and down, placing a pea-sized amount of food on the tongue, and asking your child to move it around the mouth without using the teeth. The tongue is important to help reduce excessive drooling as it helps to move saliva from the back of the mouth to the front for swallowing.


3. Oral sensory activities


In other cases, drooling is excessive due to reduced oral sensation. This means that your child may not be able to feel when saliva is present in the mouth, and as a result, is unable to swallow it in a timely manner. This can be treated with oral sensory activities, which help your child to “feel” different textures, making it easier to swallow excessive saliva.

Oral sensory activities may include brushing the lips, tongue, and roof of the mouth with a soft-bristled toothbrush or a cotton swab; having your child lick an ice cube; or placing different foods on their tongues – such as sour candy or raw vegetables.


4. Training on safe swallowing techniques


These exercises help to improve the coordination of muscles involved in swallowing and reduce excessive drooling. This may include techniques such as deep breaths, chewing gum, or sipping liquids.

Excessive drooling

As parents, it can be concerning when our children are excessively droolers. While excessive drooling is often a sign of teething or other normal behaviors in infants and toddlers, it can also be a sign of a more serious condition that may require the help of a speech pathologist or other healthcare professional. In order to determine whether excessive drooling is a problem for your child, it is important to seek an assessment from a speech pathologist.


In some cases, medications may be prescribed by your child’s healthcare team to help reduce excessive drooling. These medications work by reducing the amount of saliva produced in the mouth. This is why it is important to know what causes drooling to know the right treatment for your child.

mouth drooling

How do I prevent excessive drooling?

To prevent excessive drooling, it is important to work closely with your child’s healthcare team to develop a treatment plan that addresses the underlying cause of excessive mouth drooling.


At home, there are a number of things you can do to prevent excessive drooling, including:


  1. Stimulate the oral cavity by introducing textures such as raw vegetables, chewy foods, or sour candy. This will help your child to feel different textures and reduce excessive drooling.

  2. Straw is recommended for all children instead of sippy cups, but especially for excessive droolers, as it can help your child to swallow saliva more effectively.

  3. Elevate the head of your child’s bed or use extra pillows to help reduce excessive drooling while sleeping.

  4. Brushing the teeth after every meal and before bedtime can help to reduce excess saliva by stimulating the oral cavity, which can help to improve saliva control and swallowing.

  5. Encourage your child to take breaks throughout the day to drink liquids and eat food that will help produce saliva, such as hard candy or gum.

  6. Regularly wiping your child’s face with a warm washcloth can be helpful for stimulating the swallowing reflex. You can also try having your child suck on a pacifier or chew on non-food items such as teething rings.


In addition to these at-home strategies for excess saliva, working closely with your child’s healthcare team is also important to ensure that excessive drooling does not impact your child’s quality of life. With the right treatment plan in place, excessive drooling can be effectively managed and your child can live their best life. At Better Speech, we offer online speech therapy services convenient for you and tailored to your child's individual needs. Our services are affordable and effective - get Better Speech now.


 

About the Author

Mikee Larrazabal


I am a Speech-Language Pathologist with 14 years of experience working with children and adults who have communication difficulties. I completed my Bachelor of Science degree in Health Science at Cebu Doctors' University and have been helping people overcome their communication challenges ever since.


I have worked with individuals of different ages, including toddlers, preschoolers, school-aged children, adults and seniors. I'm passionate about speech therapy and take great satisfaction in helping people overcome their communication challenges and improve their lives through better communication skills. In my spare time I like reading books, going hiking in nature and taking care of my dog Locas.

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