Everything You Need to Know About Drooling

What is drooling?
Drooling, or poor saliva control, is when the saliva from the mouth escapes past the lips and may drip onto the chin, clothes, and/or floor. We typically see drooling in children from 6-18 months when they are still learning how to work all of the structures in their mouths. We may also see drooling when a child is teething or when they are congested. If a child is older than 18 months, not teething, and not congested, we would not expect to see drooling.
 
What causes drooling?
Drooling is not typically the result of the overproduction of saliva in the mouth. Drooling is typically the result of difficulty controlling the saliva in the mouth. There are some factors that may contribute to a child’s persistent drooling. It is first important to note if the child is breathing primarily though their mouth and/or snoring at night. If this is the case, the family should seek a visit with an ear nose and throat doctor (ENT) to determine if there is a structural cause (possible enlarged tonsils or adenoids). If the child is not breathing through their mouth and/or has already had a visit with an ENT, there may be other causes that can be assessed by a speech language pathologist or occupational therapist!
 
What happens at an evaluation for drooling?
During an evaluation, the therapist will look at multiple areas. The therapist may ask if the child has difficulty with feeding or swallowing. If a child has difficulty swallowing food and/or liquids, they may also have difficulty controlling and swallowing their own drool. The therapist will observe if the child is aware of the drool on their chin/clothes. If the child is not aware they are drooling, they may have difficulty changing this behavior. The therapist will look at the child’s posture. If the child has an unstable body posture, they may have difficulty achieving mobility in their mouth. The therapist will then assess the child’s sensory awareness in their mouth. If the child cannot feel what is happening in their mouth, how can they control their saliva? The therapist will observe the child’s lip closure. If a child is not able to maintain lip closure, it will be difficult for the child to keep the saliva from escaping their mouth. The last area the therapist will look at is the child’s ability to safely swallow their drool. If the child has difficulty swallowing water or other liquids, the child may not be able to safely swallow their drool, and the child should then seek a feeding evaluation.
 
What can I start doing now?
Maybe you are waiting for an evaluation or waiting for treatment to start, there are steps you can begin taking to help decrease your child’s drooling! The most important step you can take right now is increasing your child’s awareness of their drooling. You can start by showing them in a mirror when their chin or clothes are “wet” with drool. You can prompt the child to touch their chin when it is “wet” vs. when it is “dry” to feel the difference between their chin with drool and their chin without drool. You can provide them with a wipe and prompt them to wipe their chin when it is wet. You can also have the child wear a sweat band on their wrist and prompt them to wipe with the band when their chin is wet. Once your child begins treatment with a speech language pathologist or an occupational therapist, you will be provided with further activities for home practice that are formulated to fit your child’s specific needs!