Drooling, Excessive

What is excessive drooling?

Children can usually control drooling by 4 years of age. Excessive drooling can be embarrassing to parents and to the child at older ages.

Excessive drooling is common in children with cerebral palsy. It can happen with other neurodegenerative diseases. Excessive drooling is not normal in the older, healthy child.

You may hear excessive drooling referred to as sialorrhea (say: SYE-a-loe-REE-ah).

Signs and symptoms of excessive drooling

Excessive drooling is shown by saliva slipping out the side of your child’s mouth. It may dribble down his chin. Excessive drooling can damage clothes. It may spoil school books and drawings. Your child’s chin may also get irritated by the saliva. This is more common in cold weather.

Causes of excessive drooling

Excessive drooling is caused by poor swallowing. It may be linked with poor mouth and tongue control. Excessive drooling is not usually caused by too much saliva production.

What your health care team can do to help

Your doctor can rule out any serious condition that may be causing the drooling.

After an initial assessment, your child’s doctor may have your child assessed by a group of health providers These include a speech and language therapist, physiotherapist, orthodontist, orthotist, and otolaryngologist (ear, nose, and throat specialist).

The specialists will assess:

  • your child’s level of awareness
  • head posture and control
  • dental health
  • how well your child’s lips seal
  • whether your child can swallow safely
  • whether your child’s nose is blocked

Depending on your child’s condition, the doctor may recommend non-surgical or surgical treatment.

Treatment for excessive drooling

Non-surgical treatments may include:

  • improving posture
  • orthodontic treatment
  • reducing nose blockage to help your child close her mouth better
  • medicines to help reduce the amount of saliva produced
  • Botox injections into the salivary glands under general anaesthetic

Surgery may be recommended in severe cases of drooling.

Key points

  • Excessive drooling is not normal in the older, heatlhy child.
  • Causes may be linked with poor mouth and tongue control.
  • It is important to rule out any serious conditions that may be causing the drooling.
  • Non-surgical treatment may include improving posture, orthodontics, reducing nose blockage, or certain medications.

Mark Feldman, MD, FRCPC


Asher, Randall S.; Winquist, Heidi Appliance therapy for chronic drooling in a patient with mental retardation Special Care in Dentistry, Volume 14, Issue 1, 1994, First Page 30

Bull, Peter D., Glenis K. Scadding, and John M. Graham. Chapter 18: Drooling – Salivary Incontinence (Sialorrhoea) in Pediatric ENT, Springer Berlin Heidelberg, 2007. pgs 165-167.

J Child Neurol 2005; 20; 120, Sharon Hassin-Baer, Esther Scheuer, Aron S. Buchman, Izhak Jacobson and Bruria Ben-Zeev. Botulinum Toxin Injections for Children With Excessive Drooling. Last accessed April 2010