Drooling Causes and Treatments

Drooling, also called sialorrhea, is saliva draining outside of the mouth. Drooling is common in several disorders related to the ears, nose, and throat, as well as certain neurological disorders. For infants and toddlers, drooling is a sign of teething and is nothing to be concerned about, but it's important to be aware of the various conditions that are associated with drooling. In some rare cases, drooling is a sign of a life-threatening illness.

In most cases drooling is caused by the overproduction of saliva, problems swallowing and problems keeping saliva inside the mouth. Some people with drooling problems are at a greater risk of breathing saliva, food, or fluids into the lungs, which could cause a serious problem if the body's gagging and coughing reflexes are not functioning properly. More specifically, inhaling food or fluid into the lungs can lead to pneumonia.

Certain infections can cause the overproduction of saliva and drool. These include:

• Mononucleosis
• Peritonsillar abscess
• Retropharyngeal abscess
• Strep throat
• Tonsillitis
• Sinus infections

Other conditions that can cause the overproduction of saliva include:

• Epiglottitis (this is a rare but serious condition that causes swelling of the tongue).
• Sore throat
• Nasal obstruction
• Allergies
• GERD
• Pregnancy (due to side effects)
• Swollen tongue or adenoids
• Muscular dystrophy
• Anaphylaxis (this is life-threatening and may be accompanied by other symptoms such as tongue swelling, difficulty breathing, hives, swelling of the face).
• Use of certain medications

Drooling is also caused by nervous system disorders that cause difficulty swallowing:

• Cerebral palsy (CP)
• Parkinson's disease
• Amyotrophic lateral sclerosis (ALS)
• Down syndrome
• Multiple sclerosis
• Autism
• Stroke

Drooling in infants and toddlers isn't usually cause for concern. If you or someone you care for is dealing with excessive drooling, see your healthcare provider or seek emergency medical treatment if:

• The drooling is not related to teething or a chronic condition.
• The drooling occurs suddenly.
• The cause of drooling is undiagnosed.
• There is concern about gagging or choking on saliva.
• A child has a fever, difficulty breathing or is holding their head in an odd position.
• Drooling seems to be worsening rapidly and is accompanied by any other worrisome symptoms such as swelling of the tongue, lips or face, or difficulty breathing (wheezing).

Neglecting medical attention can lead to greater complications, from difficulty swallowing to aspiration (and subsequent pneumonia), or choking, an emergency situation.

Treatment of drooling depends on the specific disorder and determining the root cause. For example, if drooling is the result of an infection, sometimes antibiotics are used (as long as the culprit isn't a virus). If drooling is the result of severe tonsillitis, the tonsils may have to be surgically removed. Emergency conditions such as anaphylaxis are treated with a shot of epinephrine and often the administration of antihistamines such as Benadryl.

In cases where the underlying cause cannot be cured, medications such as drops, pills and liquid medicine can be utilized to treat drooling. Scopolamine patches, glycopyrrolate, and botulinum toxin are medications that can be used to decrease the amount of production from salivary glands. Severe cases of drooling can be treated with Botox shots, radiation to the salivary glands and removal of the salivary glands.

For children who are drooling with teething, chewing on popsicles and other cold objects, such as teething rings and frozen bagels, can help curb saliva production. Be sure to monitor the child to prevent choking.

For those dealing with chronic drooling, try to limit sugary food consumption, as sugar increases saliva production. Be cognizant of any skin breakdown around the mouth since redness and irritation can occur. Applying a thin layer of vaseline or a skin barrier cream around the mouth may help to protect the skin. Use a clean cloth to frequently wipe away excess saliva and try to keep things as dry as possible. If you are a caregiver, remind the person you are caring for to keep their mouth closed and chin up.

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