Alternate Names: Drool; Salivation excessive; Increased salivation; Excessive salivation

Considerations:

Drooling is usually due to excess production of saliva, inability to retain saliva within the mouth or problems with swallowing.

There is always a potential in those who have a drooling problem to inhale into the lungs saliva, food, or fluids. However, this is unlikely unless the body’s normal reflex mechanisms such as gagging and coughing are impaired.

Common Causes:

Drooling in infants and toddlers is normal and is highly unlikely to be associated with either disease or complications. Drooling typically persists longer in boys than in girls. Drooling in infants and young children may be exacerbated by upper respiratory infect and nasal allergies.

Drooling in adults (except when asleep) results from abnormal conditions. There are no common causes of drooling in adults.

Possible causes (older children and adults):
Diseases:

• achalasia
• acoustic neuroma
• amyotrophic lateral sclerosis
• Bell’s palsy
• cerebrovascular accident (stroke)
• diphtheria
• esophageal tumor
• glossopharyngeal neuralgia
• Guillain-Barre syndrome
• hypocalcemia
• Ludwig’s angina
• mental retardation
• myasthenia gravis
• myotonic dystrophy
• paralytic poliomyelitis
• Parkinson’s disease
• seizures (generalized)
• Shy-Drager syndrome
• Wilson’s disease

Environmental:

• envenomation (snake bite or scorpion sting)
• esophageal injury
• foreign body in the esophagus or airway
• pesticide poisoning (organophosphates)
• rabies
• tetanus

Drugs:

• clonazepam
• ethionamide
• haloperidol
• nicotine - transdermal

Other causes of drooling in children:

• cerebral palsy
• dysphagia
• epiglottitis
• esophageal atresia (newborn)
• pseudodiverticulism (newborn)
• peritonsillar abscess
• retropharyngeal abscess

Home Care:

Good oral hygiene is strongly recommended. In some cases, exercising the facial muscles may help.

Aspiration of substances into the lungs can be prevented by sitting upright or by lying on one side.

Call If:

• the cause of the drooling has not been diagnosed or if there is concern about aspiration.

What To Expect:

The medical history will be obtained and a physical examination performed.

Medical history questions documenting drooling in detail may include:

• Associated conditions
• Does the person have a known history of any of the diseases that cause drooling (see causes)?
• Has the person had a bite or sting? What type?
• Has the person had an injury? What type?
• What medication are being taken?
• What other symptoms are also present?
• Is there a fever?
• Is there a sore throat?
• Is there a facial droop?
• Are there other symptoms?

Diagnostic tests will be performed as indicated by other symptoms that accompany the drooling.

Aspiration may be prevented by suctioning.

After seeing your health care provider:
If a diagnosis was made by your health care provider related to drooling, you may want to note that diagnosis in your personal medical record.