Drooling (Sialorrhea)

Disclaimer: This information sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

What is it?

Drooling, dribbling or sialorrhea is a medical condition. It is not a disease, or an illness, but may be a symptom of an underlying illness or condition. Drooling is the spillage of saliva from the mouth or oral cavity and is often a problem in neurologically impaired children who have muscle weakness or incoordinated swallowing muscles. Drooling is an inability to swallow or hold saliva in the oral cavity and is rarely associated with an over production of saliva. Some medications such as, Clomazepan may worsen drooling as a side effect. Drooling occurs if a person cannot swallow their saliva faster than it is produced or can not co-ordinate their lips etc to hold the saliva in their mouths prior to swallowing it is not generally due to an `over production' of saliva.

Drooling can cause many different problems for both the child and their carers, for example:

• increased care (increased clothing/ bib changes)
• soiling of household furnishings, toys, school supplies (including computers)
• skin excoriation and rashes
• reduced self-esteem and possible embarrassment
• difficulty producing some speech sounds clearly
• and possible social stigmatism

Who do I see?

Drooling is often primarily managed by a Speech Pathologist. Non invasive procedures, such as oral exercises or awareness strategies are generally trialed and recommended in the initial management of drooling.

Sometimes in severe or chronic cases a recommendation may be made to a paediatrician or ENT surgeon for drug or surgical management.

Treatment

Difficulty swallowing saliva may be encountered at three different levels, during: the oral, pharyngeal and oesophageal (tube leading to the stomach) phases of swallowing. Drooling is managed at the level in which the breakdown has occurred and may require a variety of treatment procedures, including:

• oral musculature exercises
• self awareness and management techniques
• drug therapy (however this is rarely successful in long term management)
• surgery
• oral/dental prosthetics (in the case of structural abnormalities)
• specific positioning or seating
• suctioning (in severe and less mobile cases)

Remember

• Always consult your Speech Pathologist or Doctor if you have any concerns about your child's swallowing.
• See Swallowing/Dysphagia for more information on swallowing difficulties.

Rehabilitation Department The Children's Hospital at Westmead Cnr Hawkesbury Rd & Hainsworth St, Westmead Locked Bag 4001, Westmead, 2145 Tel: (02) 9845 2132 - Fax: (02) 9845 0685 http://www.chw.edu.au/rehabilitation/