Drooling

The uncontrolled and continuous release of saliva from the mouth is known as drooling. While accepted as normal in young children up to 2 years of age, drooling in older children and adolescents is secondary to altered orofacial neuromuscular control during development, and in the elderly it is a consequence of neurodegenerative disease. The underlying cause is patient inability to seal the lips, excess salivation and the inability to adequately swallow saliva. The estimated mean prevalence of drooling in such elderly patients is 37%. Drooling can give rise to irritation and excoriation of the skin around the mouth or chin, favors infections and gives rise to speech or eating disorders. Observational methods based on collection of the leaked saliva or documentation of the affected skin zones can be used to measure drooling. The management of such patients requires a multidisciplinary approach and comprises myofunctional therapy, behavioral change techniques, the administration of antisialagogues, botulinum toxin, or the use of certain surgical techniques designed to reduce salivary secretion or to deviate it towards posterior areas of the oral cavity.