Challenges in managing drooling in children

Drooling is the unintentional loss of saliva from the mouth, either anteriorly (visible) or posteriorly (with a risk of coughing, vomiting, aspiration and chronic respiratory disorders).(1,2) Anterior drooling is normal in infancy, but is considered neuro-developmentally abnormal if it occurs in children over the age of 4 years old, and is commonly seen in those with physical, intellectual and learning disability, and poor neuromuscular coordination and oral control.(1,3-7) For example, drooling occurs in 10-38% of children with cerebral palsy.(6,8) Drooling is usually due to failure to clear saliva rather than hyper-salivation (sialorrhoea), and a head-down posture and sucking on fingers or clothing may be contributory factors.(1,2,5-7) Here we review the challenges associated with the management of drooling in children.