Drooling is saliva flowing outside the mouth.

Salivation

Drooling is generally caused by:

• Problems keeping saliva in the mouth
• Problems with swallowing
• Too much saliva production

Some people with drooling problems are at increased risk of breathing saliva, food, or fluids into the lungs. This may cause harm if there is a problem with the body's normal reflexes (such as gagging and coughing).

Drooling caused by nervous system (neurologic) problems can often be managed with drugs that block the action of the chemical messenger acetylcholine (anticholinergic drugs). In severe cases, people can reduce drooling by injecting botulism toxin, getting high-energy x-rays (radiation) to the glands in the mouth that make saliva (salivary glands), and other methods.

Some drooling in infants and toddlers is normal and is not usually a sign of a disease or other problem. It may occur with teething. Drooling in infants and young children may get worse with upper respiratory infections and nasal allergies.

Drooling that occurs with fever or trouble swallowing may be a sign of a more serious disease, including:

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

Sudden drooling may occur with poisoning (especially by pesticides) or a reaction to snake or insect venom.

Other things that can cause drooling:

• Certain medications
• Nervous system (neurological) problems

Care for drooling due to teething includes good oral hygiene. Popsicles or other cold objects (such as frozen bagels) may be helpful. Take care to avoid choking when a child uses any of these objects.

Call your health care provider if:

• The cause of the drooling has not been diagnosed.
• There is concern about aspiration.
• Your child has a fever, difficulty breathing, or holds his or her head in a strange position.

The doctor will do a physical examination and ask questions about the symptoms, including:

• Is there a history of any other diseases?
• Has the person had a bite or sting?
• Has the person had an injury?
• What medications is the person taking?
• What other symptoms are present (such as fever, sore throat, facial droop)?

The tests performed depend on the symptoms that occur with the drooling.

Lowell MJ. Esophagus, stomach, duodenum. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 87.

Melio FR. Upper respiratory tract infections. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 73.

Vanderhoff BT, Carroll W. Neurology. In: Rakel RE. Textbook of Family Medicine. 7th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 54.

Review Date: 02/07/2010

Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.