Drooling

Drooling happens when saliva escapes from the mouth instead of being swallowed. Too much saliva production, trouble swallowing, or weak muscles around the mouth usually cause drooling.

Many people notice this during sleep, but it can also result from certain foods, allergies, dental problems, or health conditions like stroke or Parkinson’s disease. For some, drooling is just a minor annoyance. For others, it can signal an underlying issue that may need attention.

Definition of Symptom

Drooling is the unintentional flow of saliva outside the mouth. It occurs when someone cannot properly control or swallow their own saliva. Salivary glands make saliva, which helps moisten food and start digestion.

Sometimes, saliva production increases, or a person cannot keep saliva inside their mouth. This can cause excessive drooling, also called sialorrhea. Common symptoms of drooling include:

• Wetness around the mouth or chin.
• Droplets of saliva on clothing or bedding.
• Trouble swallowing or clearing saliva.

Some people notice drooling mostly while sleeping or when tired. In others, it may happen all day, especially if there are problems with the muscles in the mouth or throat. Infants and toddlers often drool because their mouth muscles are still developing. In adults, excessive drooling can point to other health conditions or problems with swallowing.

It is important to look at both how much saliva is produced and how well it is managed in the mouth. When someone produces too much saliva or has weak mouth muscles, drooling is more likely.

Key Terms

Term	Meaning
Saliva	Liquid made by salivary glands.
Sialorrhea	Another term for excessive drooling.
Hypersalivation	Producing too much saliva.
Salivary Glands	Glands responsible for saliva production.

Possible Causes/Diseases Condition

Many things can cause drooling. Sometimes it signals a health condition, other times it’s a reaction to daily situations. Neurological disorders often cause drooling. Conditions like Parkinson’s disease, ALS, stroke, and cerebral palsy can weaken the muscles around the mouth and throat, making it hard to control saliva.

Age makes a difference. Young children often drool because their mouth muscles are not fully developed. In older adults, age-related changes or health conditions may lead to drooling. Some infections can increase saliva or make swallowing difficult, such as:

• Strep throat
• Sinus infections
• Peritonsillar abscess
• Mononucleosis

Certain digestive issues like acid reflux and GERD can increase saliva production.

Table: Examples of Causes

Cause Type	Examples
Neurological	Parkinson’s disease, ALS, stroke, cerebral palsy
Infections	Strep throat, mononucleosis, sinus infections, peritonsillar abscess
Digestive	Acid reflux, GERD
Age-related	Young children, older adults

Certain medications can also cause increased saliva or make it harder to swallow, leading to drooling as a side effect.

Other Non-Disease Causes

Not all drooling comes from illness. Everyday factors can play a role. Sleeping position can cause drooling. Sleeping on the side or stomach allows gravity to pull saliva from the mouth more easily.

Teething often causes babies and toddlers to drool because new teeth increase saliva production. Allergies can trigger extra saliva. If the nose is stuffy or someone has post-nasal drip, mouth breathing becomes more common, making drooling more likely.

Some medications list drooling as a side effect, including drugs for mental health or neurological conditions. Certain foods can also make a difference. Eating very acidic or spicy foods may increase saliva. Sometimes just smelling food before a meal can trigger more saliva.

How It Causes the Symptom

Drooling happens when saliva leaks out of the mouth instead of being swallowed. This usually involves problems with swallowing, muscle control, or saliva production. People who have difficulty swallowing may not clear saliva as often or as well, so it builds up and spills from the mouth.

Weak muscle control around the lips, tongue, or throat also makes it harder to keep saliva in and move it to the back of the throat for swallowing. Neurological conditions such as cerebral palsy or Parkinson’s disease often affect these muscles. Sometimes, the body makes too much saliva. Certain health conditions, foods, medications, or infections can cause the salivary glands to work harder.

Some treatments can help manage drooling. Certain anticholinergic medications can reduce saliva production. In severe cases, botulinum toxin injections into the salivary glands may also help. The table below summarizes factors that lead to drooling:

Cause	Description
Difficulty swallowing	Trouble swallowing saliva.
Weak muscle control	Poor coordination in mouth and throat muscles.
Excess saliva production	Glands make more saliva than usual.
Medication side effects	Certain drugs boost or slow saliva production.
Neurological conditions	Brain or nerve problems reduce control over swallowing or muscles.

Possible Complications

Excessive drooling can lead to several complications that may affect daily life.

• Skin Irritation: When saliva stays on the skin for long periods, it can cause redness, rashes, or sores. The skin around the mouth and chin can become sore and painful.
• Social and Emotional Effects: Drooling can be embarrassing, especially for older children and adults. It may cause people to avoid social situations, leading to feelings of isolation or low self-esteem.
• Aspiration Risk: People with trouble swallowing have a higher risk that saliva or food might go into the lungs instead of the stomach. This can cause infections like pneumonia, especially in those with neurological problems.
• Dehydration and Loss of Nutrients: Constant loss of saliva can sometimes lead to dehydration. Saliva contains important enzymes and minerals, so losing too much may also affect nutrition.

Table: Key Complications of Drooling

Complication	Possible Impact
Skin problems	Redness, rashes, sores
Social difficulties	Embarrassment, isolation
Aspiration pneumonia	Breathing problems, lung infection
Dehydration	Dry mouth, less saliva for digestion

Some people with ongoing drooling may develop breathing issues if the body’s normal reflexes, such as coughing, don’t work well. This makes it important to address drooling, especially in those with health conditions.

When to Seek Medical Attention

Most drooling in babies and toddlers is normal, especially during teething or when they are learning to control mouth muscles. In adults and older children, occasional drooling during sleep also happens often. See a doctor if:

• Drooling starts suddenly and you can’t explain why.
• You have trouble swallowing or speaking.
• Drooling comes with weakness in the face or limbs.
• You notice pain, swelling, or a fever.

You should also visit a healthcare provider if drooling causes skin irritation, dehydration, or social problems. Go to the emergency room if drooling happens with:

• Trouble breathing
• Choking
• Sudden facial droop
• Severe confusion

Common signs that need urgent care:

Symptom	What it may mean
Trouble swallowing	Nerve or muscle problems
Sudden facial weakness	Possible stroke
High fever	Infection or inflammation
Sudden confusion	Medical emergency

If you notice drooling along with any of these signs, get checked by a medical professional right away. People who have ongoing or severe drooling should talk to their doctor to find out the cause and discuss possible treatments.