Drooling (Sialorrhea)
Chronic excessive drooling (also known as sialorrhea) is a common condition in children, especially those with neurological disorders such as cerebral palsy or developmental delays. While drooling is normal in infants and toddlers, it becomes a concern when it persists beyond the typical age or significantly interferes with daily life. Children with sialorrhea may struggle with skin irritation around the mouth and chin, social embarrassment, difficulty with speech and feeding, and a higher risk of aspiration (saliva entering the lungs) which can lead to infections.
Medical management of drooling usually starts conservatively. Some children may benefit from nasal medications like ipratropium bromide, which can reduce saliva production when used as a nasal spray. Oral medications such as glycopyrrolate or scopolamine patches may also be prescribed to help decrease saliva flow. These medications can be effective but may come with side effects like dry mouth, constipation or urinary retention and require close monitoring by your child’s doctor.
For children who do not respond well to medications or who experience side effects, Botox (botulinum toxin) injections into the salivary glands may be beneficial. This treatment temporarily reduces saliva production by weakening the nerves that stimulate the glands. Botox injections are done with the help of ultrasound guidance and can provide relief for several months at a time. It is a minimally invasive option that can be repeated as needed and is generally well-tolerated.
In more severe or persistent cases, surgical options may be considered. Drooling surgery typically involves either removing or repositioning the salivary glands or ducts to reduce saliva flow toward the front of the mouth. These procedures are usually reserved for children who have tried other treatments without success and who are good candidates based on their overall health and ability to tolerate surgery. Our physician at ENT for Kids have specialty expertise to share with families in making these decisions. With the right approach, many children experience a significant improvement in drooling and its impact on their daily lives.
If your child is struggling with chronic drooling, please reach out to our team to arrange a consultation.