Practice 10-Minute Consultation

The drooling child

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h38 (Published 29 January 2015) Cite this as: BMJ 2015;350:h38
  1. Aikaterini K Dritsoula, paediatric ear, nose, and throat senior clinical fellow 1,
  2. David Greenstreet, general practitioner2,
  3. Mahilravi S Thevasagayam, ear, nose, and throat consultant surgeon1
  1. 1Paediatric ENT Department, Sheffield Children’s Hospital, Sheffield S10 2TH, UK
  2. 2Sloan Medical Centre, Sheffield, UK
  1. Correspondence to: A K Dritsoula mdritsoula{at}yahoo.gr

The parents of a 4 year old child present with concerns about drooling. Severe drooling may be associated with comorbidities, such as cerebral palsy, severe mental retardation, and hypoxic encephalopathy, and affects the wellbeing of children with disabilities as well as increasing the demand on their carers. Treatment improves children’s quality of life and reduces their care burden.1 2

What issues you should cover

  • Is the onset sudden? This raises the possibility of oropharyngeal infection or a swallowed foreign body, which should be evident from history taking and examination of the throat.

  • Does the child have developmental delay? Drooling in a child with developmental delay and comorbidity is more likely to be a serious long term issue.

  • What is the impact of drooling on the quality of life of the child and the parents or carers?

    • -Is there perioral soreness?

    • -How often do bibs or clothes need to be changed?

    • -Is drooling causing toys, computers, and other electronic devices to get damp, malfunction, or stop working?

    • -Is there evidence that drooling affects interactions with other children?

    • -Do the parents think that the child’s self esteem is being affected?

  • Is the child getting recurrent chest infections? If the child is choking on food, a swallowing assessment of aspiration risk may be needed. Spontaneous …

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