Drooling or dribbling – the unintentional loss of saliva from the mouth – can affect both children and adults with special needs.
There may be a number of causes, including:
• Abnormalities in swallowing
• A reaction to medications which cause an increase in saliva
• Difficulty moving saliva to the back of the throat
• Tongue thrusting
• Jaw instability
• Inflammation of the mucous membranes of the mouth
Excessive drooling can have health and hygiene implications. The skin around the mouth, chin and neck can easily get red and sore, the loss of fluid can lead to dehydration, there may be problems with eating, and infections may be more easily transmitted.
The following tips have been contributed by parents of children and adults with special needs, who have experienced problems with dribbling. We hope you will find them useful.
Playing mouth games, like blowing raspberries or kisses, can help strengthen muscles and reduce drooling. Try blowing bubbles in the bath water with straws or have a competition to see how far you can both blow feathers, cotton wool balls or tissue paper.
Waterproof pillow cases
We buy waterproof pillowcases that we put underneath the children’s nice cases – still have to wash them all the time, but it saves their pillows.
Our doctor prescribes Atrovent nebules in my son’s nebuliser machines and that stops the dribbling. We used to go through about 6 bibs a day, now we’re down to 2.
Drinking pineapple juice is reported to reduce the amount of saliva produced, which can be helpful to people who have difficulties in coping with their oral secretions.
If you care for someone who dribbles, get brightly coloured flannels and sew a button to one corner and a loop of tape (name tapes work well) to the diagonally opposite corner. This makes a trendy neckerchief (folded diagonally) which is more age appropriate than a bib. Velcro is also useful and microfibre towels can be cut to size.
There are various surgical procedures that help reduce drooling including turning the salivary glands towards the back of the mouth, so that saliva runs towards the back rather than the front of the mouth.
Use a straw
Encourage the use of a straw for drinking to strengthen the muscles of the lips, mouth and throat. An upright head position and straight posture is best as stooping encourages drooling
When Timmy was younger, I used to gently remind him to swallow before talking by pretending to be be a frog and doing a big gulp. It made him laugh so didn’t seem ‘naggy’. Now as an adult, its second nature to him to swallow before opening his mouth.
Scented lip balm
I always put a strong smelling lip balm on my daughter. I’m convinced it helps remind her to swallow her saliva
I found Ahmed drooled less at night if he used nasal strips. Breathing through his nose, not his mouth really helps
A Speech & Language Therapist advised us to gently massage our daughter’s cheeks using a forefinger in a circular motion. This encourages her to swallow
Scopoderm /Hyoscine patches
There are patches available which can be cut up and worn behind the ear to help reduce excessive saliva. Ask your doctor about them. They don’t suit every patient but may be worth trying out
Make your own face wipe
Make your own bib/face wipe by sewing elastic onto a face cloth or – if you want it bigger – use a hand towel. You can pull it forward easily to wipe the person’s mouth, without pulling on their neck. You can also attach to a tennis sweat band to put it on their wrist for them to wipe their own mouth.
I have just ordered a Logitech Washable Keyboard K310, as my son destroys keyboards with drool. It’s a washable keyboard that is easy to clean and easy to dry because it’s submergible in up to 30 cm (12 inches) of water and has convenient drainage holes at the back. We also use a Griffin Defender case for his iPad and have found this to be the most drool resistant.