Understanding Persistent Drooling in Young Children

Megan Crooks
Oct 29
3 min read

Helping feeding, speech, and function take flight for little ones in Santa Barbara.

It’s common for babies to drool when they’re teething or exploring new textures. During infancy, drooling is a normal part of development and helps the mouth stay moist while supporting early oral exploration. However, if your child continues to drool excessively beyond the age of two, it may signal an underlying orofacial myofunctional issue that deserves attention.

What Is Persistent Drooling?

A child with curly hair is enjoying a sunny day at the beach, displaying an open mouth and poor lip seal.

Persistent drooling (also known as sialorrhea) is the excessive, unintentional loss of saliva from the mouth due to challenges with lip closure, swallowing coordination, or overall oral motor control. This is not simply a “messy phase.” Instead, it can indicate a need for oral motor strengthening or speech therapy for drooling to help your child achieve better muscle coordination and saliva management.

Key Points

Causes: Persistent drooling in toddlers is often linked to oral muscular weakness, impaired swallowing patterns, or a restrictive tongue tie (ankyloglossia). In some children, neurological conditions can further impact saliva control, requiring a collaborative team approach.

Health Implications: Ongoing drooling can cause skin irritation, social discomfort, and feeding or speech difficulties. Left untreated, it may also affect orofacial growth and oral hygiene over time.

Common Causes of Drooling

Understanding the “why” behind excessive saliva helps guide the most effective therapy plan.

Cause	Impact on Oral Health & Function	Resulting Condition
Weak Lip & Jaw Muscles	Inefficient lip seal and reduced intraoral pressure.	Continuous saliva loss and visible dribbling.
Tongue Thrust or Reverse Swallowing Patterns	Poor coordination of the swallowing reflex.	Increased saliva pooling and drooling.
Ankyloglossia (Tongue Tie)	Restricted tongue movement affecting swallowing efficiency.	Ineffective saliva clearance and chronic drooling.
Neuromuscular Conditions	Impaired orofacial coordination and poor control of oral structures.	Chronic drooling that may require multidisciplinary management.

These patterns are commonly addressed through myofunctional therapy, which helps retrain the muscles used for swallowing, chewing, and speech.

Clinical Presentation: What Parents Should Watch For

Knowing what to look for can help you decide when to seek support from a speech-language pathologist or orofacial myologist.

Category	Key Points to Look Out For
Physical Signs	- Open-mouth posture with reduced lip seal. - Saliva pooling in the front of the mouth. - Constantly wet clothing or frequent wiping.
Symptoms	- Difficulty swallowing or managing saliva. - Muffled or unclear speech due to saliva buildup. - Skin irritation or redness around the chin and mouth.
Long-term Impacts	- Social discomfort or self-consciousness. - Speech delays from weak oral motor coordination. - Ongoing hygiene challenges or recurrent rashes.
Red Flags for Referral	- Neurological conditions affecting swallowing (e.g., cerebral palsy, muscular dystrophy). - Severe speech or feeding issues. - Drooling that interferes with daily life or confidence.

What’s Happening Inside the Mouth

When the lips, tongue, and jaw don’t work efficiently, saliva can’t be cleared properly. This leads to poor saliva control and frequent drooling. Over time, the habit of keeping the mouth open or swallowing incorrectly may also affect speech clarity, feeding, and oral development.

How Therapy Can Help

A customized speech therapy or myofunctional therapy program can address the root cause of persistent drooling by:

Strengthening oral muscles for better tone and endurance.
Retraining swallowing patterns to promote efficient saliva management.
Improving intraoral pressure to support consistent lip closure and saliva control.

With consistent practice, children often experience reduced drooling, clearer speech, easier eating, and improved confidence.

When to Seek Professional Help

If your child is over two years old and still drooling frequently - especially outside of meals -it’s time to seek guidance from a speech-language pathologist near you who specializes in orofacial myology. Early evaluation and therapy can make a lasting difference in your child’s comfort and development.