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Drooling or dribbling is not uncommon in young children. This may be due to the fact that the child has difficulty swallowing the saliva either due to lack of co-ordination in swallowing the saliva or a low tone in the oral region or due to enlarged tonsils and adenoids causing difficulty swallowing the saliva and breathing at the same time. Most commonly dribbling is seen in children with neurologic conditions such as Cerebral Palsy and Down Syndrome as well as those with intellectual handicap. In some children with very enlarged adenoids and tonsils there may not be any other associated cause.

The first management is to establish a possible cause and then to arrange a treatment plan for this. Most medications used for drooling have not been effective in the long term. Therefore surgical management, the first of which is usually tonsillectomy and adenoidectomy, if these are enlarged, is indicated. If these procedures are unsuccessful, then the salivary glands involved in secreting saliva, which are the parotid, submandibular and sublingual glands may need to be addressed. In some cases the ducts that come from the parotid gland into the mouth are tied off and in some cases the duct from the submandibular gland to the front of the mouth are relocated back into the tonsillar region so that the saliva can drain down the throat rather than out of the mouth.  On some occasions the submandibular glands are removed surgically.

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