Drooling: review of the literature and proposals for management

Nunn, June

doi:10.1046/j.1365-2842.2000.00575.x

Cited by 51 publications

(56 citation statements)

References 21 publications

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“…By the age of 24 months, most children are able to engage in advanced fine motor tasks such as manipulation of small objects in play or speaking two-word sentences without drooling (23). When drooling persists in children aged 4 years and older, psycho-social and physical well-being is negatively affected (24).…”

Section: Not-s Examinationmentioning

confidence: 99%

Oral motor dysfunction in children with adenotonsillar hypertrophy—effects of surgery

Lundeborg

McAllister

Graf

et al. 2009

Logopedics Phoniatrics Vocology

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Full terms and conditions of use: http://www.informaworld.com/terms-and-conditions-of-access.pdf This article may be used for research, teaching and private study purposes. Any substantial or systematic reproduction, re-distribution, re-selling, loan or sub-licensing, systematic supply or distribution in any form to anyone is expressly forbidden.The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material. Department of Nursing Science, School of Health Sciences, Jönköping, SwedenAbstract Adenotonsillar hypertrophy is associated with a wide range of problems. The enlargement causes obstructive symptoms and affects different functions such as chewing, swallowing, articulation, and voice. The objective of this study was to assess oral motor function in children with adenotonsillar hypertrophy using Nordic Orofacial Test-Screening (NOT-S) before and 6 months after surgery consisting of adenoidectomy combined with total or partial tonsil removal. A total of 67 children were assigned to either tonsillectomy (n 033) or partial tonsillectomy, 'tonsillotomy' (n034); 76 controls were assessed with NOT-S and divided into a younger and older age group to match pre-and post-operated children. Most children in the study groups had oral motor problems prior to surgery including snoring, open mouth position, drooling, masticatory, and swallowing problems. Post-surgery oral motor function was equal to controls. Improvement was independent of surgery method.

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Section: Not-s Examinationmentioning

confidence: 99%

Oral motor dysfunction in children with adenotonsillar hypertrophy—effects of surgery

Lundeborg

McAllister

Graf

et al. 2009

Logopedics Phoniatrics Vocology

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show abstract

“…On the other hand, there is no single protocol that can be applied to the different clinical cases seen; rather, an individualized management strategy must be developed for each patient (14). The different therapeutic options found in the literature include myofunctional therapy, behavioral change programs, drug treatments and surgery designed to correct or avoid drooling (7,(14)(15)(16). Other options have not been considered in this study, due to their side effects (as in the case of radiotherapy) or because of their minority application in current clinical practice (as in the case of acupuncture) (17).…”

Section: Review Of the Literature -Physiopathology Of Drooling And Etmentioning

confidence: 99%

Clinical-therapeutic management of drooling: Review and update

Silvestre‐Rangil¹,

Silvestre²,

Puente-Sandoval³

et al. 2011

Med Oral

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Drooling is the uncontrolled leakage of saliva outside the mouth, generally as a result of difficulty in swallowing the saliva produced. Many factors contribute to drooling, though it is more commonly seen in children with brain paralysis -particularly those receiving anticonvulsivant medication. Drooling is also often seen in patients with lip sealing problems or malocclusions such as anterior open bite. Clinically, the affected patients can develop skin irritation or abrasions, problems of hygiene, unpleasant smell and -in the more severe presentations -the need to wear protectors or frequently change clothing. Treatment of this disorder is complex, and should be addressed from a multidisciplinary perspective, with planning on an individualized basis. Among the different existing managements, myofunctional therapy, behavioral change programs and drug treatments are the most widely used options, though there are also more invasive surgical techniques designed to reduce or cause submandibular saliva secretion to be rerouted towards posterior zones of the oral cavity. In any case, no scientific evidence-based management protocol has yet been established capable of affording favorable results in the majority of cases. The present study offers a review and update on the clinical and dental management aspects of drooling.

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“…Drooling also occurs frequently in tetraplegic patients with severe brain injury and persistent drooling may cause nausea, vomiting, and coughing due to continuous sucking of saliva, aspiration into the airway and, if severe, recurrent aspiration pneumonia as well as hygiene problems that may significantly decrease quality of life. A variety of surgical and non-surgical treatments have been used to diminish drooling; those with few, uncertain or unsatisfactory results lead to complications [7]. …”

Section: Introductionmentioning

confidence: 99%

Botulinum Toxin in the Treatment of Drooling in Tetraplegic Patients With Brain Injury

Shin

Min

et al. 2013

Ann Rehabil Med

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ObjectiveTo investigate the effect of botulinum toxin type A (BTA) injection into the salivary gland and to evaluate the changes of drooling in varied postures in tetraplegic patients with brain injury.MethodsEight tetraplegic patients with brain injury were enrolled. BTA was injected into each parotid and submandibular gland of both sides under ultrasonographic guidance. Drooling was measured by a questionnaire-based scoring system for drooling severity and frequency, and the sialorrhea was measured by a modified Schirmer test for the patients before the injection, 3 weeks and 3 months after the injection. Drooling was evaluated in each posture, such as supine, sitting, and tilt table standing, and during involuntary mastication, before and after the injection.ResultsThe severity and frequency of drooling and the modified Schirmer test improved significantly at 3 weeks and 3 months after the injection (p<0.05). Drooling was more severe and frequent in tilt table standing than in the sitting position and in sitting versus supine position (p<0.05). The severity of drooling was significantly increased in the patients with involuntary mastication (p<0.05).ConclusionSalivary gland injection of BTA in patients with tetraplegia resulting from brain injury who had drooling and sialorrhea could improve the symptoms for 3 months without complications. The severity and frequency of drooling were dependent on posture and involuntary mastication. Proper posture and involuntary mastication of the patients should be taken into account in planning drooling treatment.

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Drooling: review of the literature and proposals for management

Abstract: The aetiology of drooling is described alongside the alternative treatment strategies for what is a disturbing disorder for many children. The advantages and disadvantages of each treatment modality are discussed. Conditions for optimal management are described.

Cited by 51 publications

References 21 publications

Oral motor dysfunction in children with adenotonsillar hypertrophy—effects of surgery

Oral motor dysfunction in children with adenotonsillar hypertrophy—effects of surgery

Clinical-therapeutic management of drooling: Review and update

Botulinum Toxin in the Treatment of Drooling in Tetraplegic Patients With Brain Injury

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