Review of management of drooling problems in neurologically impaired children: a review of methods and results over 6 years at Chailey Heritage Clinical Services

Abstract

Drooling can be a difficult problem for a child to endure, both physically and socially, especially if they are also having to cope with physical disabilities. Chailey Heritage Clinical Services and associated School look after a large number of severely physically disabled children and adolescents. This paper reviews the management strategy of the multidisciplinary oral-motor clinic at Chailey Heritage Clinical Services, and reviews the results of children treated between 1990 and 1996. The management ranges from oral-motor skills training through palatal training appliances to surgery. Seventy-eight children, ranging from 3 to 17 years, were treated and there were complete records for 73. Eighteen per cent responded to oral skills training alone. Thirty per cent of children had good results with a palatal training appliance and did not need any further intervention. Forty-seven per cent of patients underwent some form of surgery to control their drooling. Only 8% of children were treated with medication.

Clinical-therapeutic management of drooling: Review and update

“…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).…”

An evidence‐based approach to the child who drools saliva

“…It helps to involve a trained speech and language therapist. Children with mild drooling problems can achieve significant benefit from such a programme; but those with severe developmental delay will not be able to comply. The advice of a dentist or orthodontist may be required if caries or malocclusion are an issue. Palatal training appliances can promote increased oral awareness , which is thought to increase tongue movement and promote swallowing initiation 4 . These are acrylic plates similar to those used for orthodontic treatment, with a wire posteriorly which stimulates the soft palate.…”

“…Palatal training appliances can promote increased oral awareness , which is thought to increase tongue movement and promote swallowing initiation 4 . These are acrylic plates similar to those used for orthodontic treatment, with a wire posteriorly which stimulates the soft palate.…”

“…• Palatal training appliances can promote increased oral awareness, which is thought to increase tongue movement and promote swallowing initiation. 4 These are acrylic plates similar to those used for orthodontic treatment, with a wire posteriorly which stimulates the soft palate. These require a dental impression to fit and are limited to children over the age of six as partial dental maturity is required to secure them in position.…”

Behavioral Treatment of Drooling

“…It is a normal phenomenon in infancy and usually subsides as oral motor function matures. Drooling while awake after 4 years of age is considered abnormal Behavioral procedures to treat drooling should be considered before other, more intrusive treatments like medication and surgery are implemented (Blasco, 2002;Brei, 2003;Hussein et al, 1998;Lloyd Faulconbridge, Tranter, Moffat, & Green, 2001;Meningaud, Pitak-Arnnop, Chikhani, & Bertrand, 2006;Nunn, 2000). However, empirical studies on behavioral procedures are scarce.…”