Abby Barnes, M.S., CCC-SLP
It’s normal to see your toddler drooling, especially when they're sick or teething. But excessive, heavy drooling may point to a condition called sialorrhea, or hypersalivation, in which a child has a hard time managing their saliva. This article explains the difference between typical drooling and sialorrhea, along with the signs that your child may need help with excessive drooling.
Key takeaways
Sialorrhea, also called hypersalivation, is heavy, persistent drooling. It is more excessive than typical baby or toddler drooling.
Oral-motor development, mouth breathing, sensory differences, developmental/neurological differences, or other natural factors can contribute to sialorrhea.
There are several treatment options for excessive drooling, including speech therapy and occupational therapy.
Be sure to tell your pediatrician if you see sudden, excessive drooling in your toddler.
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Screener for childrenWhat is sialorrhea?
“Sialorrhea” is the medical term commonly used to describe excessive or persistent drooling. Sialorrhea occurs when a child has difficulty managing their saliva.
Sialorrhea, also known as hypersalivation, is different from typical drooling in babies and young toddlers, which can be a normal part of development. Children often drool as they’re learning to coordinate their lips, tongue, jaw, and swallowing muscles. Teething can also cause your child to have more saliva.
Young children may drool more when they’re:
Teething
Sick with a cold or congestion
Dealing with allergies
Learning new oral-motor skills, or ways to move their mouth
Eating new foods or developing feeding skills
Tired or highly focused on an activity
As children grow, they generally become better at managing their saliva. Some children simply drool more than others, and frequent drooling doesn't automatically mean that something is wrong. However, if drooling is persistent, heavy, or sudden, it may be worth looking into the cause.
Signs of sialorrhea
Sialorrhea can look different from child to child. Parents and caregivers may notice these signs of sialorrhea:
Frequent or constant drooling
Wet shirts, bibs, or bedding
Chapped or irritated skin around the mouth and chin
Frequent wiping of the mouth
Difficulty participating comfortably in certain activities
Learn the feeding and swallowing milestones for toddlers 12 to 36 months old, plus tips for helping your toddler try new foods.
How is excessive drooling different from typical toddler drooling?
There isn't one specific age or amount of drooling that automatically makes drooling abnormal. Instead, healthcare and therapy professionals consider a child's age, overall development, how often they drool, and whether it affects everyday life.
A toddler who occasionally has a wet chin while teething is different from a child whose clothing is consistently soaked or whose skin is repeatedly irritated by saliva.
In kids who are drooling excessively, in addition to the signs above, you may notice:
The mouth is often open
Breathing through the mouth
Difficulty managing food or liquids
Coughing or choking during meals
Difficulty chewing
Tongue or jaw movements that seem hard to coordinate
Reduced awareness of saliva around the mouth
If you notice several of these signs, talk with your child's pediatrician.
What causes sialorrhea in toddlers?
There isn’t one single cause of excessive drooling. Some common causes of sialorrhea include:
Problems with oral-motor development
Children use their lips, tongue, cheeks, and jaw together to manage saliva. As these skills develop, children become better at keeping saliva in their mouths and swallowing it.
Some children may take longer to develop these skills. Some kids may even need extra support from a speech therapist. Difficulty with oral-motor skills can also occur alongside feeding problems.
Mouth breathing
Congestion, allergies, enlarged tonsils or adenoids, or other factors can cause a child to breathe through their mouth. When a child’s mouth is often open, it’s more likely that saliva will escape.
If you often notice both mouth breathing and excessive drooling, mention it to your child's pediatrician.
Sensory differences
Some children may not notice saliva around their mouths as easily as others. If a child has less awareness of saliva, they may not automatically swallow or wipe their mouth.
Problems with sensory processing and emotional regulation are often related in children. Here’s how occupational therapy can help.
Developmental or neurological differences
Some developmental and neurological conditions can affect muscle control, coordination, or swallowing and may make sialorrhea more likely.
However, persistent drooling alone does not mean that a child has one of these conditions. There are many possible explanations, and an evaluation considers the child's overall development.
Natural factors
Teething, illness, nasal congestion, and changes in feeding can all temporarily increase drooling.
What about sudden excessive drooling in toddlers?
Sudden excessive drooling in toddlers deserves attention because it's a change from your child’s usual pattern.
Sometimes, the reason is straightforward. Teething, a sore throat, congestion, or another temporary illness can all cause an increase in saliva or make swallowing less comfortable.
However, if sudden drooling is accompanied by choking, difficulty swallowing or breathing, or a child who appears very ill, seek medical attention right away.
If your toddler is simply drooling more than usual but is otherwise acting normally, eating and drinking comfortably, and breathing normally, there may be a less concerning explanation. Keep an eye on it, and contact your child's pediatrician if it continues or you’re unsure.
Learn the signs of sensory food aversion, swallowing problems, and other childhood feeding disorders that may mean feeding therapy is needed.
How is sialorrhea treated?
Treatment for sialorrhea depends on the cause of hypersalivation, the child’s age, and how much the drooling affects their daily life. Treatment options may include:
Speech or occupational therapy to improve oral‑motor control and swallowing
Medications that help reduce saliva production
Medical procedures such as injections that help decrease saliva flow
Surgery may be considered for severe or persistent sialorrhea when other treatments have not worked. Your child’s doctor can determine the right treatment plan based on your child’s needs.
How speech therapy helps with drooling
A speech-language pathologist, also known as a speech therapist, can evaluate the skills involved in saliva management. Depending on the child’s age and concerns, a speech therapist may look at the lips, tongue, cheeks, jaw, oral sensation, and natural mouth resting posture. Alexis Irazoque, M.S., L/SLP, a speech therapist with Expressable, explains that during an evaluation, the therapist will also likely assess the child’s swallowing and feeding skills. She says, “The therapist will observe the child as they eat and drink as part of their everyday activities, such as eating a favorite snack or drinking from their usual cup. This gives us a functional picture of the child’s oral-motor and feeding skills.”
If the evaluation suggests that oral-motor coordination, swallowing, or awareness is contributing to the drooling, therapy may focus on skills and strategies to help the child better manage saliva. This might include oral-motor strengthening, improving swallow function, or general awareness of when it’s time to swallow to keep saliva in the mouth.
Research shows that speech therapy can help children with significant sialorrhea. A 2025 retrospective study found improvements in drooling impact among children with developmental and neurological conditions who participated in speech therapy.
Knowledge is power
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Start the screenerHow occupational therapy helps with drooling
In some cases, occupational therapy (OT) may also be helpful. OT may be considered when sensory, motor, or functional differences are part of the bigger picture. Depending on the child, an OT evaluation may assess sensory processing, body awareness, posture, motor coordination, self-care skills, and other functional factors.
Lauren Galipp, OTR, OTD, an occupational therapist at Expressable, explains that OT can help children notice saliva and the feeling of when their face is wet. “Some children may also benefit from working on posture,” she adds. “There are many ways we as OTs can help with excessive drooling. From motor skills to sensory processing, we will holistically assess how we can best help your child.”
Occupational therapy for kids helps build the skills they need to play, learn, and grow. Learn how OTs support kids’ independence and confidence.
Find a therapist for your child
Drooling is a normal part of early childhood. But persistent or excessive drooling can sometimes be a clue that a child could use extra support.
If you’re concerned your child’s drooling might be sialorrhea, talk to your pediatrician. You can also contact Expressable to schedule a speech or occupational therapy evaluation.
Frequently asked questions (FAQs)
Babies and young toddlers drool for many reasons. Drooling might be due to teething, a cold or congestion, or allergies. Some young children drool when they’re tired or heavily focused on an activity. As babies get older, they generally become better at managing their saliva, and you should see drooling decrease.
There isn’t one trick to stop toddlers from drooling, and you don’t always have to. Drooling can be normal. If your child is otherwise developing typically, you can start with some simple strategies. Remind them to swallow, encourage them to wipe their mouth, and help them notice when their mouth or chin is wet vs. dry.
Occasional drooling generally isn’t a reason to worry. However, it’s worth bringing up to your pediatrician if the drooling is frequent or heavy, appears suddenly, or interferes with your child’s comfort or ability to participate in daily activities. It’s also important to talk with your pediatrician if your child often coughs or chokes, has difficulty swallowing, has feeding difficulties, or shows other signs of developmental issues.
How Expressable Can Help
Concerned your child isn't reaching age-expected milestones? Looking for communication support from a professional? Expressable is a national online speech and occupational therapy practice serving children and adults. We treat all major areas of communication, feeding, and developmental skills, offer flexible hours including evenings and weekends, and accept most major health insurance plans. We’re proud to have earned more than 4,500 5-star reviews from our clients (4.83/5 average).
Our therapy model is centered on parent and caregiver involvement. Research proves that empowering caregivers to participate in their loved one’s therapy leads to better outcomes. That’s why we combine live, 1-on-1 speech and occupational therapy with personalized education and home practice activities for faster progress.
