What Is Pediatric Chronic Sialorhea?

What Is Pediatric Sialorrhea?

  • Sialorrhea is drooling or excessive salivation1
  • It is normal in infants, but usually stops by 15-18 months of age2

445,000 children under the age of 18 are estimated to suffer from pediatric sialorrhea in the United States.3,4

What Causes Pediatric Sialorrhea3

  • Cerebral Palsy (CP)
  • Traumatic Brain Injury
  • Epilepsy
  • Congenital abnormality of brain development such as down syndrome, autism, angelman syndrome, and rett syndrome

Symptoms of Pediatric Sialorrhea1

  • Hypersalivation (excessive drooling)
  • Skin breakdown around the mouth
  • Infection from the skin breakdown
  • Dehydration or not enough fluids
  • Foul odor

Impact on Daily Living5-11

Signs, symptoms, and effects of Sialorrhea


  1. Hockstein NG, Samadi DS, Gendron K, Handler SD. Sialorrhea: a management challenge. Am Fam Physician. 2004;69(11):2628-2634. http://www.aafp.org/afp/2004/0601/ p2628.html. Accessed November 19, 2020.
  2. Fairhurst CB, Cockerill H. Management of drooling in children. Arch Dis Child Educ Pract Ed 2011;96:25-30.
  3. LakrajAA, MoghimiN, Jabbari B. Sialorrhea: anatomy, pathophysiology and treatment with emphasis on the role of botulinum toxins.Toxins (Basel). 2013;5(5):1010-1031.
  4. AACPMD.org/publications/care-pathways/sialorrhea
  5. Kalf JG et al. J Neurol 2007;254:1227–32.
  6. Ou R et al. Parkinsonism Relat Disord 2015;21:211–5.
  7. Banfi P et al. Respir Care 2015;60:446–54.
  8. Leibner J et al. Parkinsonism Relat Disord 2010;16:475–7.
  9. Schirinzi T et al. Clin Neurol Neurosurg 2017;156:63–5.
  10. El-Hakim H et al. Arch Otolaryngol Head Neck Surg 2008;134:470–4.
  11. DamianA et al. Parkinsonim Relat Disord 2012:18:1089-93.