Ask Dr. Marla: My 2-year-old daughter drools non-stop

My daughter is two and she drools non-stop. I don’t think she’s teething but there are spaces between her teeth and she has an underbite. Could this be the reason she always ends up with a wet shirt or is there some underlying condition at work?

Answer:

To answer your question I turned to Dr. Mindy Cash, a dentist at the University of Toronto. Generally a child has all of their 20 “baby” teeth in the mouth by age two and a half to three. If your daughter is still teething, the excess saliva may be a result of her teeth coming in a bit later.

Drooling is a normal occurrence in children before the development and control of their muscles around the mouth and lips. Part of that control means children can feel the wetness around the mouth and chin, swallow frequently to control the saliva buildup, close their lips and ultimately have the ability to control salivary suction. This involves quite a bit if you look at all the steps that are involved in controlling drooling. It usually happens around age two, but is not considered a problem until after age four.

Saliva serves several purposes, including:

• lubricating the mouth for chewing, swallowing and speech 
• washing away debris
• preventing tooth decay by buffering acids in the mouth
• helping in digestion

Too much saliva, however, can cause persistent wetness of the mouth and chin leading to skin irritations and possible infections, wetness and staining of clothing, and may become a potential embarrassment as the child gets older.

Children who have neurologic impairments may show delays in this whole process, but may continue with development for several years. Excessive drooling in an otherwise normally developing child may be due to an abnormal oral sensitivity, with or without a delay in the muscle control. Less commonly it is due to excess production of saliva. Other causes may include oral infections, nasal obstructions and medications. The incidence of chronic excessive drooling is about 0.6 percent.

As far as bite is concerned, Dr. Cash reminds us that young children often show variations in their bite, but these aren’t necessarily a predictor of future problems. If your child is a persistent thumb sucker, you might want to encourage them to stop.

To help deal with the excess drooling, you may need to keep absorbent bibs or wristbands on your child to help to control the wetness. Some young children are simply unaware of the drooling. If the problem becomes chronic, talk to your doctor who might suggest a referral to a speech pathologist, dentist or Ear, Nose and Throat specialist who can assess your child’s needs and help develop a plan.

Originally published in ParentsCanada, July 2012