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Practical Guide to Reducing Dribbling in Children: Myofunctional Therapist Insights

Excess saliva is produced during teething, and until 18-24 months, infants have not fully developed the muscles and sensory awareness needed to control and regulate this.

We all expect a small amount of dribbling in our little ones during those pesky teething months, but what is considered normal….?

The short answer is, if your child is over the age of 2, they should not be dribbling. Wet chins and soaked shirts past those early toddler years is a sign that there is a problem we need to address.

What’s the problem?

Dribbling is common in the developmental stages of infants, often accentuated during teething (Sexton & Natale, 2009)[Sexton-Natale-2009]. However, the persistence or excessive presence of this symptom beyond the developmental stage – typically post toddlerhood, when salivary control is expected to mature (O’Dell & Parsons, 2004)[#ODell-Parsons-2004] – may be indicative of underlying issues related to oral-motor coordination, swallowing disorders, or broader myofunctional deficits. Indicators that suggest the necessity for a more comprehensive evaluation include:

  • Persistent drooling beyond the teething stage
  • Difficulties with chewing or swallowing (Arvedson & Brodsky, 2002)[#Arvedson-Brodsky-2002]
  • Speech / articulatory deficits (Boshart, 2018)[#Boshart-2018]
  • Habitual mouth breathing (Jefferson, 2010)[#Jefferson-2010]
  • Observable facial muscle incoordination or asymmetry

Mouth breathing, possible tongue tie, low oral tone, immature swallowing habits and sensory differences/retained reflexes are likely to blame for your child’s dribbling. These issues are usually a package deal.

Breathe First’s Top Tips for Reducing Dribbling

  • Ditch the sippy cups. Use straws for drinking (only the tip of the straw sitting on the edge of rounded lips).
  • Discourage oral habits such as thumb/finger sucking.
  • Encourage lip closure- lips closed- breathe through the nose!
  • Give your child a range of textures- more raw/chewy and crunchy foods to really make those oral muscles work hard!

When to Seek Professional Help

While the tips above may help, persistent dribbling may require professional assessment and intervention.

Whether or not part of a wider developmental condition such as Cerebral Palsy or Down’s Syndrome, a combination of sensory integration, muscle strengthening and swallowing work will increase oral tone and awareness, helping your child to have better nasal breathing and oral posture, thus eliminating their dribbling, and along the way, helping them to progress with sleep, feeding, speech and wider development. Please contact me for further information.

Sources and Further Reading

  • Sexton, S., & Natale, R. (2009). Risks and benefits of pacifiers. American Family Physician. Link
  • O’Dell, K. H., & Parsons, C. L. (2004). Developmental milestones: Oral-motor skills, swallowing, and feeding. Perspectives on Swallowing and Swallowing Disorders (Dysphagia). Link
  • Arvedson, J. C., & Brodsky, L. (2002). Pediatric Swallowing and Feeding: Assessment and Management. Albany, NY: Singular Publishing Group. Link
  • Boshart, C. (2018). Functional Assessment and Remediation of TOTs (Tethered Oral Tissues). Charleston, SC: TalkTools. Link
  • Jefferson, Y. (2010). Mouth breathing: Adverse effects on facial growth, health, academics, and behavior. General Dentistry. Link
  • American Speech-Language-Hearing Association. (n.d.). Orofacial Myofunctional Disorders (OMDs). Retrieved from ASHA
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