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Drooling: Symptoms, Causes & How to Stop Drooling While Sleeping

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Last updated August 27, 2020

Drooling questionnaire

Use our free symptom checker to find out what's causing your drooling.

Drooling, is when saliva runs out of your mouth & down your chin instead of being swallowed. The most common cause of drooling is too much saliva being produced.

Drooling questionnaire

Use our free symptom checker to find out what's causing your drooling.

Drooling symptom checker

Drooling symptoms

Drooling, which means saliva runs out of your mouth and down your chin instead of being swallowed, may seem like a harmless albeit odd problem to have, unless of course you're deep asleep. However, when it happens uncontrollably it can cause damaged facial skin, embarrassment, frustration, and social isolation.

It can also be a symptom of a more serious neurologic problem in anyone over the age of about 2 to 4 years.

Drooling is also known by the medical terms sialorrhea or hypersalivation, and again is defined as saliva that runs out of your mouth beyond the margin of your lip.

Common characteristics of drooling

If you're experiencing drooling, it's likely to also experience:

  • Skin problems: Facial chapping, skin damage, and infection from the persistent moisture on your cheeks and chin and having to constantly wipe it away.
  • Mouth odor and "bad breath": There is so much saliva lost to drooling that not enough is left to maintain proper pH and help cleanse the tissues of your mouth.
  • Difficulty swallowing: This is due to food remaining too dry.
  • Impaired digestion of starches: Since this actually begins with the saliva in your mouth

Who is affected by drooling symptoms?

Drooling is more common in younger children, however, it can be present in older people due to other conditions.

  • Infants and toddlers: Drooling is normal in infants and toddlers, though it normally stops by the age of 18 months.
  • Older children and adults: If drooling continues or first begins after the age of four years, it is almost certainly due to some abnormal condition and should be addressed by your medical provider.

Are drooling symptoms serious?

The severity of drooling is ultimately dependent on the cause.

  • Not serious: Drooling is not serious if it occurs only in very young children or in response to some temporary condition such as an injury to the mouth and teeth.
  • Moderately serious: However, the condition can interfere with quality of life if it becomes chronic and causes facial skin breakdown, social isolation, and psychological distress.
  • Serious: Drooling can be a symptom of a serious neurologic condition, and sometimes other symptoms of neurologic illness might be ignored due to the more prevalent embarrassment regarding drooling.

Drooling causes

Many conditions can have drooling as a symptom. The most common are those involving dental problems, followed by neurologic illnesses and certain miscellaneous conditions.

Hypersecretion or hypersalivation

The most common cause of drooling is hypersecretion, or hypersalivation, which simply means too much saliva is being produced, which is usually due to:

  • Teething, in a young child
  • Dental problems in adults: These prevent the mouth from closing properly (malocclusion).
  • Poorly fitted dentures or other dental appliances
  • Injury to the inside of your mouth: Possibly from misaligned teeth or dentures
  • Infection or inflammation of the tissues within your mouth
  • Inflammation of your salivary glands
  • Side effects of medications
  • In many cases, the exact cause of drooling cannot be determined

Less common causes of drooling

Drooling may also be caused by:

Other causes of drooling

Other causes of drooling may include the following. All of these can result in difficulty swallowing, loss of oral and facial muscle control, and inability to sit up straight.

  • Neurologic disorders: Such as mental retardation, cerebral palsy, Parkinson disease, or stroke
  • Nerve damage from an injury causing a loss of control

This list does not constitute medical advice and may not accurately represent what you have.

Ludwig's angina

Ludwig's angina is a rare but serious infection of the space below the jaw and the floor of the mouth, under the tongue. This illness is not to be confused with "angina" which refers to cardiac pain due to coronary artery disease. The infection usually starts in the floor of the mouth th.

Drooling questionnaire

Use our free symptom checker to find out what's causing your drooling.

Drooling symptom checker

Acid reflux disease (gerd)

GERD (gastroesophageal reflux disease) in infants refers to the passage of stomach contents into the throat causing troublesome symptoms, such as feeding intolerance, inadequate oral intake of calories and/or poor weight gain. Vomiting or visible regurgitation ..

Stroke or tia (transient ischemic attack)

Transient ischemic attack, or TIA, is sometimes called a "mini stroke" or a "warning stroke." Any stroke means that blood flow somewhere in the brain has been blocked by a clot.

Risk factors include smoking, obesity, and cardiovascular disease, though anyone can experience a TIA.

Symptoms are "transient," meaning they come and go within minutes because the clot dissolves or moves on its own. Stroke symptoms include weakness, numbness, and paralysis on one side of the face and/or body; slurred speech; abnormal vision; and sudden, severe headache.

A TIA does not cause permanent damage because it is over quickly. However, the patient must get treatment because a TIA is a warning that a more damaging stroke is likely to occur. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history; physical examination; CT scan or MRI; and electrocardiogram.

Treatment includes anticoagulant medication to prevent further clots. Surgery to clear some of the arteries may also be recommended.

Rarity: Common

Top Symptoms: dizziness, leg numbness, arm numbness, new headache, stiff neck

Symptoms that never occur with stroke or tia (transient ischemic attack): bilateral weakness

Urgency: Emergency medical service

Bell's palsy

Bell’s palsy can present as acute or chronic facial paralysis. This paralysis is usually sudden in onset and worsens over the course of 48 hours. Resolution of symptoms usually occurs within two weeks to six months but permanent paralysis can rarely occur. Symptoms of this condition are a result of the paralysis of facial muscles. This paralysis usually occurs only on one side of the face. The cause of Bell’s palsy is inflammation or damage to the facial nerve, also known as cranial nerve VII. This nerve controls the muscles of the face. Treatment is aimed at reducing inflammation or targeting the underlying cause of facial nerve paralysis.

Rarity: Uncommon

Top Symptoms: arm weakness, facial numbness, arm weakness, hearing loss, pain on one side of the face

Symptoms that always occur with bell's palsy: face weakness, weakness in one side of the face

Urgency: Primary care doctor

Parkinson's disease

Parkinson's disease is a lifelong condition movement disorder. It is caused by the malfunction and death of nerve cells which results in symptoms like tremors.

Rarity: Rare

Top Symptoms: anxiety, depressed mood, difficulty concentrating, nausea, constipation

Symptoms that always occur with parkinson's disease: symptoms of parkinsonism

Urgency: Primary care doctor

Foreign body ingestion

When a non-food object is ingested, it can have unpredictable and potentially dangerous effects on the body.

Rarity: Rare

Top Symptoms: vomiting, deep chest pain, behind the breast bone, trouble swallowing, swallowing of something potentially harmful, gagging

Symptoms that always occur with foreign body ingestion: swallowing of something potentially harmful

Symptoms that never occur with foreign body ingestion: choking

Urgency: In-person visit

Esophageal obstruction (steakhouse syndrome)

When a large piece of food or an object gets stuck in the lower esophagus, it can produce some mild chest pain and excessive salivation (drooling).

Rarity: Rare

Top Symptoms: vomiting, deep chest pain, behind the breast bone, trouble swallowing, choking, swallowing of something potentially harmful

Symptoms that always occur with esophageal obstruction (steakhouse syndrome): swallowing of something potentially harmful

Urgency: Hospital emergency room

Inflammation of the epiglottis

Epiglottitis is inflammation of the epiglottis, tissue that covers the trachea (windpipe), which helps prevent coughing or choking after swallowing. It is usually caused by the bacteria H. Influenzae but can also be caused by other bacteria or viruses that cause upper respiratory infections.

Rarity: Rare

Top Symptoms: being severely ill, shortness of breath, fever, sore throat, pain with swallowing

Symptoms that never occur with inflammation of the epiglottis: cough

Urgency: Emergency medical service

Arsenic poisoning

Acute arsenic poisoning means that the symptoms of toxicity begin suddenly and severely.

Arsenic is an element found naturally in the earth. It is used in many pesticides and in industrial processes, and is still found in some "folk" remedies.

Acute poisoning occurs from ingesting a large dose of arsenic. This may happen accidentally, but unfortunately is most common in cases of attempted suicide or homicide.

Symptoms are severe and include abdominal pain, nausea, vomiting, and diarrhea, often with blood. There may be numbness and tingling in the hands and feet; mental confusion or other signs of brain damage; dehydration with resultant drop in blood pressure; irregular heartbeat; fainting; or seizure.

Arsenic is very toxic and if exposure is suspected, it is a medical emergency. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history, physical examination, urine tests, and blood tests.

Treatment involves hospitalization for IV fluid replacement and other supportive care; possible gastric lavage (stomach pumping;) and possible hemodialysis.

Rarity: Ultra rare

Top Symptoms: vomiting or diarrhea, abdominal pain (stomach ache), being severely ill, fatigue, nausea

Symptoms that always occur with arsenic poisoning: vomiting or diarrhea, being severely ill

Urgency: Hospital emergency room

Drooling questionnaire

Use our free symptom checker to find out what's causing your drooling.

Drooling symptom checker

Drooling treatments and relief

When drooling is an emergency

Seek immediate treatment in the emergency room or call 911 if:

  • You begin choking on your saliva: Or feel that you cannot breathe due to aspiration (inhaling) of saliva
  • You have sudden symptoms of stroke along with the drooling: Such as severe headache, weakness on one side of your body, or loss of vision

When to see a doctor for drooling

You should schedule an appointment for:

  • Referrals: Your primary care physician can refer you to neurologists, otolaryngologists (ear, nose, and throat specialists), speech therapists, or occupational therapists if needed. Dentists and orthodontists can correct any tooth problems and create special pieces that aid with normal mouth function.
  • Physical therapy: This can be helpful for muscle control.
  • Additional treatments: These treatments can include medications, Botox injections to the salivary glands, and sometimes surgery or radiation therapy done on the salivary glands.

At-home treatments for drooling

Drooling remedies that you can try at home:

  • Use pillows, cushions, or other supports: This can help you sit up straight and keep your head in a normal position.
  • Use diaper rash cream: Apply small amounts of diaper rash cream to any severely chapped skin on your face. Diaper rash cream is meant to both heal your skin and repel unwanted moisture.
  • Use gentle tissues: For wiping away the drool, use facial tissues that contain lotion. Don't use cloths or regular tissues, since these can be too harsh for constant use on irritated skin.

FAQs about drooling

Why am I drooling in my sleep?

Drooling or sialorrhea can occur more commonly when you are asleep than when you are awake. This is due to sleeping on your side with your mouth open. Nervous system depressants, such as alcohol, also make you more likely to drool in your sleep.

Why am I drooling when I'm awake?

There are a variety of reasons you may be drooling while you're awake. You may be producing excess saliva, you may have pain or difficulty swallowing, or you may simply have a numb mouth from visiting your dentist. Pain or difficulty swallowing may be signs of an infection and you should seek medical care if you experience those symptoms. New drooling associated with facial weakness or difficulty swallowing could be a sign of an acute neurologic problem and needs immediate medical attention.

Why am I producing so much saliva?

Excess saliva production or hypersalivation can be caused by nausea, especially during pregnancy. Other causes include medical conditions such as acid reflux (GERD), gastroparesis, and mouth ulcers; medications such as antipsychotics; and toxins such as mercury and copper.

Is excessive drooling a sign of a stroke?

Excessive drooling can be caused by a stroke. A stroke can cause weakness in the muscles of your face and jaw, making it more difficult to keep your saliva from spilling out of your mouth. A stroke can also cause difficulty swallowing and weakness in your face, arms, and legs. If you are concerned about a stroke, you should seek medical attention immediately and call 911.

Can excess drooling lead to dehydration?

Yes. A healthy individual produces 0.5 to 1.5 liters of saliva a day. If a significant portion of that amount is lost (not swallowed) in the form of drool, then fluid volume will need to be replaced. Otherwise, over time, the individual can become severely dehydrated.

Questions your doctor may ask about drooling

  • Have you ever been diagnosed with diabetes?
  • Do food or drinks get stuck when you swallow?
  • Did you swallow something that could have caused your symptoms?
  • When you examine your face closely, do you notice any small twitches in your face?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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