Hallie Bulkin explains that drooling in children usually stems from posture and motor control problems, not excess saliva. She describes a rare case where a tongue-tie near a salivary gland triggered overproduction. Clinicians should assess head posture, lip seal, jaw stability, and swallowing before looking inside the mouth.
It's typically always a control, coordination, and posture issue, not necessarily production. Now I have seen a kid who had this whose tongue tie was inserted into the floor of the mouth right next to the salivary gland, and that was actually causing— whenever they moved the tongue, it was actually causing the salivary gland to produce extra saliva, and it led to drooling. Fascinating. Not super common, but fascinating. Posture is going to be really important. So before you look in the mouth, maybe look at like head positioning. Is the trunk stable? I mentioned earlier this week, what you see on the hips you see on the lips. Is there an open mouth at rest? If the head is forward and down, saliva is literally going to pool and just spill out, right? And we can't like out-exercise bad posture, so focus on posture. Then I would look at lip seal and jaw stability, and then I would look at tongue position at rest. I'd see how frequently the kiddo is swallowing. Maybe they're not swallowing enough to manage the saliva in their mouth. And then sensory awareness— are they aware They even notice it. Is there a delayed response to having like wetness on the face? I'd be tracking airway, breathing, any concerns there. So hopefully that helps.
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