Drooling Flashcards
The unintentional spillage of saliva from mouth
Drooling
Secretions pooling in the hypopharynx and contribute to aspiration
Posterior drooling
3 major pairs of glands in the mouth
Submandibular
Sublingual
Parotid glands
Submandibular
Produce saliva through ducts in front of the mouth just under the tongue
Produce saliva through ducts in front of the mouth just under the tongue
Produce thick and mucousy saliva
Sublingual
Produces saliva through ducts which open into the mouth near the second upper molar teeth
Parotid glands
Functions of saliva
Lubricates
Food for chewing
Tongue and lips during speech
Cleanses teeth and gums
Regulates acidity/toxins
Destroys microorganisms
Taste
Initiates carb digestion
Facilitates chewing and swallowing
Begins enzymatic breakdown of proteins and carbohydrates
Protections from dental disease and oral infection
Ease of articulator movement for speech production
considerable amounts of saliva
3 months
can control saliva when supine, but drool more frequently when sitting upright to prone
6mo
ATYPICAL DROOLING COMMONLY SEEN in
Cognitive impairment
CP
Neuromuscular d/o
Dysphagia
SPD
Abnormal drooling can be due to
Lack of awareness
Inadequate lip closure
Absent/impaired oropharyngeal sensation
Abnormal movement/tone of tongue and lips
Reduced frequency/difficulty swallowing
Poor posture
Dental problems
Mouthing of objects
Medication
Negative effects of drooling include
Physical, social, and psychological effects
PATHOPHYSIOLOGICAL MECHANISM of saliva
Overproduction of saliva
Incoordination of swallowing pattern
Reduction in the rate of swallowing
Sensory integration: reduced awareness of the presence of secretions
Open mouth posture: poor muscle tone/strength, nasal obstruction
Medication side effects: clozapine, compazine, nitrazepam
How is drooling assessed?
General health
Medications
Dental history
Eating and drinking
Communication abilities
SLP assessment of drooling
assesses oral and pharyngeal sensorimotor components
ENT assessment of drooling
medical evaluation, particularly of the aerodigestive tract
OT assessment of drooling
posture, head/neck/trunk control
Dental assessment of drooling
level and effectiveness of dental care
Description of the drooling problem:
Amount
Timing
Extent
Contributing factors
Psychological
Drooling severity
1) Dry
2) Mild - wet lips
3) Moderate - wet lips and chin
4) Severe - clothing damp
5) Profuse - clothing, hands and objects wet
Tx options for drooling
Reassurance with/without re-assessment
Eliminate situational factors
Pharmacological treatment
Surgery
Therapy
THERAPY for drooling
Oral motor therapy
Behavior modification
Oral-motor therapy
Increase oral sensations
Coordination/strength
Improve swallow function
Behavior modification
Patient must be highly motivated and have mod-high cognition
Goals:
Increase sensory awareness
Retrain habitual open mouth posture
Increase voluntary swallowing rate
EFFECTS OF DROOLING
Saliva causes staining of clothes and can smell and be offensive if the drooling is severe .
When children are young, waterproof backed bibs can be changed frequently .
As children grow older, there needs to be more appropriate ways of disguising the drooling
