An evidence-based approach to the child who drools saliva.
BACKGROUND
Drooling is a common dysfunction in children with cerebral palsy and may also affect neurologically unimpaired children. It causes significant social handicap to both children and their families.


METHODS
The data in this article are supported by a Medline search (November 2008) utilising the keywords drooling, sialorrhea, botulinum toxin, salivary duct ligation and also by the use of the personal bibliographies of the senior authors.


RESULTS
The majority of the published literature for drooling is of level III/IV evidence.


CONCLUSIONS
Multiple therapeutic interventions are available for paediatric drooling. These are most appropriately introduced in a stepwise progression from behaviour therapy, to pharmacotherapy to surgical procedures.
Little
S A
SA
Department of Otolaryngology, Ninewells Hospital & Tayside Children's Hospital, Dundee, UK.
Kubba
H
H
Hussain
S S M
SS
D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D019317:Evidence-Based Medicine / Q000379:methods*; D006801:Humans; D008297:Male; D008487:Medical History Taking; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D009465:Neuromuscular Agents / Q000627:therapeutic use; D009967:Orthodontic Appliances; D013517:Otorhinolaryngologic Surgical Procedures; D010348:Patient Care Team; D012463:Saliva; D012720:Severity of Illness Index; D012798:Sialorrhea / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D014282:Trihexyphenidyl / Q000627:therapeutic use
D018680:Cholinergic Antagonists; D018727:Muscarinic Antagonists; D009465:Neuromuscular Agents; D014282:Trihexyphenidyl; D019274:Botulinum Toxins, Type A