Differential Diagnosis for Drooling

• Single Most Likely Diagnosis
  • Dental problems or poor oral hygiene: This is often the most common cause of drooling, as issues such as gum disease, tooth decay, or ill-fitting dentures can lead to discomfort, causing individuals to drool.
• Other Likely Diagnoses
  • Neurological disorders (e.g., Parkinson's disease, cerebral palsy): These conditions can affect the brain's ability to control muscles, including those involved in swallowing and saliva production.
  • Medication side effects (e.g., antipsychotics, anesthetics): Certain medications can cause drooling as a side effect, either by increasing saliva production or by affecting muscle control.
  • Gastroesophageal reflux disease (GERD): Stomach acid flowing back up into the mouth can stimulate saliva production, leading to drooling.
  • Teething (in infants): As teeth erupt, infants may drool excessively due to the discomfort and increased saliva production.
• Do Not Miss Diagnoses
  • Rabies: Although rare, rabies is a deadly viral disease that can cause drooling, among other symptoms, and must be considered in the differential diagnosis, especially if the individual has been bitten by an animal.
  • Botulism: This bacterial infection can lead to muscle weakness, including the muscles involved in swallowing, resulting in drooling.
  • Stroke or transient ischemic attack (TIA): A stroke or TIA can cause sudden weakness or paralysis of facial muscles, leading to drooling.
• Rare Diagnoses
  • Amyotrophic lateral sclerosis (ALS): A progressive neurological disease that affects muscle control, including the muscles involved in swallowing and saliva production.
  • Congenital conditions (e.g., Down syndrome, cerebral palsy): Certain congenital conditions can increase the risk of drooling due to muscle weakness or poor coordination.
  • Tumors (e.g., oral, brain, or salivary gland tumors): Although rare, tumors in these areas can cause drooling by affecting saliva production or muscle control.