Drooling or saliva spillage has been explored widely among children with neurodevelopmental conditions. Yet, the approach to drooling in an otherwise developmentally normal child remains unexplored, as it is regarded as self-limiting. Nonetheless, drooling beyond age 4 in the awake stage should raise concern.

This narrative review aims to shed light on drooling in developmentally normal children, also known as ‘healthy droolers’, and the available evidence on its management.

Most notable factors causing saliva spillage include poor oral-motor control and impaired oral sensation. Delayed saliva acquisition may be an early indicator of developmental or intellectual delay. Drooling impairs both the children's and parents' overall quality of life significantly.

Healthy droolers can be managed by simple behavioural therapy and reassurance.

To report the successful use of a surgical approach for the treatment of drooling in a case of oro-motor dyspraxia.

A seven-year-old girl with a diagnosis of oro-motor dyspraxia was referred for management of drooling; this was her only symptom. There were no focal neurological abnormalities. Conservative measures had not helped, and her parents were keen for definitive treatment. Bilateral submandibular duct transposition was performed with no complications. The patient's drooling improved immediately.

There are currently no reports in the literature of surgery for persistent drooling in children with oro-motor dyspraxia who are otherwise neurologically and developmentally normal. The mainstay of treatment is speech and language therapy. We report the successful use of surgical techniques, usually reserved for children with cerebral palsy or severe neurological disorders, to treat drooling in an otherwise normal seven-year-old child with oro-motor dyspraxia.