Drooling and
lip seal problems
Persistent drooling beyond two to three years of age - or a child who consistently breathes with their mouth open and cannot maintain lip closure at rest - is not simply a developmental quirk. It reflects a problem with oral resting posture, and tongue tie is a common and often overlooked cause.
Resting posture and the tongue connection
Normal oral resting posture requires the tongue to sit against the roof of the mouth - the palate - with the lips gently together and breathing occurring through the nose. This posture is the foundation of healthy facial development, airway, and swallowing pattern.
When tongue tie restricts upward tongue movement, the tongue cannot reach or rest against the palate. It defaults to a low resting position - typically resting against the lower teeth or the floor of the mouth. With the tongue low, the lips cannot maintain effortless closure, and the mouth remains habitually open. Saliva that would normally be managed by an active swallowing pattern accumulates, and drooling results.
A tongue that cannot elevate rests low in the mouth. This is not a habit - it is a structural consequence of restricted movement that cannot be corrected by behavioural reminders alone.
Saliva management depends on active swallowing, which requires normal tongue function. Low tongue posture leads to pooling of saliva at the front of the mouth and anterior drooling.
Lip closure requires the tongue to counterbalance from above. Without that counterbalance, the lips cannot maintain effortless closure - and open-mouth posture becomes the default resting position.
Persistent open-mouth posture and low tongue resting position affect the shape of the dental arches over time, contributing to narrow palates, crossbite, and crowding.
What NTTC assesses and what the pathway looks like
We assess tongue elevation, resting posture, lip competence, jaw position, and palatal shape - building a functional picture of why lip seal is not being maintained.
The NTTC team assesses swallowing pattern, breathing habit, and oral motor function as part of a comprehensive myofunctional evaluation.
If tongue tie is identified as the primary structural cause of low posture, Dr. Roche will advise on whether frenuloplasty is appropriate, and at what point in the rehabilitation process it should occur.
Surgery addresses the restriction; myofunctional therapy re-establishes correct tongue resting posture, nasal breathing, and swallowing pattern. Both components are essential for a lasting outcome.
About drooling and lip seal
My child is four and still drooling. Is this abnormal?
Yes. Drooling is expected in infants and toddlers up to around 18 to 24 months, and resolves as oral motor control develops. Persistent anterior drooling beyond age three in an otherwise developmentally typical child warrants clinical assessment. Tongue tie is a common - and often overlooked - structural cause.
Could exercises alone fix the lip seal without surgery?
If the underlying restriction is mild and the tongue has sufficient range to reach the palate with effort, myofunctional therapy exercises can achieve adequate resting posture without surgical intervention. However, if tongue tie is significantly limiting elevation, exercises cannot compensate for the structural restriction - the tether needs to be released before the muscles can be retrained effectively.
Who referred you? Do I need a referral from my GP?
No referral is needed. Many families come to NTTC directly, though we also accept referrals from SLTs, dentists, orthodontists, and paediatricians. If a professional has mentioned tongue tie or myofunctional therapy as a consideration, that referral is very welcome but not a prerequisite.
Other pages that may apply
Book a free Concerns Call
Speak directly with a clinician about your child's lip seal and drooling. We will advise clearly whether assessment at NTTC is appropriate.
