14 GENERAL INTRODUCTION long parotid duct (Stenson’s duct) into the mouth opposite to the second upper molar,30 and the parotid gland is responsible for 28% of the saliva in the resting state. When stimulated by chewing, smell, taste or involuntary facial movements, this ratio increases to approximately 53% of the total saliva production.32 Furthermore, there are hundreds of accessory glands in the oral mucosa, which account for approximately 5% of the oral saliva.30 Current treatment and its limitations There is a broad spectrum of treatment options for excessive drooling. Treatments include behavioural therapy, speech and language therapy, pharmacological treatmentwithsystemic anticholinergics, salivary glandsclerotherapy, intraglandular injections with botulinum neurotoxin type A (BoNT-A), and surgery.15, 23, 33, 34 Treatment choice for drooling depends on a wide range of variables such as age, the severity of the problem, type of drooling, oromotor ability, intellectual ability, and intrinsic motivation of patient and caregivers. A stepwise approach for the clinical management of drooling always starts with identifying and optimising conditions that could contribute to saliva loss. Therefore, treatment for drooling in our institute is performed in a multidisciplinary setting that includes a psychologist, speech and language therapist, pediatric neurologist, rehabilitation specialist, and an ear, nose and throat surgeon. A specialized dentist, occupational therapist, and pediatric clinician are consulted upon indication. Although drooling is rarely caused by hypersalivation, several treatments aim to reduce the total amount of saliva, so it suits the child’s oromotor capabilities. Saliva, however, has a wide variety of functions. It is essential in the digestive system because it aids in taste, softens solid foods, and has a function in the breakdown of carbohydrates. Saliva functions as an anti-viral, -bacterial, and -fungal agent, protects teeth, and prevents damage to the oesophagal mucosa by gastroesophageal reflux. Moreover, saliva is important for speaking, the
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