Do you feel strange pain or swelling in your cheek or under your jaw while eating, especially when thinking about sour foods? Does the sensation seem to fade a few hours after your meal? If so, you might be dealing with salivary gland stones, a condition medically known as Sialolithiasis. Don’t worry; let’s understand exactly what this is.
What are Salivary Gland Stones (Sialolithiasis)? Simply put...
Simply put, Sialolithiasis refers to the formation of small, stone-like structures called calculi within your salivary glands or the ducts that carry saliva into your mouth. These stones can block the flow of saliva, leading to the pain and swelling I mentioned earlier. These stones are often composed of calcium phosphate and hydroxyapatite. The resulting discomfort and swelling can occur on one or both sides of your face.
Where are these salivary glands located in your mouth?
There are three main types of glands in your mouth that produce saliva. Think of them as tiny, essential factories constantly supplying your mouth with saliva.
- Parotid glands: These are the largest of our salivary glands. They are located just in front of your ears on both sides of your cheeks.
- Sublingual glands: As the name suggests, these are located under your tongue, in the floor of your mouth.
- Submandibular glands: These are located below your lower jaw, slightly toward the back of your mouth. Surprisingly, these glands produce 70% of the total saliva in your mouth.
Stones can form in any of these glands. However, over 80% of stones occur in the submandibular gland. The duct that carries saliva from this gland to the mouth is called Wharton’s duct, where stones can also become lodged. Stones in the parotid glands are less common, occurring in about 6% to 15% of cases, while stones in the sublingual glands are very rare, accounting for only about 2% of reported cases.
Who is most likely to develop this condition?
Anyone can develop salivary gland stones, but this condition is most commonly seen in men between the ages of 30 and 60. Surprisingly, it is very rare in children.
How common is this condition?
While stone formation (Sialolithiasis) is a primary cause of salivary gland swelling (Sialadenitis), it is not a very common condition overall. Statistically, it affects about one in every 30,000 people.
What are the symptoms of salivary gland stones?
Most of the time, symptoms intensify while eating. They then gradually subside a few hours after the meal. This is because chewing stimulates your salivary glands to produce more saliva, but the stone blocks the flow, trapping the saliva within the gland and causing symptoms.
- Swelling of the salivary gland: Especially in the cheek or under the jaw.
- Difficulty swallowing.
- Difficulty opening your mouth.
- Dry mouth (Xerostomia).
- An unusual taste in your mouth.
- A painful lump under the tongue.
- Facial pain or swelling: Usually under the jaw or around the ear.
However, some people with salivary gland stones may experience no symptoms at all.
Why do salivary gland stones form? What are the causes?
Anything that causes your saliva to become thick or stagnant can lead to stone formation. Key contributing factors include:
- Dehydration: Not drinking enough water can make saliva thicker.
- Certain autoimmune diseases: Such as Lupus or Sjögren’s syndrome.
- Certain medications: Especially diuretics (water pills).
- Smoking.
- Trauma to the salivary glands.
- Radiation therapy directed at the head or neck area.
Sometimes, stones can form without any clear underlying cause.
Is this condition contagious?
No, salivary gland stones are not contagious. However, if the stones lead to a secondary viral or bacterial infection (Sialadenitis), that infection itself could potentially be spread. It is important to be mindful of this.
How does a doctor diagnose this condition?
Usually, an experienced doctor can identify this condition during a routine examination. They will palpate your face and neck, check inside your mouth for lumps, and ask about your medical history and specific symptoms.
What tests are used for confirmation?
To confirm the diagnosis or pinpoint the location of the stones, your doctor may order imaging tests:
- X-rays
- CT scans (Computed Tomography)
- MRI (Magnetic Resonance Imaging)
In some cases, your doctor may request a salivary gland scan. This involves injecting a small amount of radioactive tracer into a vein in your arm, followed by imaging with a special camera. After about 45 minutes, you may be given something sour, like a drop of lemon juice, to stimulate saliva production. The doctor then takes further images to see how much saliva is flowing or if any is remaining in the ducts.
How is it treated?
Treatment for salivary gland stones depends on the size of the stone and its location. Sometimes home care is sufficient, while other times medication or a minor procedure may be necessary.
What can you do at home?
In many cases, these stones resolve on their own with simple home care.
You can stay well-hydrated, apply a warm compress to the painful area, or gently massage it. Sucking on sour items like lemons or limes can also help stimulate saliva production, which may help push the stone out naturally.
Medications prescribed by your doctor
If you have developed an infection due to a stone, your doctor may prescribe antibiotics. It is essential to follow the course of medication exactly as directed.
Office-based stone removal
If home treatments are unsuccessful, your doctor may use a blunt instrument to carefully probe the area and attempt to remove the stone.
Surgery
For larger stones, surgery may be required. During this procedure, a surgeon might use a tiny camera called an endoscope to locate the stone within the duct and remove it using specialized instruments. Occasionally, a small incision may be necessary.
Removing the salivary gland
In very rare cases—such as when the problem is recurrent, the stone cannot be removed by other means, or if you experience severe, persistent symptoms—the doctor may recommend surgical removal of the affected salivary gland.
Are there ways to prevent salivary gland stones?
While it is not always possible to prevent them entirely, you can reduce your risk:
- Stay adequately hydrated.
- Avoid smoking.
- Maintain good oral hygiene (brushing, flossing, and using mouthwash).
If you start feeling pain or tightness in the area of your salivary glands, try sucking on something sour immediately and gently massaging the area to stimulate flow. This can sometimes help dislodge a small, developing stone before it becomes a problem.
What can someone with this condition expect?
If a salivary gland is blocked, you may experience pain or swelling near the gland during meals. These symptoms typically last for an hour or two and then subside until your next meal.
Does it resolve on its own?
In most cases, yes. Sialolithiasis often resolves with simple home care like warm compresses, gentle massage, and sucking on sour candies. However, if symptoms persist despite these efforts, seeing a doctor is the best course of action.
What happens if it is left untreated? Is it dangerous?
If left untreated, Sialolithiasis can lead to infections and the formation of abscesses. These infections can sometimes spread deep into the neck. Therefore, if you have persistent facial pain or swelling, you should definitely consult a doctor.
When should you see a doctor?
If your symptoms persist for more than two weeks without any improvement, or if the skin over the gland becomes red and you experience severe, worsening pain, you should definitely contact a healthcare provider for advice.
Are Sialolithiasis and Sialadenitis the same thing? What is the difference?
Yes, these two are often confused, but there is a distinct difference:
- Sialolithiasis: Refers to the formation of stones (calculi) in the salivary glands or ducts.
- Sialadenitis: Refers to the inflammation or infection of a salivary gland.
Sialolithiasis can lead to Sialadenitis (inflammation/infection of the gland), but this does not happen in every case.
Final Take-Home Message
Sialolithiasis occurs when a salivary duct is blocked by a stone. It is generally not a major concern and often resolves with simple home care. If you experience facial pain or swelling that worsens during meals, it may be Sialolithiasis. The best step is to see a doctor to get an accurate diagnosis and appropriate treatment if necessary. Do not worry; effective treatments are available at Nirogi Lanka!
