Salivary glands (SG) are fundamental for the maintenance of your oral cavity. Your salivary glands make saliva, which aids in digestion, keeps your mouth moist, and supports healthy teeth. Saliva is a slightly alkaline secretion of water, mucous, protein, salts, and often a starch-splitting enzyme (such as ptyalin) that is secreted into the mouth by your salivary glands.

There are three major salivary glands in your body and countless minor salivary glands.

The major salivary glands are:  

  • Parotids (located in front of the ear, on the cheeks) are the largest salivary glands

  • Submandibular (located high in your neck, just below the jaw bone on each side)  is the second salivary gland, after the parotid and before the sublingual gland.

  • Sublingual (located on the floor of your mouth) is the smallest major salivary gland.

Many other tiny salivary glands are in your lips, inside your cheeks, and throughout your mouth and throat.

There are various health issues associated with your salivary glands, from tumours or stones. Most tumours are noncancerous (benign) and they usually occur in the parotid glands. 

Stones are sometimes formed in these glands which cause extreme discomfort, pain, and swelling. 

In this article, we will look at how stones are formed inside your salivary glands, what are the symptoms and what can be done to treat them.

Causes of Stones in Your Salivary Gland

Salivary stones or salivary gland stones, also called sialolithiasis, occur when you have too much calcium in your body, are dehydrated, or suffer from an oral infection. These all can cause your salivary glands and ducts to become swollen, which will block the flow of your saliva.

A salivary gland consists of a gland (which secretes the saliva) and a duct which is the channel through which saliva passes from the gland into the oral cavity. A stone can form in the gland or in the duct and cause obstruction. Obstruction to the flow of saliva causes the saliva to build up in the gland - this causes a painful swelling which is especially prominent during meal times. 

About 87 percent of salivary gland stones occur in the submandibular gland. They can occur due to the following conditions:

  • Poor  dental hygiene

  • Oral injuries (injuries to the mouth and/or teeth)

  • Dehydration (a condition in which there is excessive loss of water from your body)

  • Post radiotherapy treatment on your head or neck (a cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors)

  • Male gender 

  • Advancing age

 Symptoms of Salivary Gland Stones

A recurrent painful swelling is the most common symptom of salivary stones. This is worse during eating or drinking something sour, as this causes the maximum salivary secretion. Other symptoms include:

  • A sore or painful lump under the tongue

  • Pain or swelling below the jaw or ears

In case the salivary stones cause an infection in or around the affected glands, you might have a fever and formation of pus (a yellowish, thick fluid containing dead tissue, cells, and bacteria) around the stone.

Risk Factors of Salivary Stones

Adult males are the most at risk of developing salivary stones. Studies show that they simply retain more minerals than others. When these minerals sit stagnant in your salivary glands, they stick together to create a stone made mostly of calcium, bacteria inside the gland, and dead skin cells.

How Your Doctor Can Help

An initial consultation with your ENT specialist will help him/her to assess and reach a diagnosis. Your doctor can recommend certain tests which include: 

1. Ultrasound (a scan or medical test that uses high-frequency sound waves to capture live images from the inside of your body) of your upper neck and the salivary glands may be conducted. 

2. Fine needle aspiration cytology (FNAC) is a needle test that may be conducted along with an ultrasound. Consult your ENT to know more about this test.

If you are diagnosed with salivary stones, then initial episodes may be treated with antibiotics in the presence of a bacterial infection. and with analgesics (medications designed specifically to relieve pain).  This usually suffices.

In the presence of recurrent episodes of painful swelling, some surgical intervention may be required based on the severity of your symptoms, location of the stone/stones, and diagnosis. This could include:

  • Intra ductal removal of the stone,  if it is readily available on the floor of your mouth

  • Gland removal, especially the submandibular gland, in case of recurrent episodes.

  • Sialendoscopy is an endoscopic technique for the removal of the stone or enlarging the duct.

Consult your ENT specialist to understand these procedures in detail.

Home Remedies for Salivary Stones

Salivary stones are usually not serious and can often be prevented and treated at home. Common home remedies include:

  • Maintaining good oral-dental hygiene. Brushing and flossing regularly and daily will prevent dry mouth and infections.

  • Drinking plenty of fluids. Staying hydrated can increase the saliva flow in your mouth.

  • Gently massaging of your salivary gland to reduce swelling. Gently massaging the affected area may relieve pain and the stone may pass through the salivary duct. 

  • Sucking on ice cubes. Sucking on something cold may also help reduce pain and swelling resulting from salivary stones.

To keep your glands healthy, you should maintain good oral hygiene and avoid habits that increase your risk of dry mouths, such as smoking and drinking alcohol. If you are diagnosed with salivary gland stones, you can treat pain at home. In case of extreme pain, consult your ENT specialist immediately.

Disclaimer: This article is written by the Practitioner for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.