Salivary gland stones, also called sialolithiasis, is a condition in which mineral deposits harden and form in the salivary glands. The majority of salivary gland stones form in the submandibular salivary glands, but may also form in the parotid glands (located on the side of the face, near the ears), sublingual glands (located under the tongue) and the minor salivary glands (located inside of the cheek or lips, under the tongue and beneath the palate).
Salivary gland stones may be formed with calcium phosphate and calcium carbonate and range in size from a few millimeters to more than two centimeters. One in four individuals with salivary gland stones develops more than one stone.
Symptoms
Symptoms of salivary gland stones include:
- Swelling, pain or both in the salivary gland
- Worsening pain or swelling when eating or anticipating eating
- Tenderness and swelling in the face, mouth or neck
- Dry mouth
- Difficulty swallowing or opening the mouth
Salivary gland stones may lead to infection in or around the affected gland. Symptoms of a salivary gland infection include fever and pus around the stone.
Causes
The exact cause of salivary gland stones is unknown, but the following factors are associated with the condition:
- Smoking
- Gum disease
- Trauma to the inside of the mouth
- Dehydration caused by illness, inadequate fluid intake or medications such as diuretics and anticholinergic drugs
- Malnutrition
Risk Factors
The condition is more common among individuals ages 30 to 60 and men. Other risk factors include:
- Having radiation therapy on the head or neck
- Gout
- Sjögren’s syndrome
- Kidney problems
Diagnosing Salivary Gland Tumors
During an initial visit, the physician will perform a physical examination of the head and neck to check for swollen salivary glands and salivary gland stones. The condition may be diagnosed with an x-ray, ultrasound or a computed tomography (CT) scan of the face.
Imaging may be necessary to rule out other conditions:
- Salivary gland tumor
- Salivary gland infection
- Malnutrition
- Radiation exposure
- Reaction to iodine given as part of an imaging exam
- Sjögren’s syndrome
Treatment Options
Patients may treat the stone by sucking on sugar-free lemon drops or ice cubes and drinking water. This will help increase saliva production and may force the stone out of the salivary glands. Patients may be able to move the stone by applying heat and gently massaging the affected area.
The physician may prescribe an antibiotic to treat the infection or ibuprofen to alleviate pain and swelling.
If the stone is not very big, the dentist or physician may press on both sides of the gland to try and push it out. Large stones may need to be surgically removed.
Sialoendoscopy is a minimally invasive procedure performed to remove a salivary gland tumor. During the procedure, the physician makes a small incision inside the mouth near the affected gland and inserts a slender tube called a sialoendoscope. Various instruments are inserted through this tube to capture and remove the stone. The patient will be under local or general anesthesia during a sialoendoscopy.
Some patients may need extracorporeal shock wave lithotripsy (ESWL). This treatment uses shock waves to break the stone into smaller pieces and allow them to pass through the gland. Patients will typically be sedated or under general anesthesia during the procedure.
Most salivary gland stones are removed without complications. However, if patients continue to develop salivary gland stones, the physician may recommend surgically removing the affected gland.