Salivary Gland Disease Sialolithiasis

Sialolithiasis is a medical term for noncancerous salivary gland stones. Also called a sialolith or salivary calculus, a salivary stone is made up of calcium and other substances.

Scientists aren’t certain what causes salivary gland stones, although sialolithiasis is the most common salivary gland disease and the most common cause of acute and chronic salivary gland infections. According to the British Dental Journal (2002), 12 out of 1,000 adults have salivary gland stones at some point, and men develop sialolithiasis twice as frequently as women.

Symptoms of Salivary Gland Stones

The salivary glands manufacture saliva and deliver it to the mouth, where it assists digestion and protects oral health. When a salivary gland stone develops, it can partially or completely block the flow of saliva from the glands to the mouth.

The result is the most common symptom of sialolithiasis — a painful, swollen lump, often on the floor of the mouth. However, you can develop salivary gland stones in any of your salivary glands, which are located as follows:

  • Parotid glands: found in the upper cheek, near your ears
  • Sublingual glands: located beneath the tongue
  • Submandibular glands: in the floor of the mouth.

The pain from salivary gland stones can get worse when you’re eating, because eating prompts the flow of saliva and the salivary gland stone blocks that flow.

Diagnosing a Salivary Stone

If you discover a painful lump in your mouth, see a doctor to find out if you have sialolithiasis. Your doctor will take your medical history to see if you might be at increased risk of sialolithiasis because of:

  • Decreased food intake
  • Dehydration
  • Medications that reduce saliva production, like antihistamines, blood pressure medications and some psychiatric drugs
  • Recent surgery, because reduced food and liquid intake after surgery can increase the risk of salivary gland stones.

Your doctor will gently explore your mouth to find the suspected location of a salivary gland stone. If the salivary gland stone is close to where the duct enters the mouth, it can be felt in such an exam. In other cases, X-rays, CAT scans, ultrasound and sialography (a test where dye is injected into the salvia duct) are used to determine the location of salivary gland stones.

Treatment for Sialolithiasis

The key to sialolithiasis treatment is removing the salivary gland stone. Small salivary gland stones may pass out of the duct on their own. In other cases, your doctor can gently press out a small salivary stone. Sometimes, sialolithiasis treatment requires surgery.

The prognosis is usually good for sialolithiasis patients once the salivary gland stone is removed, although salivary gland stones can return after treatment.

Resources

American Academy of Otolaryngology (2010). Salivary glands. Retrieved September 27, 2010, from http://www.entnet.org/HealthInformation/salivaryGlands.cfm.

British Dental Journal. (2002). Sialolithiasis: An unusually large submandibular salivary stone. Retrieved October 5, 2010, from http://www.nature.com/bdj/journal/v193/n2/full/4801491a.html.

Harvard Medical School. (2007). Salivary gland disorders. Retrieved September 27, 2010, from the InteliHealth website; http://www.intelihealth.com/IH/ihtPrint/WSIHW000/9339/31106.html?hide=t