Salivary Gland Stone (Sialolithiasis)

What is Sialolithiasis?

Sialolithiasis refers to the formation of salivary gland stones (sialoliths) within the salivary glands or their ducts. These stones block the flow of saliva, causing swelling and pain, especially during eating.

Salivary Glands Involved

• Major salivary glands:

  • Parotid gland (near the ears)

  • Submandibular gland (under the jaw)

  • Sublingual gland (under the tongue)

The submandibular gland is the most common site for stones (about 80-90%).

Causes and Risk Factors

• Dehydration (less saliva production)

• Reduced salivary flow or thick saliva

• Trauma or inflammation of salivary ducts

• High calcium content in saliva

• Certain medications that reduce saliva flow

• Poor oral hygiene or infection

Symptoms

• Sudden pain and swelling in the affected gland, often worsening during meals (mealtime syndrome)

• Dry mouth or bad taste

• Swelling near the jaw or under the tongue

• Sometimes, pus discharge if infection develops (sialadenitis)

• Tenderness over the gland area

Diagnosis

• Clinical examination (palpating swelling or stone in duct)

• Imaging studies:

  • X-ray (sometimes visible)

  • Ultrasound (best initial imaging)

  • Sialography (contrast dye imaging of ducts)

  • CT scan or MRI for complicated cases

Treatment

Conservative Treatment

• Hydration (drink plenty of water)

• Massage of the gland to promote stone expulsion

• Sialogogues (substances that stimulate saliva production, e.g., lemon drops)

• Warm compresses

• Pain relief (NSAIDs)

Medical and Surgical Treatment

• If stone does not pass spontaneously or if infection occurs:

  • Antibiotics for infection

  • Minor surgical removal of the stone through the duct opening

  • Sialendoscopy (a minimally invasive endoscopic removal)

  • In large or recurrent cases, partial or total removal of the gland may be required

Prevention

• Maintain good hydration

• Stimulate saliva flow regularly (chewing gum, sour candies)

• Maintain oral hygiene

• Regular dental checkups

Summary