Salivary duct stones

Answer 1

Definition

Salivary duct stones are crystallized minerals in the ducts that drain the salivary glands. Salivary duct stones are a type of salivary gland disorder.

Alternative Names

Sialolithiasis

Causes, incidence, and risk factors

Saliva (spit) is produced by the salivary glands in the mouth. The chemicals in saliva can crystallize into a stone that can block the salivary ducts.

When saliva cannot exit a blocked duct, it backs up into the gland, causing pain and swelling of the gland.

Salivary stones most often affect the submandibular glands (at the back of the mouth on both sides of the jaw), but they can also affect the parotid glands (on the sides of the face).

Symptoms

• Difficulty opening the mouth or swallowing
• Dry mouth
• Pain in the face or mouth
• Swelling of the face or neck (can be dramatic when eating or drinking)

The symptoms are usually most noticeable when eating or drinking.

Signs and tests

An examination of the head and neck by the health care provider or dentist shows one or more enlarged, tender salivary glands. The doctor may be able to feel the stone during examination.

X-rays, ultrasound, or CT scan of the face can confirm the diagnosis.

Treatment

The goal is to remove the stone. The doctor or dentist may be able to push the stone out of the duct. In some cases, the stone may need to be surgically cut out.

Most often, the stone can be flushed out by increasing the flow of saliva with sour candy or citrus (which stimulate the flow of saliva) combined with increased fluids and massage.

Expectations (prognosis)

Salivary duct stones are uncomfortable, but not dangerous. The stone is usually removed with only minimal discomfort.

If the person has repeated stones or infections, the affected salivary gland may need to be surgically removed.

Complications

• Discomfort
• Increased risk of salivary gland infections
• Recurrence (coming back) of stones

Calling your health care provider

Call your health care provider if you have symptoms of salivary duct stones.

Answer 2

Definition

Salivary duct stones are crystallized minerals in the ducts that drain the salivary glands. Salivary duct stones are a type of salivary gland disorder.

Alternative Names

Sialolithiasis

Causes, incidence, and risk factors

Saliva (spit) is produced by the salivary glands in the mouth. The chemicals in saliva can crystallize into a stone that can block the salivary ducts.

When saliva cannot exit a blocked duct, it backs up into the gland, causing pain and swelling of the gland.

There are three pairs of major salivary glands:

• The two largest are the parotid glands, one in each cheek over the jaw in front of the ears.
• Two submandibular glands are at the back of the mouth on both sides of the jaw.
• Two sublingual glands are under the floor of the mouth.

Salivary stones most often affect the submandibular glands, but they can also affect the parotid glands.

Symptoms

• Difficulty opening the mouth or swallowing
• Dry mouth
• Pain in the face or mouth
• Swelling of the face or neck (can be dramatic when eating or drinking)

The symptoms are usually most noticeable when eating or drinking.

Signs and tests

An examination of the head and neck by the health care provider or dentist shows one or more enlarged, tender salivary glands. The doctor may be able to feel the stone during examination.

X-rays, ultrasound, or CT scan of the face can confirm the diagnosis.

Treatment

The goal is to remove the stone.

Drink lots of water and use sugar-free lemon drops to increase the saliva, which may remove the stone. Massaging the gland with heat may help.

The doctor or dentist may be able to push the stone out of the duct. In some cases, the stone may need to be surgically cut out or reduced to small fragments using extracorporeal shock wave lithotripsy.

Expectations (prognosis)

Salivary duct stones are uncomfortable, but usually not dangerous. The stone is usually removed with only minimal discomfort. Some people may feel more pain.

If the person has repeated stones or infections, the affected salivary gland may need to be surgically removed.

Complications

• Discomfort
• Increased risk of salivary gland infections
• Recurrence (coming back) of stones

Calling your health care provider

Call your health care provider if you have symptoms of salivary duct stones.

References

Elluru RG. Physiology of the salivary glands. In: Cummings Cw, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elseiver;2010:chap 84.

Lacey J. Diagnostic imaging and fine-needle aspiration of the salivary glands. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elseiver;2010:chap 85.

Rogers J, McCaffrey TV. Inflammatory disorders of the salivary glands. In: In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elseiver;2010:chap 86.

Reviewed By

Review Date: 08/08/2011

A.D.A.M. Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington (2/28/2011).