If you would like to know more about Salivary Gland Stones symptoms and diagnosis, and about Salivary Gland Stones treatments, read the following article for more information.
Salivary gland stones can cause pain and swelling of salivary glands. They usually need to be removed by a small operation.
What are the salivary glands?
There are 3 pairs of glands that make saliva. Saliva drains into the mouth from these glands down short ducts (tubes). The parotid glands lie just below and in front of the ears. Saliva passes down the parotid duct into the inside of the cheeks. The submandibular glands are under the floor of the mouth - one on each side - and drain saliva up into the floor of the mouth. The sublingual glands are just beneath the tongue.
Small amounts of saliva are made all the time to keep the mouth moist. When we eat, much more saliva is made and pours into the mouth.
What are salivary gland stones?
Some people form a small stone in a salivary gland. This is more common in men and in people over 40. The reason why a stone forms is not known. Most salivary stones are mainly made of calcium. However, there is no abnormality of the blood calcium level or any other problem with calcium in the body. Salivary gland stones are not usually associated with any other disease.
Where do salivary gland stones occur?
About 8 in 10 salivary stones form in one of the submandibular glands. It is thought that the 'uphill' drainage and the slightly thicker saliva that is made in these glands is why stones are more likely to form there. (The larger parotid glands drain saliva sideways into the mouth. They also make saliva that is 'thinner' than the submandibular glands.)
What are the symptoms of salivary stones?
The common symptoms are pain and swelling of the affected gland at mealtimes. This occurs if the stone completely blocks a duct. You normally make extra saliva during a meal which pours into the mouth. However, the saliva cannot pass into the mouth if the duct is blocked by a stone. The pain can be sudden and intense just after starting a meal. Swelling soon follows. The pain and swelling ease over about 1-2 hours after a meal.
However, most stones do not block a duct completely. A stone may only partially block saliva flow, or not block the flow at all if it is embedded in the body of the gland. In these situations the symptoms can vary and include one or more of the following.
- Dull pain from time to time over the affected gland.
- Swelling of the gland. Swelling may be persistent, or vary in size from time to time.
- Infection of the gland may occur causing redness and pain. This may develop into an abscess (ball of infection and pus) and make you feel quite unwell.
- No symptoms at all. A stone may be found by chance on an x-ray taken for another reason.
Are any tests needed?
Symptoms are often typical and the diagnosis is clear. A doctor can sometimes feel or see a stone at the opening of a duct. An x-ray can detect and show the position of about 8 in 10 salivary stones. No further tests are then needed. A scan (such as a CT scan) or special x-ray tests are sometimes done if the exact location of a stone is not clear.
What is the treatment for salivary stones?
- Sometimes a small stone comes out into the mouth by itself.
- Most stones that cause symptoms will not go away unless they are removed:
- Gentle probing into the duct from inside the mouth can sometimes free a stone. This is done by a doctor.
- A small operation is the usual treatment to remove most stones.
- 'Shock wave' treatment (lithotripsy) may be an option. This uses ultrasound waves to break up stones. The broken fragments then pass out along the duct. This is a relatively new treatment for salivary stones (although it has been used for some years to treat kidney stones). It may become more common over time.
A salivary stone is usually a 'one-off' event. After it is removed there are usually no further problems. However, some people develop one or more further stones at some later time. Sometimes several stones form in the same gland. An operation to remove the whole gland may be an option for people who develop recurring or multiple stones. (Enough saliva is made by the remaining glands if one is removed.)
©EMIS and PIP 2004 Updated: December 2003 CHIQ Accredited
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