Salivary gland problems
Problems can develop with the glands that produce saliva in the mouth, including swelling, infection, cysts developing or salivary gland stones forming.
Saliva production & functions
You may not realise how busy your salivary glands are. They produce around 1.5 litres of saliva a day, delivering it into the mouth through tiny ducts.
Saliva plays a vital role in the mouth protecting teeth, providing lubrication and helping swallowing and digestion.
Chewing usually prompts production of a watery saliva from the upper mouth, while a thicker saliva with mucus in it comes from glands beneath the tongue and the jaw.
The other substance you may notice in the mouth is phlegm, but this comes from the lungs and nose.
Where are the salivary glands?
The three main pairs of salivary glands are:
- Parotid glands on the sides of the face
- Submandibular glands at the bottom of the mouth
- Sublingual glands under the tongue
Signs of a salivary gland disorder
Symptoms and signs of problems with salivary glands or salivary ducts include:
- Salivary gland swelling
- Dry mouth
- Bad taste in the mouth.
Types of salivary gland disorders
Types of salivary gland problems include:
Salivary stones (sialoliths, salivary calculi). Crystallised deposits block saliva flow causing pain and swelling. These are usually under 1cm across but can be larger. Pain may be felt more when eating. Some medications make these stones more likely to form.
Salivary gland bacterial infection (sialadenitis). Bacterial infection caused by blocked ducts and resulting in a bad tasting pus going into the mouth, pain, fever and abscess. This condition can often affect young babies and older adults.
Viral infections, including mumps, flu, the Epstein-Barr virus, cytomegalovirus, Coxsackie virus and HIV. The infection causes swelling of the parotid salivary glands resulting in an enlarged 'hamster cheeks' appearance.
Cysts and tumours. These growths are usually benign - non-cancerous - but cancerous tumours can occur.
Sjögren's syndrome. An autoimmune disease where the body's defences wrongly attack parts of the body, including salivary glands.
Sarcoidosis. Causing inflammation of salivary glands.
Diagnosis of salivary gland problems
A diagnosis of salivary gland problems will be made based on the symptoms and a person's medical history, such as having medical conditions that make the problems more likely, and examination.
Salivary stones may be visible in the mouth, or an X-ray, CT scan or MRI scan may be arranged. Special dye may be injected before an X-ray to improve the image. Another diagnostic procedure is using a thin tubular instrument in the duct called a sialendoscopy. If a stone is found, the instrument also allows for stone removal.
Blood tests, swabs of the infected area or biopsy samples may be taken for laboratory testing to check for infections and other causes of the problem.
Treatment for salivary gland problems
Treatment for salivary gland problems will depend on what's caused the problem, how severe it is and the location.
Some salivary stones may come out on their own, especially if helped with increased saliva flow by sucking a lemon. Warm compresses, such as a flannel held against the affected gland, and gentle massage may help with the pain and with dislodging a stone.
A doctor may try to remove salivary stones manually. If that is not possible, treatments include:
- Extracorporeal shock wave lithotripsy to break up a stone
- Surgery (rarely).
Infections may be treated with antibiotics.
Preventing salivary problems
It is not always possible to prevent salivary gland problems, but keeping hydrated by drinking plenty of fluids can help.
Seeking medical advice for any conditions causing dry mouth is also recommended.