The majority of stones affect the submandibular glands located at the floor of the mouth. Less commonly, the stones affect the parotid glands, located on the inside of the cheeks, or the sublingual glands, which are under the tongue. Many people with the condition have multiple stones.
Salivary Gland Stone Causes and Symptoms
Salivary stones form when chemicals in the saliva accumulate in the duct or gland. They mostly contain calcium. The exact cause is not known. But factors contributing to less saliva production and/or thickened saliva may be risk factors for salivary stones. These factors include: dehydration, poor eating, and use of certain medications including some antihistamines, blood pressure drugs, psychiatric drugs, and bladder control drugs. Trauma to the salivary glands may also raise the risk for salivary stones.
The stones cause no symptoms as they form, but if they reach a size that blocks the duct, saliva backs up into the gland, causing pain and swelling. You may feel the pain off and on, and it may get progressively worse. Inflammation and infection within the affected gland may follow.
Salivary Gland Stones Diagnosis and Treatments
If a stone is detected, the goal of treatment is to remove it. For small stones, stimulating saliva flow by sucking on a lemon or sour candies may cause the stone to pass spontaneously. In other cases where stones are small, the doctor or dentist may massage or push the stone out of the duct.
For larger, harder-to-remove stones, doctors usually make a small incision in the mouth to remove the stone.
More and more, doctors are using a newer and less invasive technique called sialendoscopy to remove salivary gland stones. Developed and used successfully in Europe for a decade, sialendoscopy uses tiny lighted scopes, inserted into the gland's opening in the mouth, to visualize the salivary duct system and locate the stone. Then, using micro instruments, the surgeon can remove the stone to relieve the blockage. The procedure is performed under local or light general anesthesia, which allows the patient to go home the same day.
For people with recurrent stones or irreversible damage to the salivary gland, surgical removal of the gland may be necessary.
In addition, antibiotics are prescribed if salivary stones have caused infection.