What Is a Sialogram?

Medically Reviewed by Dan Brennan, MD on November 27, 2021
3 min read

‌Your salivary glands are responsible for making saliva. Saliva helps you digest food and keep up your oral health. When you can’t make enough saliva, your doctor may order an X-ray of your salivary glands to find out why. The resulting X-ray image is called a sialogram.

‌A sialogram lets your doctor check for blockages in your salivary ducts or glands. It can help diagnose infections or diseases, like tumors, in your mouth. ‌

Your doctor may order a sialogram if you have these symptoms:‌

  • Less saliva causing dry mouth
  • Foul taste in your mouth
  • Pain in your mouth, face, or neck
  • Swelling in your jaw, face, or neck

‌A sialogram can help pinpoint the cause of these symptoms, which usually happen for reasons like:‌

  • Blocked or narrow salivary ducts
  • Salivary gland stones, known as calculi or sialolithiasis
  • Salivary gland infection or sialadenitis
  • Salivary gland inflammation or sialectasis
  • Salivary gland tumor

Once your doctor checks your sialogram, they can spot the underlying problem and give you the right treatment for it.

‌The most commonly used technique is to take an X-ray image after injecting a contrast dye into your salivary glands. Other modern techniques to diagnose salivary gland problems include CT scans and magnetic resonance imaging, or MRI. ‌

Sialography is usually done by a radiologist at a clinic or hospital. A conventional sialogram using X-ray involves these steps: ‌

  • You may have to remove metal objects like earrings or dentures‌.
  • Your technician will have you lie down, and they’ll place the X-ray machine over your mouth or jaw.
  • You might receive anesthesia if you’re uncomfortable during the procedure.
  • The technician may give you a sour liquid, like lemon juice, to open up your salivary ducts.
  • You’ll have to open your mouth. A radiologist will then find your salivary gland and insert a tube into its duct.
  • A contrast dye that has iodine will be injected into your salivary duct through the tube. The dye blocks X-rays and produces a clear image of the glands. This helps your doctor identify the problem.
  • After the image is taken using the X-ray machine, the tube will be removed from your mouth.
  • The contrast dye will then be released into your mouth from the salivary duct. If not, you may be asked to massage your salivary glands to release the dye.
  • You can either swallow or spit the dye out. It may taste bitter, but it’s safe for most people to swallow.‌

‌This procedure typically takes up to 30 minutes.

Once it’s done, you can eat or drink normally. You may feel some pain, uneasiness, or swelling in your mouth, but the procedure itself is painless. 

The radiologist will share the X-ray findings of your sialogram with your doctor, who will then diagnose the problem.

It may take several days for your doctor to interpret the results of your sialogram. ‌Based on the sialogram and the radiologist’s report, your doctor can spot the problem affecting your salivary glands. Results may point to one of these conditions:‌

  • Bacterial or viral infection in your salivary gland
  • Salivary duct stones
  • Oral cancer or parotid gland tumor
  • Parotid gland inflammation
  • Salivary fistula, or the abnormal connection of the salivary duct and your skin
  • Sjogren’s syndrome, an autoimmune condition that causes dryness in your mouth and eyes

‌Depending on the results, your doctor may suggest medicines or surgery. Or they might order more tests to confirm the results.

The procedure is safe and effective. But it’s still important to talk with your doctor before you get a sialogram to minimize the risk of any bad effects. It’s especially important to let them know if you have any preexisting infections or allergies, since a sialogram could make those conditions worse. ‌

The main risks of a sialogram include:‌

  • Exposure to radiation. If you’re pregnant or breastfeeding, you may be at a higher risk of harm due to radiation. 
  • Some pain or swelling. A sialogram is an invasive procedure, as it involves the insertion of a tube into your salivary ducts, which can result in discomfort. 
  • Infection. Prolonged pain, swelling, bleeding, or fever are all signs of an infection that you need to get medical help for right away. 
  • Allergic reaction to the contrast dye or iodine. To avoid complications, you should get an allergy test done before you get a sialogram. If you already know you have an allergy, you have to tell your doctor before the procedure.