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Salivary duct stones

Definition

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

Alternative Names

Sialolithiasis

Causes

Spit (saliva) is produced by the salivary glands in the mouth. The chemicals in saliva can form a hard crystal that can block the salivary ducts.

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

There are 3 pairs of major salivary glands:

  • Parotid glands: These are the 2 largest glands. One is located in each cheek over the jaw in front of the ears. Inflammation of 1 or more of these glands is called parotitis, or parotiditis.
  • Submandibular glands: These 2 glands are located just under both sides of the jaw and carry saliva up to the floor of mouth under the tongue.
  • Sublingual glands: These 2 glands are located just under the front area of the floor of the mouth.

Salivary stones most often affect the submandibular glands. They can also affect the parotid glands.

Symptoms

Symptoms include:

The symptoms occur most often when eating or drinking.

Exams and Tests

The health care provider or dentist will do an exam of your head and neck to look for 1 or more enlarged, tender salivary glands. The provider may be able to find the stone during the exam by feeling under your tongue.

Tests such as x-rays, ultrasound, MRI scan or CT scan of the face are used to confirm the diagnosis.

Treatment

The goal is to remove the stone.

Steps you can take at home include:

  • Drinking lots of water
  • Using sugar-free lemon drops to increase the saliva

Other ways to remove the stone are:

  • Massaging the gland with heat. The provider or dentist may be able to push the stone out of the duct.
  • In some cases, you may need surgery to cut out the stone.
  • A newer treatment that uses shock waves to break the stone into small pieces is another option.
  • A new technique, called sialoendoscopy, can diagnose and treat stones in the salivary gland duct using very small cameras and instruments
  • If stones become infected or come back often, you may need surgery to remove the salivary gland.

Outlook (Prognosis)

Most of the time, salivary duct stones cause only pain or discomfort, and at times become infected.

When to Contact a Medical Professional

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

References

Elluru RG. Physiology of the salivary glands. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 83.

Jackson NM, Mitchell JL, Walvekar RR. Inflammatory disorders of the salivary glands. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 85.

Miller-Thomas M. Diagnostic imaging and fine-needle aspiration of the salivary glands. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 84.


Review Date: 8/5/2015
Reviewed By: Sumana Jothi MD, specialist in laryngology, Clinical Instructor UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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