Salivary Stones
What You Need to Know
- If the stone blocks the salivary duct, the gland can become infected, a condition called sialadenitis.
- A doctor may be able to feel a salivary gland stone while examining a patient, or see one by using imaging technologies such as a CT scan or ultrasound.
- Conservative treatments bring temporary relief, but most people will benefit from minimally invasive surgery to resolve the problem.
Salivary stones, also called sialolithiasis, are hardened mineral deposits that form in the salivary glands. The condition is more likely to affect people age 30 to 60 and men are more likely to get salivary stones than women.
Of all salivary gland stones, 80 percent form in the submandibular salivary glands, but they can form in any of the salivary glands, including:
The parotid glands on the side of the face, near the ears
The sublingual glands under the tongue (uncommon)
The minor salivary glands in the inside of the cheek or lips, under the tongue and beneath the palate (rare)
What causes salivary stones?
The cause is not known, but several factors are associated with salivary stone formation:
Dehydration, due to inadequate fluid intake, illness, or medications such as diuretics (water pills) and anticholinergic drugs
Trauma to the inside of the mouth
Smoking
Gum disease
Salivary Stones: Symptoms
Salivary stones cause swelling, pain or both in the salivary gland. Symptoms get worse when the person is eating or anticipating eating. A dentist might notice symptom-free salivary stones on a person’s x-ray during routine exams.
The symptoms can come and go over a period of weeks, or be persistent. If the stone moves or grows in a way that blocks the duct of the gland, symptoms may worsen, a sign that the gland is becoming infected, a condition called sialadenitis.
Salivary Stones: Diagnosis
The doctor will take a medical history and examine the person by gently feeling the salivary glands inside of the mouth.
If a stone is detected, the doctor may recommend imaging to rule out other conditions such as:
Malnutrition
Radiation exposure
Reaction to iodine given as part of an imaging exam
Imaging studies, including computed tomography (CT) and ultrasound, can detect salivary stones and distinguish them from other problems.
Salivary Stones: Treatment
Most salivary gland stones resolve with conservative treatment. Patients will get instructions on applying moist heat and gentle massage to the salivary gland. Staying well-hydrated is important. Lemon drops or other tart candies can help stimulate salivation.
Ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce pain and swelling. If the doctor notices evidence of infection, an antibiotic may be prescribed.
It is important to let the doctor know about use of dehydrating medications such as antihistamines and anticholinergic medicines.
Surgical Treatment
If conservative therapy does not improve a salivary stone, an otolaryngologist may remove it with a minimally invasive procedure called sialendoscopy.
After giving the patient local or general anesthesia, the surgeon makes a small incision inside the mouth near the affected gland and inserts a slender tube called a sialoendoscope. The surgeon can use small instruments inserted through this tube to capture and remove the stone if possible. Sialendoscopy can also help doctors locate and capture small stones or fragments deep within the salivary gland.
If a salivary stone is very large or irregularly shaped, more invasive open surgery techniques may be necessary. These procedures can usually preserve the salivary gland.
Reviewed by Dr. David Eisele from the Department of Otolaryngology-Head and Neck Surgery.
Salivary Gland Center
The Johns Hopkins Salivary Gland Center offers the latest in evaluation, diagnosis and treatment for patients with salivary gland tumors and other salivary gland disorders.
