Salivary gland stones (sialolithiasis) occur when calcified structures form within the glands or their ducts, obstructing the flow of saliva into the mouth. These stones are composed mainly of calcium phosphate and other mineral salts that precipitate out of the saliva, creating a physical blockage. This obstruction causes discomfort and swelling, which patients often resolve using non-invasive, at-home methods. This guide provides information on how to gently encourage the expulsion of a small salivary gland stone using manual techniques and supportive measures.
Identifying Salivary Gland Stones and Symptoms
A salivary gland stone is a small, hard mass that typically forms in the submandibular glands, located beneath the jaw and draining through Wharton’s duct beneath the tongue. This location accounts for over 80% of all salivary stones. The primary indication of a stone is pain or swelling in the neck or under the tongue, particularly when eating or anticipating food. This occurs because eating stimulates saliva production, and the increased flow pushes against the obstruction, causing the gland to distend. The pain usually subsides after the meal as the saliva pressure decreases, returning when eating resumes.
Step-by-Step Manual Removal Technique
Manual manipulation can help dislodge a small stone situated near the duct opening. Begin by thoroughly washing your hands. Locate the affected gland, which will feel like a firm, tender lump, most often found under the jawline for the submandibular gland.
For a submandibular stone, manipulation is performed both externally and internally. Place one finger inside the mouth, under the tongue, near the duct opening, and two fingers on the outside of the neck, directly beneath the jaw. Apply gentle but firm pressure to the gland, ensuring the force is always directed toward the duct opening. The goal is to push the stone along the duct’s path, not to squeeze the gland forcefully.
The massage should consist of a slow, sustained sweeping motion that begins at the back of the gland and moves forward toward the front of the mouth. If the stone is in the parotid gland, located in the cheek area in front of the ear, the massage should sweep forward along the cheek toward the opening near the upper molars. Repeat this milking motion consistently for several minutes, pausing if the pain becomes sharp or intense. The stone may require repeated sessions over a day or two to be successfully expelled.
Supportive Measures to Stimulate Saliva Flow
Combining manual manipulation with measures that increase saliva flow aids in expulsion. Saliva acts as a natural lubricant and pressure source, helping to push the stone along the duct. Maintaining a high fluid intake is a foundational step, as chronic dehydration contributes to the thickening of saliva, making it harder for the stone to pass.
Applying a warm compress or moist heat to the swollen gland for five to ten minutes before and after the massage is helpful. The warmth helps relax the tissues around the duct, easing the stone’s passage. Simultaneously, employ “sialogogues,” which are substances that stimulate the salivary glands to produce more fluid.
Sucking on sour items, such as a lemon wedge, sour candy, or a sugar-free lemon drop, effectively triggers a strong salivary response. Acidic liquids, like pure lemon juice or malt vinegar, produce high rates of salivary flow. This increased flow creates hydrostatic pressure behind the stone, aiding the manual effort to push it out of the duct.
Signs Requiring Professional Consultation
While many salivary gland stones pass with home care, certain signs indicate the need for immediate professional medical attention. Consult a healthcare provider if symptoms do not improve after 48 hours of consistent home treatment. Severe, persistent pain that prevents eating indicates the stone is completely blocking the duct.
The development of an infection is a complication requiring professional intervention. Watch for signs such as a fever or chills, spreading redness or warmth over the skin, or pus draining from the affected duct. These symptoms suggest bacteria have accumulated behind the obstruction, which may require oral antibiotics to treat the infection.