Salivary stones, or sialoliths, are hardened mineral deposits that form within salivary glands or their ducts, obstructing saliva flow. They typically consist of calcium phosphate and organic materials. While they can occur in any salivary gland, over 80% develop in the submandibular glands under the jaw. This is due to their longer, winding ducts, higher calcium concentration, and thicker, more alkaline saliva.
Symptoms include pain and swelling in the affected gland, especially during or before meals when saliva production is stimulated. This occurs because the stone blocks saliva, leading to a buildup. Pain might come and go, but complete blockage can worsen symptoms and lead to gland infection, known as sialadenitis.
Self-Care Approaches for Salivary Stones
For smaller salivary stones, several self-care approaches can encourage their natural passage and help alleviate discomfort. Staying well-hydrated by drinking plenty of water can help thin the saliva and facilitate stone movement. This increased fluid intake makes it easier for the saliva to flow and potentially dislodge the stone.
Massaging the affected salivary gland can also be beneficial in encouraging the stone to move through the duct. For submandibular glands, this involves gently massaging from under the jaw towards the front of the mouth or under the tongue. For parotid glands, located in front of the ears, the massage should move forward towards the cheek. Applying gentle pressure in a sweeping motion can help push the stone towards the duct opening.
Applying warm compresses to the swollen gland can help reduce irritation and promote relaxation of the surrounding tissues, which might aid in stone expulsion. This can be done by holding a warm, moist cloth against the skin over the affected gland for several minutes.
Stimulating saliva flow is another effective self-care method. Sucking on sour candies, lemon drops, or wedges of citrus fruits like lemons or oranges can significantly increase saliva production. This surge in saliva can create pressure behind the stone, potentially pushing it out of the duct. Chewing sugar-free gum can also help maintain consistent saliva flow.
While these home remedies can be effective for smaller stones, it is important to seek medical advice if symptoms persist, worsen, or if signs of infection like fever, increased redness, or pus draining from the area appear. These methods are not guaranteed to work for all stones, especially larger ones, and professional medical assessment helps ensure proper management and prevent complications.
Medical Procedures for Salivary Stone Removal
When self-care measures are not sufficient to dislodge a salivary stone, professional medical interventions become necessary, particularly if there is persistent pain, recurring swelling, or signs of infection. A healthcare provider might initially attempt manual manipulation, where a dentist or oral surgeon gently probes the area with a blunt instrument or massages the stone out of the duct. This approach is typically considered for smaller stones located closer to the duct’s opening.
For stones that are deeper within the duct or larger, a minimally invasive procedure called sialendoscopy is often performed. This procedure involves inserting a very thin endoscope, ranging from 0.8 to 1.6 millimeters in width, into the salivary duct through the mouth. The endoscope is equipped with a camera and light, allowing the surgeon to visualize the stone directly. Specialized tiny instruments, such as baskets or graspers, can then be threaded through the scope to extract the stone. Sialendoscopy is generally an outpatient procedure, meaning the patient can often return home the same day, with a relatively quick recovery time and minimal scarring.
In some cases, if the stone is too large to be removed by sialendoscopy alone, it may be broken into smaller pieces using a laser (lithotripsy) before extraction. If the stone is exceptionally large, deeply embedded, or if the gland has sustained irreversible damage or recurrent infections, surgical removal of the stone through an incision or even removal of the entire affected salivary gland (sialadenectomy) might be considered. Gland removal is typically reserved for severe cases where other methods have failed or are not suitable, and it is a more invasive procedure with a longer recovery period compared to sialendoscopy.
Strategies to Prevent Salivary Stones
While it is not always possible to completely prevent the formation of salivary stones, certain strategies can help reduce the risk of their development and recurrence. Maintaining good hydration is a primary preventive measure, as dehydration can lead to thicker saliva, which increases the likelihood of stone formation. Drinking sufficient water daily helps ensure a consistent and healthy flow of saliva through the glands and ducts.
Practicing good oral hygiene is also beneficial. Although not a direct cause of stones, poor oral hygiene can contribute to an environment where bacteria might thrive, potentially leading to inflammation or infection in the salivary glands, which can be associated with stone formation. Regular brushing and flossing help maintain overall oral health.
Regularly stimulating saliva flow can also aid in prevention by keeping saliva moving through the ducts, reducing the chance of mineral buildup. Chewing sugar-free gum or occasionally sucking on sugar-free sour candies can encourage consistent saliva production. This constant flow helps flush the ducts, minimizing the opportunity for deposits to form and accumulate.
Regular dental check-ups are important for early detection and management of any oral health issues, including potential signs of salivary gland problems. While these strategies contribute to a healthier oral environment and may lower the risk of stone formation, they do not offer a complete guarantee against future occurrences.