A salivary gland infection, or sialadenitis, occurs when bacteria or viruses build up in the glands responsible for producing saliva, such as the parotid or submandibular glands. This condition is frequently triggered by reduced saliva flow, often due to dehydration or a physical blockage like a salivary stone. Effective treatment involves a combination of at-home care and professional medical intervention.
Identifying Causes and Symptoms
The most common signs of a salivary gland infection are swelling and tenderness in the affected gland, usually located near the ear or beneath the jawbone. This swelling is often accompanied by pain that intensifies when eating, which is a key symptom as the act of eating stimulates saliva production. Other symptoms include a dry mouth or the drainage of foul-tasting fluid or pus into the mouth.
The underlying cause often determines the specific presentation of the infection. Bacterial infections, commonly caused by Staphylococcus aureus or oral bacteria, often present with systemic symptoms like fever and chills. Conversely, an obstruction, known as sialolithiasis or a salivary stone, causes saliva to back up, creating an environment for infection. When obstruction is the cause, the gland may visibly swell after eating and then decrease in size, a pattern less common with a pure bacterial infection.
Essential Steps for Home Management
Initial management of a salivary gland infection focuses on maximizing saliva flow to flush out the blockage or infection and alleviate discomfort. Maintaining hydration is fundamental, as drinking plenty of water thins the saliva, making it easier to pass through the ducts. Thin, flowing saliva helps wash away bacteria and may encourage the passage of a small salivary stone.
Gentle massage, sometimes called “milking,” can encourage drainage from the affected gland. For the parotid gland near the ear, the massage should be directed forward toward the mouth opening. If the submandibular gland under the jaw is involved, the massage should be directed from the back of the jawline toward the chin. This manual pressure assists in moving any trapped saliva or small stones through the duct.
Applying warmth to the area helps reduce swelling and increase blood flow, supporting natural drainage. A warm compress or washcloth applied over the swollen gland for 10 to 15 minutes several times a day is effective. The heat helps open the salivary ducts and provides relief from pain.
Actively stimulating saliva production is highly beneficial, and this is achieved by using sialogogues, or substances that promote flow. Sucking on sour candies, especially lemon-flavored ones, or using lemon juice or tart lozenges, causes a strong reflex to produce saliva. This surge of saliva can exert enough pressure to dislodge a stone or flush out the duct, helping to clear the infection. For pain relief, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can manage both the pain and inflammation.
Professional Medical Treatment Options
When symptoms persist or worsen despite consistent home care, a medical professional introduces more targeted treatments. Bacterial infections necessitate antibiotic therapy, which is the first line of defense to control the spread of the infection. Common antibiotics prescribed include dicloxacillin, cephalosporin, or clindamycin, chosen to target the bacteria most likely responsible, such as Staphylococcus aureus. Patients must complete the entire course of antibiotics prescribed, even if symptoms improve quickly.
If the infection is caused by a persistent salivary stone (sialolithiasis) that does not pass naturally, procedural interventions may be required. Sialendoscopy is a minimally invasive procedure involving the insertion of a tiny endoscope into the salivary duct to visualize and remove the stone. This technique is effective for smaller stones and aims to preserve gland function.
For larger or more complex stones, or if the gland has been repeatedly infected and damaged, surgical removal of the gland may be considered. If the infection has progressed to form an abscess (a localized pocket of pus), the physician may need to perform needle aspiration or an incision and drainage procedure. This surgical drainage relieves pressure and allows the infection to resolve quickly.
In severe cases where a person is significantly dehydrated, has a high fever, or the infection is spreading systemically, hospitalization may be necessary. Intravenous (IV) fluids are administered to correct dehydration and promote saliva flow. IV antibiotics are given to rapidly achieve high concentrations in the bloodstream to fight the infection.
Recognizing Signs of Severe Infection
While many salivary gland infections resolve quickly, certain symptoms indicate a rapidly worsening condition requiring immediate medical attention. A high fever, defined as a temperature above 101°F (38.3°C), suggests a significant systemic bacterial infection not controlled by the body’s defenses or early home care.
Any rapidly worsening swelling, particularly if redness extends down the neck, is a serious sign of the infection spreading into the deep tissues. Difficulty or pain when swallowing (dysphagia) or breathing (stridor) is concerning, as severe swelling in the neck can compromise the airway. These symptoms indicate a potentially life-threatening situation that warrants an immediate emergency room visit.