A salivary gland stone is a calcified structure that forms within a salivary gland or its duct, potentially blocking the flow of saliva into the mouth. These glands produce saliva, which aids in food digestion and helps maintain oral hygiene. Most stones develop in the submandibular glands on the floor of the mouth, but can also affect the parotid glands inside the cheeks or the sublingual glands under the tongue.
What Salivary Gland Stones Look Like
Salivary gland stones are hardened mineral deposits, appearing as white or yellowish calcifications. Their size can vary significantly, from less than a millimeter to larger than a pea, and their texture can be smooth or irregular. While the stones themselves are often not visible, their presence can cause noticeable swelling in the face or neck.
When saliva cannot exit the gland, it backs up, causing the gland to enlarge. This may appear as a tender lump under the jawline, on the side of the face in front of the ear, or on the floor of the mouth.
Common Symptoms
The symptoms of salivary gland stones often begin as a dull, intermittent pain in the mouth. A primary indicator is pain and swelling that intensifies just before or during meals. This occurs because the salivary glands increase saliva production to aid in digestion, but the blockage prevents its release, causing pressure to build.
Individuals may experience tenderness in the cheek, under the tongue, or along the jaw. Other common symptoms include dry mouth, difficulty swallowing, and problems fully opening the mouth. If an infection develops, signs can include redness, the presence of pus, and a high temperature.
Causes and Risk Factors
The precise cause of salivary gland stones is often unknown, but their formation is linked to the crystallization of chemicals in saliva. These stones consist mostly of calcium phosphate, which hardens into a solid mass when saliva becomes concentrated, allowing minerals to accumulate.
Several factors can increase the risk of developing these stones. Dehydration is a significant contributor because it thickens saliva, making crystallization more likely. A decrease in food intake can also be a factor, as it reduces the demand for saliva. Certain medications, such as some antihistamines, blood pressure drugs, and psychiatric medications, cause dry mouth, which can contribute to stone formation.
Treatment and Removal Options
Initial management of salivary gland stones often involves simple, at-home methods. Drinking plenty of water can help increase saliva flow. Sucking on sour or tart items like lemon drops or citrus fruits can stimulate saliva production, which may help push a small stone out of the duct. Gently massaging the affected gland can also encourage the stone to pass.
If these measures are not successful, medical intervention may be necessary. A doctor might be able to gently push a small stone out of the duct using a blunt instrument. For larger stones, a minimally invasive procedure called sialendoscopy can be used. This technique involves inserting a tiny camera and instruments into the duct to locate and remove the stone. In some cases, a small incision inside the mouth is required for removal.