Sialoliths, also known as salivary gland stones, are hardened deposits that can form within salivary glands or their ducts. These stones can cause discomfort and disrupt normal salivary flow. Understanding what these stones are and how they are addressed can help individuals recognize symptoms and seek appropriate care.
What Are Sialoliths and How Do They Form?
Sialoliths are calcified masses that develop within the salivary glands or their ducts. These stones are primarily composed of calcium phosphate and hydroxyapatite, mineral salts found in saliva. They can vary in size from a few millimeters to over two centimeters.
The majority of sialoliths, approximately 80%, form in the submandibular glands, located under the jaw. They can also appear in the parotid glands near the ears or, less commonly, in the sublingual glands under the tongue. The exact cause of their formation is not fully known, but it is believed to involve the accumulation of calcium and phosphate, sometimes with dead cells or infection. Factors that may increase the risk of stone formation include dehydration, certain medications that reduce saliva production, and prior injury to the salivary glands.
Identifying Sialolith Symptoms
The most common symptom associated with sialoliths is pain and swelling in the affected salivary gland. This discomfort worsens during or just before eating, as increased demand for saliva production leads to a buildup behind the obstruction. The pain can be intermittent or persistent.
Beyond pain and swelling, individuals might experience tenderness in the area, a dry mouth, or difficulty swallowing. A blocked duct can also lead to an infection of the gland, known as sialadenitis. Signs of an infection may include fever, redness over the affected area, or a foul taste in the mouth.
Diagnosis and Treatment Options
Diagnosing sialoliths begins with a physical examination. A healthcare provider may gently feel the salivary glands inside the mouth or under the jaw to detect any enlarged, firm, or tender areas. If a stone is suspected, imaging techniques are used for confirmation. Common methods include X-rays, ultrasounds, and CT scans, with CT scans offering higher sensitivity.
Treatment approaches for sialoliths range from conservative measures for smaller stones to more invasive procedures for larger or recurrent ones. Initial management involves encouraging hydration, applying moist heat to the affected area, and gently massaging the gland. Sucking on sour candies or lemon slices can stimulate saliva flow, which may help small stones pass on their own. If an infection (sialadenitis) is present, antibiotics may be prescribed.
For stones that do not pass spontaneously, a healthcare provider might attempt to manually push out smaller stones from the duct. More advanced procedures include sialendoscopy, where a thin tube with a camera is inserted into the salivary duct to visualize and remove the stone. In cases of larger or deeply embedded stones, or if conservative methods fail, surgical removal of the stone through a small incision may be necessary. If stones are recurrent or cause severe damage, the entire salivary gland might need to be surgically removed.