Sialolithiasis, or salivary gland stones, are collections of minerals that create small stones in the salivary ducts in the mouth. They most commonly occur in the ducts on the bottom of the mouth, but they can also appear in the glands under the tongue and in the cheeks. It is possible to have several stones.
Why Salivary Gland Stones Occur
Salivary gland stones are created when certain minerals, such as calcium, precipitate out of the saliva. Any situation where someone develops thicker saliva or less saliva can lead to stones. Dehydration and an inadequate diet can create the conditions for stone formation, as can certain medications or an injury to the salivary glands. It has also been seen in autoimmune medical conditions like Sjogren’s syndrome and lupus, where there can be decreased production of saliva.
Commons Symptoms of Salivary Gland Stones
When a salivary gland stone starts to form, there may be no symptoms at all. As it increases in size, however, there can be swelling of the mouth and pain. The swelling can be worse with eating as the body produces extra saliva. Patients may also notice dry mouth and pain with mouth movements. The saliva that is stuck behind the stone can build up and become infected, which may lead to a fever, redness to the area, or a bad taste in the mouth.
How to Diagnose Salivary Stones
Patients who suspect that they have a salivary gland stone should see an otolaryngologist as soon as possible. The specialist will examine the mouth and may need to do further testing with imaging studies such as x-rays, ultrasound, or a CT scan.
Salivary Gland Stone Treatments
There are several different treatments used to remove salivary gland stones. When the stones are small, simple treatments can prove effective. Specialists usually recommend that the patient drink plenty of fluids, suck on sour hard candies, or attempt massage to gently remove the stone.
If the stone is larger, it may need to be removed surgically through a procedure called sialendoscopy. The otolaryngologist uses a tiny scope with a light to enter the salivary gland and take out the stone after the patient has received medication to numb the area. Typically, the patient does not need to spend the night in the hospital and can go home after the procedure.
Some people develop repeat salivary gland stones that can damage the glands themselves, and, at that point, a specialist may recommend the removal of the entire salivary gland. When there is evidence of an infection behind the stone, a physician will usually prescribe antibiotics to resolve it.
Prevention of Salivary Gland Stones
Some patients are predisposed to have a dry mouth or thick saliva, and it is strongly advised that they take steps to reduce their risk of developing salivary stones. Sucking on hard candy and preventing dehydration can be critical to avoid this health problem. Experts recommend six to eight glasses of water daily to stay hydrated. For some, a health care provider may also prescribe a medication that can increase saliva production, in an attempt to avert the formation of salivary gland stones.