Overview:

Salivary stones, also called sialolithiasis, are small deposits of calcium and other minerals that form in the salivary glands. Larger stones can block the flow of saliva and cause the affected gland to swell. This disease is more common in men.

Eighty percent of salivary gland stones occur in the submandibular gland. Others can occur in the parotid and sublingual glands. (Fig 1)

Figure 1.Sialolithiasis is caused by stones that obstruct one of the salivary gland ducts. This illustration also shows the 3 salivary glands (parotid, submandibular, and sublingual) with their ducts.

Causes:

The cause of these stones is not known. However, many factors can contribute to their formation. These factors include:•

advancing age.

•

having radiation therapy on the head or neck.

•

mouth injuries or trauma.

•

taking medications that affect saliva production.

•

Sjogren's syndrome.

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having kidney problems.

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not drinking enough water.

Symptoms:

Salivary stones do not usually cause symptoms when they are forming and they can sometimes disappear on their own. However, these stones can result in pain and swelling in the affected gland if the flow of saliva in the gland is blocked. The affected gland can get infected. This is called sialadenitis.

Testing:

To diagnose this problem, your oral and maxillofacial surgeon will obtain a medical history and examine you. He or she might order some imaging studies to detect stones and rule out other potential causes.

Treatment:

Management of these stones is usually done with conservative measures. This includes applying moist heat and gentle massage to the salivary gland. Staying well hydrated is important. Lemon drops can help stimulate salivation.

Ibuprofen or other nonsteroidal anti-inflammatory drugs can reduce pain and swelling. If your surgeon notices evidence of infection, an antibiotic may be prescribed.

For larger, harder-to-remove stones, the oral and maxillofacial surgeon can make a small incision in the mouth to remove the stone.

Another treatment option involves a less invasive technique called sialendoscopy. This technique uses small lighted scopes inserted into the gland's opening in the mouth to visualize the salivary duct system and locate the stone. Then, using small instruments, the surgeon can remove the stone. (Fig 2)

Figure 2Sialendoscopy involves a small instrument that goes through the duct in order to remove the stone.

For patients with recurrent stones or irreversible damage to the salivary gland, surgical removal of the gland may be necessary.

Article InfoPublication History

Accepted: April 15, 2021

Received: April 14, 2021

Simply Put – JOMS Information for PatientsFootnotes

Conflict of Interest Disclosures: None of the authors have any relevant financial relationship(s) with a commercial interest.

Identification

DOI: https://doi.org/10.1016/j.joms.2021.04.021

Copyright

© 2021 The American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

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