Salivary Gland Stones

Salivary gland stones, also called sialolithiasis, are small mineral deposits that form inside a salivary gland or its duct and can block the flow of saliva. They most often cause swelling, tenderness or pain in the jaw, cheek or under the tongue, especially during meals.

Overview

Salivary gland stones are hard mineral deposits that develop in the saliva-producing glands or in the small tubes, called ducts, that carry saliva into the mouth. The medical term is sialolithiasis. When a stone partially or completely blocks a duct, saliva can build up behind the blockage, causing swelling and discomfort.

The major salivary glands include the parotid glands in the cheeks, the submandibular glands under the jaw, and the sublingual glands under the tongue. Stones most often affect the submandibular glands because their saliva is thicker and must travel upward through a longer duct. A stone may be very small, or it may grow large enough to be felt as a firm lump.

Most salivary gland stones are not cancer and are not usually dangerous, but they can be painful and can lead to repeated inflammation or infection if saliva remains blocked. Many cases can be managed effectively, especially when assessed early by an ear, nose and throat specialist or an oral and maxillofacial specialist.

Symptoms

The most common symptom of salivary gland stones is swelling in the affected gland that becomes more noticeable when a person eats, thinks about food or tastes something sour. This happens because the gland tries to release saliva, but the blocked duct prevents normal flow. The swelling may decrease after a meal as saliva slowly drains.

Symptoms can vary depending on the location and size of the stone. Some small stones cause no symptoms and are found by chance during dental or medical imaging. Larger stones or stones near the duct opening are more likely to cause obvious discomfort.

• Pain or tenderness under the jaw, in the cheek or under the tongue
• Swelling that comes and goes, especially around meals
• A dry or unpleasant taste in the mouth
• A firm lump along the duct or in the gland area
• Reduced saliva flow from one side of the mouth
• Redness, warmth, pus or fever if infection develops

Symptoms that include fever, increasing redness, severe pain, pus from the duct or difficulty opening the mouth may suggest infection or a more significant blockage. These symptoms should be assessed promptly by a qualified doctor.

Causes & Risk Factors

Salivary gland stones form when minerals in saliva, mainly calcium-based substances, collect and harden within a gland or duct. The exact reason this happens is not always clear. Slow saliva flow, thick saliva or changes in saliva composition may make stones more likely to form.

Several factors can increase the chance of developing a salivary gland stone. Dehydration can reduce saliva production and make saliva more concentrated. Reduced eating, certain medical conditions that cause dry mouth, previous gland inflammation, duct narrowing, and some medicines that reduce saliva flow may also contribute.

• Not drinking enough fluids, especially in hot weather or during illness
• Dry mouth, including dry mouth related to some health conditions
• Previous episodes of salivary gland infection or inflammation
• Reduced saliva flow after surgery, illness or poor oral intake
• Duct anatomy that makes saliva drainage slower

Salivary gland stones are not usually caused by poor hygiene, although good oral care can help reduce the risk of infection when saliva flow is reduced. They are also different from kidney stones or gallstones, even though all are described as stones because they are hardened deposits.

Diagnosis

Diagnosis begins with a careful medical history and physical examination. The doctor may ask when swelling occurs, whether it worsens during meals, whether there is dry mouth, and whether there have been repeated infections. During the examination, the clinician may gently feel the gland and duct and look inside the mouth for swelling, redness or reduced saliva flow.

In some cases, a stone near the duct opening can be seen or felt directly. If the stone is deeper or symptoms are unclear, imaging may be recommended. Ultrasound is commonly used because it is non-invasive and can often show stones and gland swelling. CT imaging may be used when a stone is difficult to locate, when there are complications, or when treatment planning requires more detail.

Other tests may be considered if symptoms suggest a different condition. For example, persistent gland swelling without a clear stone may require evaluation for autoimmune dry mouth conditions, duct narrowing, cysts, infection or, rarely, tumors. The aim is to confirm the blockage, identify its location and choose the safest treatment approach.

Treatment Options

Treatment for salivary gland stones depends on the stone’s size, location, symptoms and whether infection is present. The right approach is decided by a specialist after assessment. The goals are to restore saliva flow, relieve pain and swelling, prevent infection, and preserve the gland whenever possible.

For small stones and mild symptoms, conservative measures may be advised. These may include good hydration, warm compresses, gentle gland massage, oral hygiene, and stimulating saliva flow with sugar-free sour sweets or lemon flavor if appropriate. Pain relief or medication for infection may be considered by a doctor when clinically needed, but medicines do not dissolve most salivary stones.

If a stone does not pass or symptoms keep returning, a specialist may recommend a procedure. Minimally invasive techniques include salivary duct endoscopy, also called sialendoscopy, which uses a very small camera and instruments to locate and remove or loosen stones. Some stones near the duct opening can be removed through a small intraoral incision. Larger, deeper or complex stones may require combined endoscopic and surgical techniques.

Removal of the entire salivary gland is less common today but may be considered for selected cases, such as repeated severe infections, stones that cannot be removed safely by other methods, or significant gland damage. Any procedure should be discussed in detail with the treating specialist, including expected benefits, possible risks, recovery and alternatives.

Living With / Prognosis

Many people recover well after a salivary gland stone is removed or after saliva flow improves. Symptoms often settle once the blockage is relieved. Some people may have more than one stone or may experience recurrent episodes, so follow-up can be important, especially if swelling returns.

Daily habits can support salivary gland health. Drinking enough water, maintaining regular oral hygiene, attending dental check-ups, and avoiding prolonged dry mouth may help reduce irritation and infection risk. People who take medicines associated with dry mouth should not stop them on their own, but they can discuss dryness with their doctor to see whether adjustments or supportive measures are appropriate.

Living with repeated gland swelling can be uncomfortable, but effective diagnostic and treatment options are available. At Acibadem International, multidisciplinary ENT, oral and maxillofacial, radiology and surgical teams in JCI-accredited hospitals evaluate and treat salivary gland conditions for international patients, with care plans tailored after specialist assessment.

When to See a Doctor

A doctor should be consulted if swelling under the jaw, in the cheek or under the tongue keeps returning, especially when it is linked to meals. Medical assessment is also recommended if there is a persistent lump, reduced saliva flow from one side, dry mouth that does not improve, or discomfort that interferes with eating.

More urgent care is needed if symptoms suggest infection or a spreading problem. These include fever, chills, rapidly increasing swelling, redness or warmth over the gland, pus or a foul taste from the duct, severe pain, difficulty swallowing, difficulty breathing, or inability to open the mouth normally.

People with weakened immune systems, significant dehydration, diabetes or other chronic illnesses should seek medical advice earlier if they develop salivary gland swelling or pain. Early evaluation can help prevent complications and allows the specialist to choose the least invasive effective treatment where possible.

Frequently asked questions

What are salivary gland stones?

Salivary gland stones are hardened mineral deposits that form in a salivary gland or salivary duct. They can block saliva from flowing into the mouth, causing swelling and pain, especially during meals. The condition is also called sialolithiasis.

Are salivary gland stones dangerous?

Most salivary gland stones are benign and not cancerous. However, they can cause repeated pain, swelling and infection if the duct remains blocked. A doctor should evaluate persistent or recurrent symptoms to prevent complications.

Can a salivary gland stone pass on its own?

Some small stones near the duct opening may pass with hydration, gentle massage and saliva stimulation. Larger or deeper stones often need specialist treatment. A person should not try to forcefully remove a stone at home because this can injure the duct or introduce infection.

How are salivary gland stones diagnosed?

Diagnosis usually starts with a medical history and examination of the mouth, jaw and gland area. If the stone cannot be clearly seen or felt, imaging such as ultrasound or CT may be used. The doctor may also check for infection or other causes of gland swelling.

What is the treatment for salivary gland stones?

Treatment depends on the stone’s size, position and symptoms. Options include conservative care, minimally invasive salivary duct endoscopy, removal through the mouth, or surgery in selected cases. The best approach is chosen by a specialist after examination and imaging when needed.

Can salivary gland stones come back?

Yes, some people can develop another stone or have repeated duct blockage, although many recover fully after treatment. Staying well hydrated, managing dry mouth and maintaining oral hygiene may support gland health. Recurrent swelling should be reviewed by an ENT or oral and maxillofacial specialist.

When is salivary gland swelling an emergency?

Urgent medical care is needed if swelling is rapidly worsening or is accompanied by fever, pus, severe pain, difficulty swallowing, difficulty breathing or trouble opening the mouth. These symptoms may indicate infection or significant obstruction. Prompt treatment helps reduce the risk of complications.

References

• American Academy of Otolaryngology–Head and Neck Surgery
• Merck Manual Professional Edition
• National Institute of Dental and Craniofacial Research
• Cleveland Clinic
• BMJ Best Practice

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.