Salivary Gland Stones

Salivary gland stones most commonly occur in the parotid or submandibular glands. The parotid glands are located under the skin in front of the ear overlying the jaw bone, and the submandibular glands are located underneath the jaw. All of these glands produce saliva which is useful for chewing, swallowing, and maintenance of proper oral health. Ducts are tube like structures which transfer the saliva from the gland into the mouth.

Salivary gland stones may occur in either the gland or the duct. Stones typically cause discomfort or swelling of the affected gland, and are often associated with tenderness and even an infection. Salivary gland stones may occur as a result of dehydration when saliva is not produced in large quantities. Most commonly stones are produced in the submandibular glands. Saliva from the submandibular glands must be pumped against gravity through a long narrow duct and between many muscles. All of these are obstacles which are thought to lead to stone production. Stones may be felt on physical examination or seen on X-ray or CT examination.

Treatment of a salivary gland stone begins with adequate hydration and massage of the gland. By massaging the gland affected the saliva is pushed out of the duct and gland and into the mouth, thus encouraging the stone to be expressed. Occasionally stones that are felt in the floor of the mouth where the submandibular gland is located may be removed through a small procedure in the mouth.

Sialodendoscopy is a procedure in which a small camera is placed through the mouth into the duct to identify the stone. The stone is treated with a laser to break it into pieces and then removed.

Occasionally patients with stones may need the salivary gland removed. This is known as a submandibular gland resection or parotidectomy.