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Salivary duct stones

Definition

Salivary duct stones are deposits of minerals in the ducts that drain the salivary glands. Salivary duct stones are a type of salivary gland disorder.

Alternative Names

Sialolithiasis; Salivary calculi

Causes

Spit (saliva) is produced by the salivary glands in the mouth. The chemicals in saliva can form a hard crystal that can block the salivary ducts.

When saliva cannot exit a blocked duct, it backs up into the gland. This may cause pain, swelling, or an infection of the gland.

There are three pairs of major salivary glands:

  • Parotid glands -- These are the two largest glands. One is located in each cheek over the jaw in front of the ears. Inflammation of one or more of these glands is called parotitis, or parotiditis.
  • Submandibular glands -- These two glands are located just under both sides of the jaw and carry saliva up to the floor of mouth under the tongue.
  • Sublingual glands -- These two glands are located just under the front area of the floor of the mouth.

Salivary stones most often affect the submandibular glands. They can also affect the parotid glands.

Symptoms

Symptoms include:

The symptoms occur most often when eating or drinking.

Exams and Tests

The health care provider or dentist will do an exam of your head and neck to look for one or more enlarged, tender salivary glands. The provider may be able to find the stone during the exam by feeling under your tongue.

Tests such as x-rays, ultrasound, MRI scan or CT scan of the face are used to confirm the diagnosis.

Treatment

The goal is to remove the stone.

Steps you can take at home include:

  • Drinking lots of water
  • Using sugar-free lemon drops to increase the saliva

Other ways to remove the stone are:

  • Massaging the gland with heat -- The provider or dentist may be able to push the stone out of the duct.
  • In some cases, you may need surgery to cut out the stone.
  • A newer treatment that uses shock waves to break the stone into small pieces is another option.
  • A new technique, called sialendoscopy, can diagnose and treat stones in the salivary gland duct using very small cameras and instruments.
  • If stones become infected or come back often, you may need surgery to remove the salivary gland.

Outlook (Prognosis)

Most of the time, salivary duct stones cause only pain or discomfort, and at times become infected.

When to Contact a Medical Professional

Contact your provider if you have symptoms of salivary duct stones.

Gallery

Head and neck glands
There are several pairs of salivary glands in different locations a major pair in front of the ears (parotid glands); two major pairs on the floor of the mouth (sublingual and submaxillary glands); and several minor pairs within the lips, cheeks, and tongue.

References

Elluru RG. Physiology of the salivary glands. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 81.

Jackson NM, Mitchell JL, Walvekar RR. Inflammatory disorders of the salivary glands. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 83.

Orlowski HLP, Miller-Thomas M. Diagnostic imaging and fine-needle aspiration of the salivary glands. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 82.

Last reviewed August 31, 2021 by Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team..

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