What to know about salivary stones

Salivary stones are small stones that form in the glands of the mouth. They can block the flow of saliva and cause pain or discomfort.

The medical term for salivary stones is sialoliths. When they block the salivary glands, this is known as sialolithiasis.

Salivary stones are rarely a cause for concern, and people can often get rid of them at home. However, some stones may require treatment from a doctor.

In this article, we explain what salivary stones are and discuss their symptoms and causes. We also explore home remedies, when to see a doctor, medical treatment, and possible complications.

What are salivary stones?

Salivary stones can form in the ducts of any salivary gland.Image credit: James Heilman, MD, 2012

The salivary glands in the mouth produce a liquid called saliva. Saliva protects the teeth, helps with chewing and swallowing food, and initiates the process of digestion.

The mouth contains hundreds of minor, or small, salivary glands. There are also three pairs of major, or large, salivary glands. These large glands include the:

parotid glands, which sit below the ears on the inside of the cheeks

submandibular glands at the bottom of the mouth near the jawline

sublingual glands, which are underneath the tongue

Salivary stones are small deposits of calcium and other minerals. They can form in the ducts of any type of salivary gland. Larger stones can block the flow of saliva and cause the glands to swell.

According to research from 2012, more than 80 percent of salivary stones form in the submandibular gland, while 6–15 percent occur in the parotid gland, and 2 percent are in the sublingual and minor salivary glands.

Symptoms

Salivary stones do not usually cause symptoms when they are forming, and they can sometimes disappear on their own. The stones can vary in size, but they are usually hard and white.

Larger stones can block the flow of saliva in the gland. This blockage can cause saliva to build up behind the stone, which can lead to pain and swelling.

Common symptoms of blocked salivary glands include:

a sore or painful lump under the tongue

pain or swelling below the jaw or ears

pain that increases when eating

Salivary stones can sometimes also lead to infection in or around the affected gland. Symptoms of infection can include fever and the formation of pus around the stone.

Causes

Doctors do not fully understand what causes salivary stones. However, certain factors can increase a person’s risk of getting them.

These risk factors include:

being male

advancing age

having radiation therapy on the head or neck

mouth injuries

taking medications that affect saliva production, such as anticholinergics

having gout or Sjogren’s syndrome

having kidney problems

not drinking enough water

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Home remedies

Salivary stones are rarely serious, and a person can often treat them at home.

Home remedies for getting rid of salivary stones include:

Sucking on citrus fruits or hard candies. Sucking on a wedge of lemon or orange increases the flow of saliva, which can help dislodge the stone. A person can also try sucking on sugar-free gum or hard, sour candies, such as lemon drops.

Drinking plenty of fluids. Regular fluid intake helps keep the mouth hydrated and can increase saliva flow.

Gentle massage. Gently massaging the affected area may relieve pain and encourage the stone to pass through the salivary duct. The Sjogren’s Syndrome Foundation have an illustrated guide on how to do this on their website.

Medications. Some over-the-counter drugs, such as ibuprofen and acetaminophen, can help relieve pain and swelling.

Sucking on ice cubes. Sucking on something cold, such as an ice cube or ice pop, may also help reduce pain and swelling resulting from salivary stones.

When to see a doctor

Salivary stones can sometimes cause infections or abscesses, so people who are unable to remove the stones by themselves should see a doctor. If the doctor is unable to remove the stones, they may refer the person to the hospital.

Anyone who has signs of an infection or abscess should see a doctor immediately. A doctor can usually treat an infection with antibiotics.

Medical treatment

Salivary stones that are large may be difficult to remove. Image credit: Wouter Hagens, 2011

The doctor will look inside the person’s mouth to examine any painful areas and feel the size and shape of the stones. They may also request an X-ray or CT scan to determine the number of stones and their exact location.

Doctors are sometimes able to massage or press on a salivary stone to dislodge it from the gland. They may also use an ultrasound machine, which emits high-frequency sound waves that can break the stone into smaller pieces and make it easier to remove.

Salivary stones that are large or situated deep within the salivary gland may be harder to remove.

In these cases, a doctor may need to perform a sialendoscopy. This procedure involves using an endoscope to examine the inside of the mouth and widen the affected salivary duct, allowing the stone to pass through. As this procedure can be uncomfortable, the doctor will use a local anesthetic to numb the person’s mouth first.

Complications

Doctors can usually remove salivary stones that are less than 2 millimeters wide without surgery. For larger or more difficult-to-remove stones, a person may need to go to the hospital. Surgery for salivary stones involves making a small incision in the person’s mouth to remove the stone.

For people with recurring stones, a doctor may recommend having surgery to remove the salivary gland. There are multiple salivary glands in the mouth, so people can still produce enough saliva if they lose a gland.

Surgery to remove the salivary gland does have some risks, which people can discuss with their doctor.

Summary

Calcified stones can sometimes form in the salivary glands of the mouth and may cause pain or discomfort. They are rarely serious, and a person can often remove the stones themselves.

A person should see a doctor if they are unable to remove the stones at home or if the stones keep coming back. It is also essential to see a doctor if the area around the stone becomes infected or if an abscess forms.

Doctors are often able to remove the stones by massaging them or using an endoscope. However, for very large or difficult-to-remove stones, they may recommend surgery. In some cases, a person may need to have surgery to remove the affected salivary gland.

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