Understanding Salivary Gland Stones: Causes, Symptoms, and Modern Treatments

A salivary gland stone, also known as a salivary duct stone, is a hard, calcified mass that can develop within a salivary gland or its ducts, potentially obstructing the natural flow of saliva into the mouth. While these stones can affect any of the salivary glands, they most frequently occur in the submandibular glands, located beneath the floor of the mouth. Less commonly, they can be found in the parotid glands (near the cheeks) or the sublingual glands (under the tongue). It's not unusual for individuals to develop multiple stones. The formation of salivary stones is attributed to the accumulation of chemicals, mainly calcium, within the saliva. Although the precise cause remains unknown, certain factors are believed to contribute by reducing saliva production or thickening its consistency. These risk factors include dehydration, poor dietary habits, and the use of particular medications such as antihistamines, certain blood pressure drugs, psychiatric medications, and bladder control drugs. Additionally, trauma to the salivary glands can increase the risk of stone formation. Initially, salivary stones typically cause no symptoms. However, as they grow and begin to block a duct, saliva backs up into the gland, leading to pain and swelling. This discomfort can be intermittent and progressively worsen. If left untreated, the affected gland may become inflamed or infected. Diagnosing a salivary gland stone usually begins with a physical examination by a doctor. Imaging tests like X-rays, CT scans, or ultrasounds may also be ordered to confirm the presence and location of the stone. The primary goal of treatment is to remove the stone. For smaller stones, stimulating saliva flow by sucking on sour candies or a lemon can sometimes help the stone pass on its own. A doctor or dentist might also be able to massage or push small stones out of the duct. Larger or more stubborn stones often require a small incision in the mouth for removal. A more contemporary and less invasive approach gaining popularity is sialendoscopy. This technique involves inserting tiny, lighted scopes into the gland's opening in the mouth to visualize the salivary duct system and pinpoint the stone. Micro-instruments are then used to remove the stone and clear the blockage. Sialendoscopy is typically performed under local or light general anesthesia, allowing patients to return home the same day. In cases of recurrent stones or irreversible damage to the salivary gland, surgical removal of the gland itself might be necessary. If a bacterial infection accompanies the salivary stones, antibiotics will also be prescribed.