Salivary stones, or sialolithiasis, can cause significant pain and discomfort. They are a common salivary gland disorder that occurs when certain minerals form into hard pieces of matter within the ducts of the salivary glands. Symptoms typically include swelling of the affected area, as well as pain when eating or drinking. In some cases, individuals may notice white lumps inside their mouths.
The most common cause for salivary stones is dehydration and a lack of saliva production. Other factors such as infection in the mouth, poor dental hygiene, and excessive smoking can also contribute to their formation. Additionally, certain medications (such as anticholinergics) can reduce saliva production and make stones more likely to form.
Treatment for salivary stones will depend on their size and location. In some cases, the stones can be broken up or dissolved using simple methods such as drinking plenty of fluids or sucking on ice chips. If these remedies do not work, more invasive techniques may be necessary such as surgical removal or ultrasound-guided sialolithotripsy (breaking apart the stone with sound waves).
It is important to note that prevention is key when it comes to salivary stones. By maintaining proper hydration and keeping good oral hygiene habits, individuals can reduce their risk of developing them in the first place. Additionally, avoiding smoking and medications that reduce saliva production are also effective measures to take.
Are salivary stones dangerous?
Salivary stones are harmless in themselves and often remain asymptomatic. In the best case, the stones are washed away from the glands by themselves after a while.
But if the stones remain stuck in the glandular outlets and block them, this can lead to pain and, in the worst case, to acute salivary gland inflammation.
Where can salivary stones form?
Salivary stones can form on all salivary glands. Humans have three pairs of salivary glands in the oral cavity:
- The lower jaw salivary glands are located on either side of the lower jaw in the back of the mouth. This is where salivary stones occur most frequently (in approximately 83% of all cases).
- Rarely, the stones can also form in the parotid glands, which are located on the side of the face under the ears (10 percent of all cases).
- In only 7% of cases do salivary stones form in a sublingual gland, which – as the name suggests – has its place under the tongue.
It is quite possible for more than one stone to form per gland. In about a quarter of those affected, several stones develop at once.
What are the symptoms of salivary stones?
Very often, salivary stones go unnoticed. But when symptoms do manifest, they are usually pain in the:
- mouth area
- neck area
- lower jaw area
Typically, symptoms worsen before and during meals because the glands then produce more saliva to make chewing easier. If one of the glands is blocked, saliva backs up in the gland.
In the worst case, this leads to salivary gland inflammation (sialolithiasis)
What is the manifestation of salivary gland inflammation?
When a salivary gland becomes inflamed due to acute obstruction, it may result in the following symptoms:
- A visible swelling around the face, neck, or mouth in the affected area
- Difficulty swallowing
- Pain when opening the mouth
If a bacterial infection also occurs because stale saliva builds up in the gland, this is usually manifested by:
- Bad taste in the mouth
- A visible redness in the affected area
If you suffer from one or more of the signs described above, you should see your doctor immediately.
Salivary calculitis definitely requires medical attention and usually requires the administration of antibiotics.
What are the causes of salivary stones?
Our saliva contains certain substances – such as calcium phosphate and calcium carbonate – that can harden and clump together.
When the resulting stones block the glandular outlets, saliva backs up and the glands swell.
What are the risk factors?
The exact cause of why some people develop such stones in the first place is not known.
But there are some factors that have been shown to increase the risk of salivary stones. These include, but are not limited to:
- Taking certain medications, such as blood thinners or antihistamines. This is because these lead to reduced saliva production, which in turn promotes the formation of salivary stones.
- Dehydration (dehydration) of the body. If you have taken too little fluid, this increases the concentration of minerals in the saliva, which makes it easier for saliva to stick and form stones.
- Decreased food intake: If you eat too little, this also curbs saliva production and increases the risk of salivary stones.
- Poor oral hygiene: Insufficient dental hygiene promotes the development of bacteria in the oral cavity.
- In rare cases, certain infectious diseases, as well as mumps or cystic fibrosis can also lead to salivary stones, as saliva thickens in these diseases.
What preventive measures can I take?
The risk of salivary stones can never be completely eliminated. However, you can reduce the risk by:
- Always drink enough fluids – doctors recommend at least one to two liters a day & gargle salt water.
- Eat regular meals to ensure balanced saliva production
- In between meals, chew sugar-free gum – this also increases saliva flow.
- Attention to a thorough dental care and oral hygiene: Regular brushing with an electric toothbrush or sonic toothbrush, as well as additional mouthwashes are important.
Because oral hygiene stimulates the flow of saliva and counteracts bacteria in the oral cavity.
What is the diagnosis and treatment?
If salivary stones are suspected, your doctor will first examine your face and neck area to see if the salivary glands there are swollen.
A comprehensive examination at the dentist’s office is the first step in treatment.
To get a more accurate diagnosis, he or she may then order a diagnostic imaging procedure, such as an X-ray, ultrasound or computed tomography (CT scan).
If your doctor finds salivary stones, there are several ways to treat them. If the salivary stones are not too large and there is no inflammation, the doctor may first try simple treatments:
Home remedies for salivary stones
Very often, simple home remedies are enough to get rid of salivary stones. Your doctor may recommend or use the following methods on you:
- Gently massage the affected region. Sometimes the stones can simply be massaged out of the glands. Once they have successfully dislodged, they can drain away along with the saliva.
- Sucking sugar-free lemon candies.The idea behind this is to increase saliva production by sucking acidic candies, so that the stones are washed away.
- Drink plenty of water – preferably with a dash of lemon added. Because the acidity of citrus fruits increases salivation.
- The chewing of sugar-free chewing gum also increases the amount of saliva.
Treatment by means of medication
If salivary gland inflammation has already occurred, your doctor will probably prescribe antibiotic therapy
This does not dissolve the stones, but it does counteract bacterial inflammation.
Other treatment methods
If the conservative treatment methods described above are not successful, your otolaryngologist may use one of the following procedures:
- Extracorporeal shock wave lithotripsy (ESWL)This is a specialized form of shock wave therapy that uses ultrasound waves to break up the stone. Ideally, the lump disintegrates into small individual parts, which can then flow off with the saliva.
- In some cases, however, surgical intervention is necessary. In a salivary duct endoscopy, you are placed under anesthesia and the doctor makes a small incision in the salivary gland duct, which allows him to remove the stone.
- If the salivary stone is located so inconveniently that it cannot be removed by simple surgery, the doctor may need to remove the entire affected salivary gland This is a major procedure and you should plan on a week’s hospital stay for it.
Can I remove a salivary stone myself?
If you suspect that you have formed a salivary stone, you can of course try it yourself with the above home remedies, according to guides on the Internet.
- The exits of the salivary glands, they can find with the help of a mirror and a flashlight relatively easily.
- Some sufferers can massage the salivary stone with purposeful movements in the direction of the gland outlet.
However: By such a „self-treatment“ you neither eliminate the causes & risk further complications – better go to an expert!
What is the prognosis for salivary stones?
In the vast majority of cases, salivary stones can be removed without any further complications.
However, if you keep developing salivary stones or salivary gland inflammation, your ENT doctor may recommend operating to remove the affected gland.
Because there are multiple salivary glands, removing one gland will not negatively affect salivary flow.
However, the surgery does carry some risk. Nerves responsible for certain facial movements as well as sweat production run close to the large salivary glands. These could be injured during surgery.
It is best to discuss the benefits and possible risks of surgery with your doctor.
Salivary stones are very often harmless and are flushed out again with saliva without the affected person even noticing.
However, salivary stones are the main cause of salivary gland blockages, which can be painful.
See your dentist or ENT if you suspect you are suffering from salivary stones. For the most part, the small stones can be removed relatively easily and without after-effects.
To prevent the formation of salivary stones, you should pay particular attention to adequate fluid intake and thorough dental hygiene – preferably with an electric device such as the Oral-B Pro 3000 or a Panasonic toothbrush.
This is an effective way to prevent many oral and dental problems!