Blocked Salivary Gland

Definition

The salivary glands are responsible in producing saliva to maintain the moisture of the mouth and other parts of the digestive system. These glands produce enough amount of saliva to as much as a quart every day.

There are three major pairs of salivary glands and these are the parotid glands found on the inner side of the cheeks; submandibular glands located at the foot of the mouth; and the sublingual glands which are under the tongue.

Important functions of saliva:

To lubricate the mouth of a person with the passage of food
To provide help in the swallowing of food being eaten
To provide protection of the teeth against bacteria
Act as an aid in food digestion in the break down process of carbohydrates

Minor salivary glands which are hundreds in numbers are also found in the mouth and the throat. Saliva is draining itself into the mouth by means of some small tubes which are called ducts. When a person encounters a problem involving the salivary glands or ducts, some manifestations can be observed like presence of pain, fever, mouth becomes dry, foul-tasting drainage arise in the mouth and there will also be swelling of the salivary gland.

The most known reason for swollen salivary glands to exist is due to the presence of salivary stones which are made up of the buildup of saliva deposits that appear to be crystallized. This problem is referred to as sialolithiasis, and the stone that can be formed is called the salivary duct calculus.

The stones that block the salivary glands are mostly seen among middle aged adults. It rarely ends up into a serious problem and it can be treatable with some measures in the home setting.

Symptoms of Blocked Salivary Gland

The main clinical symptom for the presence of salivary duct stones is the pain felt in the face, in the mouth or in the neck that may become worse prior to mealtime or even during mealtime, when an individual eats or drinks something.

This happens due to an impaired function of the salivary gland to produce sufficient amount of saliva which can facilitate the eating of a person. Swelling and pain is being felt as the saliva cannot freely flow through a duct and it gets accumulated in the gland.

Other common symptoms include:

Tenderness and swelling felt in the mouth, face or neck
Mouth becomes dry
Swallowing problem
Problem with opening the mouth
Bacterial infections manifested through fever, some redness on affected area and the mouth has a foul taste

Causes

The exact reason as to the formation of Blocked Salivary Gland/ salivary duct stones is not known yet. There are certain substances found in the saliva, and these are calcium phosphate and calcium carbonate. These specific substances can crystallize themselves and can form stones ranging from a size between a few millimeters until about more than two centimeters.

Once the stones being formed are blocking the salivary glands, there will be an automatic buildup of saliva in the salivary glands, which in turn can make them swollen and pain can be felt then. The formation of salivary stones mostly affects the submandibular glands and they are found to be affecting the parotid glands as well.

Predisposing risk factors to develop salivary duct stones (Blocked Salivary Gland) are the following:

Dehydration as this can make the saliva to have a more concentrated form
Inadequate food intake as this can lead to a lesser production of saliva
Effect of taking some medications, such as antihistamines and those that control blood pressure, as it can decrease the amount of saliva being produced by salivary glands

Diagnosis

Attending physicians and dentists can perform a thorough physical examination of the patient, focusing more on the head and neck region, in order to completely assess the presence of swollen salivary glands and the growth of salivary duct stones on affected site.

Imaging tests can be done to confirm the diagnosis of a blocked salivary gland and these are:

Multiple X-rays taking some cross-sectional view
Ultrasound to create facial image utilizing some form of sound waves
Computed tomography scan of the face
Magnetic resonance imaging to provide an image of specific affected site where blockage occurs

Treatment

The main goal of treatment for a blocked salivary gland is the removal of the stone.

Home remedies:

Drinking plenty of water to prevent dehydration
Use of sugar-free lemon drops to facilitate an increase in the production of saliva

Other methods to remove the stone:

Massaging the affected gland to manually remove the stones
Application of heat or warm compress in order to push and move the stone out of the blocked duct
Extracorporeal shock wave lithotripsy can break the stone into small pieces utilizing some shock waves
Sialoendoscopy to diagnose and treat the stones found in the salivary gland duct
Prescription of antibiotics for bacterial infection of the salivary gland
Surgical removal of the salivary gland in cases of infected stones or when the stones are frequently coming back despite some treatment measures done

Complications

The removal of salivary duct stones generally does not result with complications. In instances with the frequent occurrence of the stones or infections of the salivary gland, physicians usually recommend the removal of these glands.

References:

Salivary gland stones (calculi) at http://www.nhs.uk/Conditions/salivary-gland-stones/Pages/Introduction.aspx
https://www.nlm.nih.gov/medlineplus/ency/article/001039.htm
http://www.healthline.com/health/salivary-duct-stones#Overview1
Elluru RG (2010: chap 84). Physiology of the salivary glands. In: Cummings Cw, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier.
Lacey J (2010: chap 85). Diagnostic imaging and fine-needle aspiration of the salivary glands. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elseiver.
Rogers J, McCaffrey TV (2010: chap 86). Inflammatory disorders of the salivary glands. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elseiver.