Salivary duct stones are masses of crystallized minerals that form in the tubes that saliva passes through after it’s made in your salivary glands. This condition is also known as sialolithiasis, and the stone may be referred to as salivary duct calculus. These stones mainly occur in middle-aged adults. They are the most common cause of blockages in the salivary ducts. (Merck)
Because the salivary ducts are in your mouth and a stone causes mouth pain, both doctors and dentists diagnose this condition and provide medical treatment if necessary. Salivary duct stones rarely cause serious problems and can often be treated at home.
Certain substances in your saliva, such as calcium phosphate and calcium carbonate, can crystalize and form stones that range in size from a few millimeters to more than two centimeters. When these stones block your salivary ducts, saliva builds up in your salivary glands, which makes them swell.
The reason why the stones form in the first place isn’t known. A few factors have been associated with a higher risk of having these stones. These include:
- taking medications, such as blood pressure drugs and antihistamines, which reduce the amount of saliva your glands produce
- being dehydrated, as this makes your saliva more concentrated
- not eating enough food, which causes a decrease in saliva production
You have three pairs of major salivary glands in your mouth. Salivary duct stones occur most often in the ducts connected to your submandibular glands. These salivary glands are located on both sides of your jaw in the back of your mouth.
Stones can also form in the ducts connected to the parotid glands, which are located on each side of your face in front of your ears. The stones in the submandibular glands are usually bigger than the ones that form in the parotid glands.
You can have one or more stones in your duct. About 25 percent of people with this condition have more than one stone, according to the Merck Manual Home Health Handbook. (Merck).
The main symptom of salivary duct stones is pain in your face, mouth, or neck that becomes worse just before or during meals. This is because your salivary glands produce saliva to facilitate eating. When saliva cannot flow through a duct, it backs up in the gland, causing swelling and pain.
Other common symptoms include tenderness and swelling in your face, mouth, or neck. You might also have a dry mouth and trouble swallowing or opening your mouth.
Bacterial infections can occur when the gland is filled with stagnant saliva. Signs of an infection include fever, a foul taste in your mouth, and redness over the affected area.
Your doctor or dentist will examine your head and neck to check for swollen salivary glands and salivary duct stones.
Imaging tests can provide a more accurate diagnosis because your doctor will be able to see the stones. Your doctor might order X-rays, an ultrasound, or a computed tomography (CT) scan of your face. An ultrasound creates an image of your face using sound waves, and a CT scan combines multiple X-rays into one cross-sectional, detailed image.
Treatment for salivary duct stones involves getting rid of the stones. Your doctor or dentist might suggest sucking on sugar-free lemon drops and drinking a lot of water, which cause an increase in saliva production. This can sometimes be enough to force the stone out of the duct. You might also be able move the stone by applying heat and gently massaging the affected area.
If you can’t get the stone out at home, your doctor or dentist can try to push it out by pressing on both sides of the duct. Stones that are large or located deep within your duct might need to be surgically removed.
In some cases, your doctor might suggest using shock waves to break the stone into smaller pieces. Then these pieces can pass through the duct. This is called extracorporeal shock wave lithotripsy (ESWL). During this procedure, high-energy sound waves are directed at the stone while you are sedated or under general anesthesia. ESWL is more commonly used to break up other types of stones in the body, such as those in the kidney or bladder.
If you have a bacterial infection in your gland, your doctor will prescribe antibiotics to treat it.
In most cases, the salivary duct stone is removed without any complications. If you keep getting salivary duct stones or salivary gland infections, your doctor might recommend having the affected gland surgically removed.
Because you have many other salivary glands, you will still have enough saliva if one is removed. However, these surgeries can be tricky because nerves that control various facial movements and sweating run through or near the major salivary glands. Talk to your doctor about the risks this kind of surgery presents.