Salivary Duct Stones: Causes, Symptoms, and Diagnosis
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Salivary Duct Stones

What are salivary duct stones?

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. The condition is also known as sialolithiasis. The stone is often referred to as salivary duct calculus and mainly occurs in middle-aged adults. It’s the most common cause of blockage in the salivary ducts.

Because salivary duct stones cause mouth pain, both doctors and dentists can diagnose this condition and provide medical treatment if necessary. Although the stones rarely cause serious problems and can often be treated at home.

What are the symptoms of salivary duct stones?

Symptoms

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 may 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.

What causes salivary duct stones?

Causes

Certain substances in your saliva, such as calcium phosphate and calcium carbonate, can crystalize and form stones. They can range in size from a few millimeters to more than two centimeters. When these stones block your salivary ducts, saliva builds up in the 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 produced by your glands
  • being dehydrated, as this makes your saliva more concentrated
  • not eating enough food, which causes a decrease in saliva production

Where do salivary duct stones occur?

Location

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 are the glands 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 usually develop more than one stone.

How are salivary duct stones diagnosed?

Diagnosis

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. An X-ray, ultrasound, or a computed tomography (CT) scan of your face are the some of the imaging tests that may be ordered.

How are salivary duct stones treated?

Treatment

There are several different treatments for salivary duct stones:

Home treatments

Treatment for salivary duct stones involves activities to get rid of the stones. Your doctor or dentist may suggest sucking on sugar-free lemon drops and drinking a lot of water. The goal is to increase saliva production and force the stone out of your duct. You may also be able move the stone by applying heat and gently massaging the affected area.

Medical treatments

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 may need to be surgically removed.

In some cases, your doctor may suggest using shock waves to break the stone into smaller pieces. This is called extracorporeal shock wave lithotripsy (ESWL) and allows the smaller pieces to pass through the duct. During this procedure, high-energy sound waves are directed at the stone. You will likely be sedated or under general anesthesia during this process. 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.

What is the long-term outlook?

Outlook

In most cases, the salivary duct stone is removed without any complications. If you continue to develop salivary duct stones or salivary gland infections, your doctor may 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 are not without risk. Nerves that control various facial movements and sweat production run through or near the major salivary glands. Talk to your doctor about the risks of such surgeries.

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