Salivary Gland Stone – Symptoms, Causes, Diagnosis, Treatment

A salivary gland stone is the formation of a stone in the salivary gland or in the tube (duct) that drains them. A stone may cause a blockage of the flow of saliva and cause the gland to become inflamed.  The submandibular glands at the floor of the mouth are the most common to develop stones.  Imaging tests like X-ray and CT play a role in the diagnosis of salivary gland stones.

What is a salivary gland stone?

This is the formation of a stone in the salivary gland or its duct.  This most commonly occurs in the submandibular gland.  Stones form most commonly in adults.

Symptoms of salivary gland stone

Salivary stones present most commonly with pain and swelling in the involved gland.  This is worst with eating.  The blockage of saliva outflow predispose the gland to infection. Chronic cases lead to shrinking of the gland and eventual resolution of symptoms.

How is a salivary gland stone diagnosed?

The clinical presentation and physical exam raises suspicion.  Salivary gland stones can be diagnosed on imaging studies.

What does a salivary gland stone look like on imaging?

Stones can be diagnosed on X-rays, however, not all stones are visible.  Stones may not be seen because of bone and teeth.

CT scans can diagnose stones within the gland and the duct.  Inflammation of the gland associated with the stone can also be seen.

Ultrasound can diagnose a stone.  We can see the stone and the obstructed duct.  We can also see an inflamed salivary gland.

MRI can diagnose salivary gland stones.  We can see the dilated salivary gland duct and obstructing stone.  We can also see an inflamed salivary gland.

What else can look like a salivary gland stone in radiology?

Other calcifications by the salivary gland duct can mimic a stone on X-ray.  These can be phleboliths or vascular calcifications.

A filling defect in a salivary gland duct can also be a blood clot, tumor or air bubble.

What causes a salivary gland stone?

It is not known for sure.  Risk factors include dry mouth and dehydration.

Is a salivary gland stone dangerous? (or cancerous)

A salivary gland stone can cause infection.  It is also important to rule out a cancerous mass if the gland is enlarged and painful.

What type of doctor treats a salivary gland stone?

An otolaryngologist or ear, nose and throat specialist.

Salivary gland stone treatment

Most salivary stones go away on their own.  A stone may pass if you drink water, suck on sour candy or massage the area.

Antibiotics may be indicated if there is an infection of the gland.

Your doctor may remove the stone in the office using instruments and an endoscope.

Surgery or removal of the gland is indicated in rare cases.

Salivary gland stone: summary

Salivary gland stones form in the salivary glands or ducts that provide outflow of saliva to the mouth.  A stone will most commonly form in the submandibular gland at the floor of the mouth.

Stones will cause pain and swelling in the area of the gland.  Imaging tests like CT can confirm the presence of the stone and any associated inflammation of the gland.  Treatment is often conservative but more invasive procedures are sometimes indicated.