Salivary Stones

What are salivary stones?

This is a common condition where calcified stones form either in the gland or the duct. This occurs most commonly in the submandibular duct and is associated with dehydration, local trauma, smoking and some medications.

What are the signs & symptoms of salivary stones?

Typical symptoms are pain when eating and swelling of the affected gland. You may be able to feel a small stone in the floor of the mouth. Fevers, severe pain and swelling may be suggestive of an abscess, an uncommon complication that requires emergency treatment.

How are salivary stones diagnosed?

There are multiple ways to image for stone disease, the most useful is a computed tomography (CT) sialogram which can demonstrate the stone and its location within the duct.

Most stones under 2 mm in size will pass spontaneously. Medical management includes maintaining hydration, massage of the gland and milking the duct, and lemon drops (these stimulate saliva production).

When is surgery indicated?

Surgery is indicated for larger stones and those that fail medical management. The type of surgery is dependent on the location and size of the stone. The stones can often be extracted from the duct using an incision in the mouth. If this fails or the stone is within the gland, removal of the gland is indicated.