Salivary Gland Disorders​

Saliva plays an important role in your oral health. In addition to keeping your mouth moist, saliva also aids in food digestion and protects against tooth decay. Saliva is produced by the salivary glands located in your cheeks, under the jaw and tongue, along the lips, and in the throat.

Types of Salivary Gland Disorders

Blockage

The most common disorder affecting the salivary glands is a blockage, particularly in males between 30 and 60 years old. This results in obstruction of the flow of saliva, which then leads to swelling and pain. The blockage may be caused by the formation of tiny calcified stones, a condition called sialolithiasis, or from a narrowing of the ducts.

Blocked salivary glands can also result in a subsequent infection, termed sialadenitis, typically caused by bacteria. A persistently blocked and swollen gland can develop into a more severe infection or an abscess.

Symptoms of a blocked salivary gland include swelling and discomfort during eating, with these symptoms subsiding between meals. If there is an infection, you may also experience:

• Pus discharging from the swollen area
• Fever
• Swelling of the nearby lymph nodes

Tumors

The salivary glands may develop a tumor or growth. These tumors can be cancerous or non-cancerous, so it’s important to always have these growths assessed by an ENT (ear, nose, throat) specialist.

Salivary gland tumors will typically involve one of the glands in the cheek, under the jaw, floor of the mouth, palate, or the lips. They tend to first present as painless growths.

Cancerous tumors of the salivary glands are most common in the 50-60 year old age group, but overall are considered rare. Malignant growths can become painful. They tend to grow rapidly, and can affect the facial nerve, resulting in loss of muscle movement on the affected side of the face.

Systemic diseases

Disorders of the salivary gland can be part of another condition affecting other areas of the body. Associated systemic diseases include:

• HIV
• Sjogren’s syndrome
• Rheumatoid arthritis
• Diabetes

These medical conditions can cause the salivary glands to become enlarged or inflamed.

Management of Salivary Gland Disorders

It’s important to stay hydrated to help avoid certain salivary gland disorders. An adequate daily intake of water helps to maintain a healthy mouth and supports good saliva production.

The treatment of salivary gland disorders depends on the underlying reason. If there is an associated systemic disease, such as Sjogren’s syndrome, then managing the systemic condition well will also help to treat the salivary gland disorder.

A blockage of the glands caused by sialolithiasis can often be managed conservatively at home, such as gently massaging the blocked gland or taking non-steroidal anti-inflammatory medications. However, if there are signs of an infection, you will need to see a doctor for antibiotics.

For more stubborn blockages, or larger or more numerous stones, your doctor may use a small tool called a sialendoscope to examine the ducts and remove the stones surgically. If the stones are unable to be removed with sialendoscopy, your specialist can use another therapy called external shockwave lithotripsy as a second option.

If a tumor is found in the salivary gland, you may need to have an imaging scan, such as a CT or MRI, to properly visualize what’s happening. A fine needle aspiration biopsy can also be useful to take samples of the growth or surrounding tissues for identifying potentially cancerous cells. Tissue biopsies can also help to determine if there is an underlying autoimmune disease, such as Sjogren’s syndrome.

Cancerous masses are treated using surgery, sometimes followed by radiation therapy. If the growth is found to be non-cancerous, your doctor may recommend either just monitoring it or having it surgically removed, depending on the features of the tumor and your symptoms.

Fortunately, salivary gland disorders are not common overall. The most frequently encountered disorder – sialolithiasis – is reported at an incidence of only 1 in 10,000 to 1 in 30,000. Salivary gland cancers are found at a rate of about 3 in 100,000 across the Western world. Despite the rarity of these disorders, any new symptoms that may point to a salivary gland disorder should be assessed by your family physician first.