Sialolithiasis is the formation of stones within the ducts of the salivary glands. These stones can block the flow of saliva and lead to inflammation.
This can cause symptoms such as pain, swelling, difficulty swallowing, and general discomfort. Sialolithiasis may be linked to low water intake, dehydration, smoking, or gout, as these factors can increase the risk of substances in saliva, such as calcium phosphate and calcium carbonate, crystallizing and forming salivary stones.
Treatment is typically managed by a primary care physician, oral and maxillofacial surgeon, or ear, nose, and throat (ENT) specialist. It may include massage, medications that stimulate saliva production, or surgery in more severe cases.
Main symptoms
The main symptoms of sialolithiasis are:
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Swelling in the salivary gland, usually on one side
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Pain in the face, mouth, or neck
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Difficulty swallowing
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Pain that gets worse during meals
In addition, the mouth may become drier, and bacterial infections may develop, causing symptoms such as fever, a bad taste in the mouth, and redness in the affected area.
Confirming a diagnosis
Sialolithiasis is typically diagnosed by a primary care provider, dentist, or specialist, such as an otolaryngologist (ENT), oral and maxillofacial surgeon, or head and neck surgeon, through an assessment of symptoms, medical history, and a physical exam.
According to a 2024 study published in Ear, Nose & Throat Journal, ultrasound and CT scans can help diagnose sialolithiasis by identifying salivary stones and assessing their location.
Risk factors
The exact cause of sialolithiasis is not fully known, but some factors are believed to increase the risk of developing it, such as:
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Low water intake
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Use of medications that reduce the amount of saliva produced by the glands
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Dehydration
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Smoking
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Frequent and excessive alcohol consumption
In addition, people with gout are more likely to develop sialolithiasis due to stone formation from uric acid crystallization.
Sialolithiasis occurs most often in the salivary ducts connected to the submandibular glands. However, stones can also form in the ducts of the parotid glands and, very rarely, in the sublingual glands.
Treatment options
Treatment for sialolithiasis is typically guided by a healthcare provider, such as a primary care physician, dentist, otolaryngologist (ENT specialist), oral and maxillofacial surgeon, or head and neck surgeon. It varies depending on the size of the salivary stone and the severity of symptoms.
For small stones, the doctor may recommend warm compresses, massage of the affected area, and nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve symptoms, as well as medications that stimulate saliva production.
In more severe cases, the doctor may try to remove the stone by applying pressure on both sides of the duct or perform surgery to remove the salivary stone or the affected gland.
In some cases, shock waves may also be used to break the stones into smaller pieces, making it easier for them to pass through the ducts.