Medicines for Salivary gland stones

What it is

Salivary gland stones (sialolithiasis) are small, hard stones — made mostly of calcium salts — that form within a salivary gland or the tube (duct) that carries saliva into the mouth. They most commonly affect the gland under the jaw (the submandibular gland). When a stone blocks the flow of saliva, it causes a build-up behind the blockage, leading to a characteristic pattern: pain and swelling of the affected gland, typically coming on or worsening at mealtimes (when saliva production increases) and easing afterwards. The swelling may come and go. If the trapped saliva becomes infected, the gland can become more painful, red, hot and swollen, with feeling unwell — an infection needing treatment. Salivary stones are diagnosed from the typical symptoms, examination, and imaging such as an ultrasound or X-ray. They are usually not serious, but can be uncomfortable and recurrent.

How it is treated

Treatment aims to relieve the blockage and remove the stone. For small stones, simple measures often help the stone pass on its own: staying well hydrated, and stimulating saliva flow (for example by sucking on sour sweets or citrus, gentle massage of the gland towards the mouth, and applying warmth), which can help flush the stone out. Any infection is treated (for example with antibiotics). For stones that do not pass, or larger ones, procedures can remove them — ranging from techniques to push or retrieve the stone from the duct, to a minimally invasive telescope technique (sialendoscopy), to, occasionally, an operation, sometimes to remove the gland if it is repeatedly affected. The approach depends on the size and position of the stone and how troublesome it is. Care is guided by an ENT or oral surgery specialist for stones that do not clear with simple measures. The reassuring message is that most salivary stones can be managed effectively.