Sialolithiasis is a condition in which stones are formed in salivary glands. Sialolithiasis affects mainly submandibular glands and parotid glands.
The exact cause of sialolithiasis is not known. There are certain risk factors which may play role in the formation of stones in salivary glands. These are as follows:-
- Dehydration – Drinking less water or dehydration due to other reasons may lead to thickening of saliva leading to stone formation.
- Dieting – Eating less food or loss of appetite for long period of time may decrease the demand of secretion of saliva leading to stone formation.
- Antihistamine medicines, drugs used to treat blood pressure and certain drug used for psychiatric treatment decrease saliva secretion causing dryness of mouth and sialolithiasis.
- Sjogren’s syndrome.
- When local calcium level increases, it can lead to stone formation.
- Many a times sialolithiasis is idiopathic.
Symptoms Of Sialolithiasis
- Patient will complain of pain in mouth.
- Salivary glands will be enlarged and tender to touch. The affected area may appear red.
- Pain will worsen while chewing food. Chewing stimulates secretion of saliva. Hence pain is aggravated during meals.
- Pain starts in the floor of the mouth.
- Sometimes there is referred pain in neck.
- Bacteria such as staphylococcus aureus and streptococcus viridans may cause secondary infection in salivary glands which may remain persistent. This condition occurs due to obstruction in salivary duct. This is called as sialadenitis.
- There may be fever associated with secondary infection.
- Swollen glands may be visible in neck.
Diagnosis: Diagnosis is done on the basis of medical history and physical examination of the patient. Salivary glands will be palpable. X-ray may be advised to confirm the diagnosis. Most of the stone are visible on x-ray. Sialogram or ultrasound can be done if necessary.
Treatment Of Sialolithiasis
- Keep yourself well hydrated. Drink plenty of water.
- Give gentle massage on salivary glands which may help expulsion of small stones.
- Suck some citrus fruits or lemon drops which will promote secretion of saliva and spontaneous expulsion of stone may occur.
- Local application of moist heat or hot fomentation may prove useful.
- Painkillers or anti inflammatory drugs are given to reduce pain and swelling. In case of secondary infection course of antibiotic is given.
- If stone cannot be expelled by simple measures then surgical removal is necessary. Stones can be removed by sialotomy in which surgeon will canulate the salivary duct. Certain cases may require removal of gland.
- Sometimes endoscope is used to remove salivary calculus. Endoscope is pushed in the salivary duct to locate the stone and with the help of device attached to endoscope stone is grabbed and removed.
- Keep eating at regular intervals to promote saliva secretion.
- If medicine that you are taking is causing dryness of mouth, report to your doctor so that he can stop that medicine if necessary and may provide some other alternative.
- To reduce dryness of mouth one can rinse mouth frequently with salt water solution.
- Maintain oral hygiene to prevent secondary infection.