Salivary Gland Stones: What They Are, How to Remove and Prevent Them

Medically Reviewed By Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP
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Salivary gland stones are calcium deposits that obstruct the salivary glands and slow or prevent the flow of saliva. They typically occur in the submandibular and parotid glands. This article explains salivary gland stone causes, signs and symptoms, diagnosis, treatment, and prevention.

What are salivary gland stones?

A collage of a person's open mouths
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Salivary gland stones, also called sialolithiasis, are calcifications that obstruct the salivary glands.

The salivary glands are responsible for making saliva to help digest food. Saliva also helps prevent infections from occurring in the mouth or throat. The salivary glands deposit saliva in the mouth through ducts located under the tongue.

The three major pairs of salivary glands are:

  • Submandibular glands: These glands are found along the inner jawline. About 80% of salivary gland stones occur here, obstructing the Wharton duct.
  • Parotid glands: These glands are located in front of the ear, between the cheekbone, jaw joint, and jawline. Salivary gland stones here block the Stensen duct.
  • Sublingual glands: This pair of glands are found in the front of the jaw. Stones rarely form in this gland — less than 1% of salivary gland stones occur in the sublingual glands.

Most salivary gland stones are white and hard. They are typically pea size, but size can vary.

Most of the time, the stone is not visible unless it is near the duct opening or just below the mucosa (the lining of the floor of your mouth).

The stones are made of calcium phosphate and may have small amounts of carbonate or magnesium. Salivary gland stones in people with gout may contain uric acid.

Salivary gland stones are most common in older adults. Multiple stones occur in about 25% of people.

In children and older adults, salivary gland stones can lead to a painful infection called sialadenitis. The infection is usually caused by staph or strep bacteria.

What are the signs and symptoms of salivary gland stones?

Symptoms of salivary stones may occur at any time but they are most exaggerated during eating or drinking when the body is producing saliva.

Some common signs and symptoms include:

  • dry mouth
  • pain, swelling, and tenderness in the cheek area and under the tongue
  • problems opening the mouth or swallowing
  • swelling and tenderness of the salivary glands
  • swelling of the face or neck

In severe cases, the glands can become infected, causing fever and increased pain. Contact your doctor if you experience a high fever or mouth pain that is not subsiding.

What causes salivary gland stones to form?

The cause of salivary gland stones is unknown. Salivary gland stones are not contagious or genetic. No particular food or drink causes salivary gland stones to form.

However, some people may have a higher risk of developing salivary gland stones than others. Some risk factors include:

How do doctors diagnose salivary gland stones?

A dentist or doctor can typically diagnose salivary gland stones by performing an oral exam. They may:

  • palpate your neck, feeling for signs of swelling
  • press on the outside of the cheek, checking for a stone in the parotid glands
  • look inside your mouth
  • press on the floor of your mouth

A doctor may be able to locate the stone by feeling and looking under the tongue.

If salivary gland stones are not apparent from an exam, a dentist or doctor may give you lemon juice or hard candy to trigger saliva flow. The medical name for a substance that produces saliva flow is a sialagogue.

If producing saliva flow causes symptoms, it may indicate a salivary gland stone is present. However, symptoms could also be a sign of inflammatory salivary duct stenosis.

If your doctor feels it’s necessary to order imaging tests, possible ones include:

  • Sialogram: This is an X-ray of the salivary gland to look for a mass. A contrast dye will be inserted into the suspected salivary gland. The X-ray is taken before and after the dye is inserted.
  • CT scan: This can be done to visualize the mass and rule out other conditions, such as tumors, dental abscesses, or swollen lymph glands.
  • MRI: This scan uses strong magnets and radio frequency waves to produce images of the body.
  • Neck ultrasound: This scan uses sound waves to create images of the body.

How do you treat or remove salivary gland stones?

Treatment focuses on removing salivary gland stones. Increasing saliva production usually helps. 

Things you can do at home to help treat salivary gland stones include:

  • Suck on a lemon, hard candy, or ice cubes.
  • Drink plenty of water.
  • Gently massage the area around the stone.
  • Treat pain or swelling with acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).
  • Use a warm compress on swollen glands.

Do not use sharp instruments to remove the stone yourself. Contact your doctor or dentist if:

  • you have tried at-home remedies and your symptoms continue
  • you have signs of infection such as fever, yellow discharge, or worsening pain

If the salivary gland stone involves an infection, your doctor or dentist will prescribe an antibiotic.

Two procedures that doctors or dentists can perform to remove salivary gland stones are:

  • Sialoendoscopy: This procedure involves anesthesia. Doctors use an endoscopy, a very small camera to locate the stone, and a basket-like instrument to remove it.
  • Sialolithotomy: This surgical approach is for removing large or multiple stones. The surgeon makes an incision in the floor of the mouth to locate and remove the stone. In rare cases, when the gland has become infected or damaged, the entire gland may need to be removed.

What are the potential complications of salivary gland stones?

The most common complication of salivary gland stones is an infection called sialadenitis. Staph or strep bacteria usually causes this infection.

An infection can cause:

  • increased pain
  • fever
  • damage to the gland (rarely)

Contact your doctor immediately if you have signs of infection such as fever, worsening pain, or yellow discharge in the mouth.

How do you prevent salivary gland stones?

The best way to prevent salivary gland stones and the recurrence of stones is to drink more water and practice good oral hygiene. Dehydration is a common risk factor for developing salivary gland stones.

Visit your dentist regularly so they can examine your mouth for the presence of salivary gland stones. Notify your doctor if you have mouth pain, especially when eating or drinking.

Frequently asked questions

Here are other frequently asked questions people have about salivary gland stones:

How common are salivary gland stones?

Salivary gland stones remain relatively rare. They occur between 1 in 10,000 to 1 in 30,000.

Is a salivary gland stone serious?

Salivary gland stones are usually not serious and can typically be taken care of at home. But in cases where the stone is large, there are multiple stones, or the stones keep recurring, you may need treatment from your doctor. If you cannot treat salivary gland stones at home, contact your doctor right away to prevent infection.

Can you squeeze a salivary gland stone to get it out?

You can sometimes gently massage around the stone to help dislodge it. Avoid forcibly squeezing it, as this can lead to increased inflammation. Other at-home treatments include drinking plenty of water and sucking on a lemon or hard candy. This can increase saliva production and help loosen the stone.

Summary

Salivary gland stones are calcium deposits that form inside the salivary glands. They can cause discomfort, especially when eating or drinking.

At-home treatments for salivary gland stones include drinking more water, sucking on a lemon or hard candy, or gently massaging around the stone to remove it. This is usually enough to take care of these stones.

In cases where salivary gland stones cannot be removed at home, doctors can surgically remove them.

Dehydration is a common risk factor for salivary gland stones. You can help prevent the formation of stones by drinking plenty of water and practicing good oral hygiene.

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Medical Reviewer: Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP
Last Review Date: 2022 Sep 19
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