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List of All Topics
Parotid Gland Disorders
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Introduction
Causes
Symptoms
Dry Mouth
Sialadenitis
Sialoliths
Treatment
Prevention
Causes
The salivary glands produce saliva (spit), which moistens food to aid chewing and swallowing. Saliva contains enzymes that begin the digestion process. Saliva also cleans the mouth by washing away bacteria and food particles. Saliva keeps the mouth moist and helps to keep dentures or orthodontic appliances (such as retainers) in place.
There are three pairs of salivary glands:
- The two largest are the parotid glands, one in each cheek in front of the ears.
- Two submandibular glands are at the back of the mouth on both sides of the jaw.
- Two sublingual glands are under the floor of the mouth.
All of the salivary glands empty saliva into the mouth through ducts that open at various locations in the mouth.
The salivary glands may become inflamed (irritated) because of infection, tumors, or stones.
Page TopSymptoms
- Swelling of the face or neck
- Swelling in front of the ears
- Pain in the face or mouth pain
- Abnormal tastes, foul tastes
- Decreased ability to open the mouth
- Discomfort when opening the mouth
- Dry mouth
Dry Mouth
People get dry mouth when the glands in the mouth that make saliva are not working properly. Because of this, there might not be enough saliva to keep your mouth wet. There are several reasons why these glands (called salivary glands) might not work right.
- Side effects of some medicines. More than 400 medicines can cause the salivary glands to make less saliva. Medicines for high blood pressure and depression often cause dry mouth.
- Disease. Some diseases affect the salivary glands. Sjögren's Syndrome, HIV/AIDS, diabetes, and Parkinson's disease can all cause dry mouth.
- Radiation therapy. The salivary glands can be damaged if they are exposed to radiation during cancer treatment.
- Chemotherapy. Drugs used to treat cancer can make saliva thicker, causing the mouth to feel dry.
- Nerve damage. Injury to the head or neck can damage the nerves that tell salivary glands to make saliva.
- Sip water or sugarless drinks often.
- Avoid drinks with caffeine, such as coffee, tea, and some sodas. Caffeine can dry out the mouth.
- Sip water or a sugarless drink during meals. This will make chewing and swallowing easier. It may also improve the taste of food.
- Chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow; citrus, cinnamon or mint-flavored candies are good choices.
- Don't use tobacco or alcohol. They dry out the mouth.
- Be aware that spicy or salty foods may cause pain in a dry mouth.
- Use a humidifier at night.
Sialadenitis
The salivary glands contain a network of ducts. Saliva flows through them into the mouth. If the flow is reduced or stopped for some reason, bacteria can grow. This can cause an infection called sialadenitis . Sialadenitis is most common in the parotid gland (in front of your ear) and the submandibular gland (under your chin). It usually is caused by Staphylococcus aureus bacteria.
Sialadenitis may cause a tender, painful lump in your cheek or under your chin. Pus may drain through the gland into your mouth. If the infection spreads, you may have fever, chills and malaise (a general sick feeling).
The first step is to make sure you have enough fluid in your body. You might need to receive fluids intravenously (through a vein). Next, you will be given antibiotics to destroy the bacteria. Once fluid balance has been restored, your dentist may recommend sugarless sour candies or gum. They can stimulate your body to produce more saliva.
If the infection is not improving, you may need surgery to open and drain the gland.
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Sialoliths
Sialoliths are salivary gland stones. They are usually made of calcium phosphate and carbon. They have traces of other minerals. Sialoliths are not related to kidney stones. Most sialoliths - up to 90% - occur in the submandibular salivary gland. They also can occur in the parotid, sublingual and minor salivary glands. It is not clear what causes these stones to form. Experts think that inflammation, irritation and some medicines increase the risk of developing them. Sialoliths tend to be more common in men than in women.
The most common symptom is a painful swelling of the salivary gland. The pain and swelling may get worse during meals. The pain is caused by a back-up of saliva behind the stone. This can lead to infection. It also might destroy the gland's tissue. Because the exact cause of sialoliths is not known, there is no clear way to prevent them. However, getting enough fluids is important, especially if you exercise frequently or live in a warm climate.
Stones near the end of a salivary gland duct often can be removed by squeezing them out by hand. Deeper ones require surgery. The entire salivary gland may need to be removed. Sometimes stones can be smashed with shock waves. This is similar to a process used for kidney stones. However, this procedure has side effects, and not everyone is a candidate for it
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Treatment
The treatment varies depending on the specific disorder. Treatment of salivary diseases falls into two categories: medical and surgical. Selection of treatment depends on the nature of the problem. If it is due to systemic diseases (diseases that involve the whole body, not one isolated area), then the underlying problem must be treated. This may require consulting with other specialists. If the disease process relates to salivary gland obstruction and subsequent infection, your doctor will recommend increased fluid intake and may prescribe antibiotics. Sometimes an instrument will be used to open blocked ducts.
If a mass has developed within the salivary gland, removal of the mass may be recommended. Most masses in the parotid gland area are benign (noncancerous). When surgery is necessary, great care must be taken to avoid damage to the facial nerve within this gland that moves the muscles face including the mouth and eye. When malignant masses are in the parotid gland, it may be possible to surgically remove them and preserve most of the facial nerve. Radiation treatment is often recommended after surgery. This is typically administered four to six weeks after the surgical procedure to allow adequate healing before irradiation.
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Prevention
Most of the problems with salivary glands are not preventable. Adequate hydration, use of sialogogues (things that increase salivation -- for example, sour candy), and massage of the gland can increase salivary flow and help prevent infection.
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Information obtained from National Institute of Health