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.

Sialoliths affect about 1 out of 100 adults. Men are affected twice as often as women.

Most sialoliths — up to 9 out of 10 — 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. Some people are more likely to form sialoliths than others. They include people who:

• Have illnesses such as gout and Sjögren's syndrome


• Have undergone head and neck radiotherapy


• Have suffered injury to the area


• Are elderly


• Have kidney disease

Symptoms

The most common symptom is a painful swelling of the salivary gland. But in about 3 out of 10 cases, the swelling is painless. Pain and swelling usually get worse when people eat. The pain is caused by a back-up of saliva behind the stone. This can lead to infection. If left untreated for a long time, it may also destroy the gland's tissue. 



Diagnosis

This condition usually is diagnosed with an X-ray. But some stones (at least 2 out of 10 submandibular stones and 5 out of 10 parotid stones) will not show up on an X-ray. Ultrasound and computed tomography (CT) scans usually are used in these cases. The dentist may try to squeeze saliva from the gland to see if it is blocked.

The stone will stay in the gland until it is removed. This is done by surgery or by squeezing it out using finger pressure. In most cases, removing the stone will relieve the pain. In other cases, there may be an infection that needs to be treated as well.



Prevention

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.



Treatment

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 are smashed with shock waves. This procedure is known as lithotripsy. This is similar to a process used for kidney stones. However, this procedure has side effects, and not everyone is a candidate for it.

Any infections will be treated with antibiotics.

When to call a Professional

Always call your dentist if you have facial pain or swelling. It could be from a sialolith. It also could be another problem.



Prognosis

If the stone is removed before infection or tissue damage occurs, the outlook usually is excellent.