When That Pain in Your Mouth Is a Salivary Stone

Pain combined with a swollen salivary gland could indicate a stone

Pain in your mouth can make the joy of eating disappear – especially if the pain seems to get worse right as you’re about to eat.

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That’s a hallmark symptoms of a salivary gland stone, or sialolithiasis. It’s not one of the more common causes of mouth pain, but it’s one that can be identified and usually treated successfully by someone who specializes in ear, nose and throat (ENT) issues.

A stone forms when salivary material mixes with a substance in the salivary glands and calcifies.

ENT specialist Tony Reisman, MD, describes it as essentially a plumbing problem.

The stone blocks one of the ducts that your saliva travels through to get from the gland (where it’s produced) to your mouth (where it’s needed to break down food and keep teeth strong), causing saliva to get backed up in the gland. The gland swells and can become infected and painful.

There are several glands on each side of your face that produce saliva. Salivary stones most often occur in or near the submandibular glands under the jaw, but they can also occur in the parotid glands on the sides of the jaw.

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Pain accompanied by a visibly swollen gland on the side of your face or under your jaw is the telltale sign of a salivary gland infection, and possibly a stone, Dr. Reisman says.

The other thing is that you might be able to actually see a stone under the tongue or on the inside of the cheek. According to Dr. Reisman, stones have a whitish or yellowish color and can get as large as 2 centimeters in diameter.

They’re most likely to occur in:

  • People who are prone to dehydration (including the elderly)
  • People with conditions that cause dry mouth
  • People with chronic dental disease

Salivary stones may be discovered by accident during a dental X-rays, Dr. Reisman adds.

Removing a salivary stone

If a doctor is able to see the stone, he or she may be able to remove it in the office by giving the patient a local anesthesia and making a tiny incision over the stone.

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If it’s not visible, a doctor will use a CT scan with contrast to locate it. If the stone is very deep, the doctor may want to remove it using a relatively new technique called salivary sialendoscopy.

“It’s done in the operating room, where you use a tiny scope to go through the actual duct in the floor of the mouth or the side of the cheek, and then there are baskets you can use to retrieve these stones,” Dr. Reisman says.

If the stone is very close to the gland, or stuck inside of the gland, the patient may require surgery to remove the gland.

The good news is, while salivary stones can be painful, they aren’t usually a symptom of a bigger problem or disease.

Dr. Reisman says, “For most patients, it’s one-and-done.”

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