When it comes to dental health, most of us assume that as long as we keep our teeth and gums healthy, things will be okay. For the most part this is a correct assumption, but in some unfortunate cases, problems can occur with one of the more overlooked parts of our mouths — the salivary glands.
The production of saliva is essential, both to help us digest food and to kill harmful bacteria inhabiting the mouth. A number of problems and conditions can inhibit the proper function of our salivary glands, but one of the most common (and potentially painful) is the development of sialoliths, more commonly known as salivary gland stones.
What are salivary gland stones, and why do they form?
Salivary gland stones are quite similar in form to the stones that can grow in the kidneys, bladder and gall bladder, and they consist of hardened masses that grow within the duct of an affected salivary gland. They mostly consist of calcium and other minerals that are naturally carried in the saliva. Ordinarily, these minerals remain in a dissolved state, and stones form when they solidify before reaching the mouth.
The exact reasons why and how salivary gland stones form is not known for certain, and they do develop in some people with otherwise perfect oral health. However, there are some known risk factors that can increase the chances of developing salivary stones, such as poor oral hygiene, poor diet, chronic dehydration, use of certain medications and physical trauma to the salivary glands.
What are the symptoms of salivary gland stones?
If a stone is large enough, the hardened mass can often be seen and felt under the skin covering the affected salivary gland, but many stones that are too small to be detected so easily can still cause problems. Other characteristic symptoms of salivary gland stone formation include:
- Dry mouth
- Tenderness and pain in the affected gland, particularly before and during meals
- Chronic bad breath
- Visible redness and palpable swelling around the affected gland
- Discharge of pus (this usually signifies that the stone has caused an infection)
How can salivary gland stones be removed?
If you suspect that you have a stone forming in one of your salivary glands, you should book an appointment with a dentist as soon as possible. They will be able to use their equipment and expertise to determine whether you have a stone, gauge the size of any stones that are present and provide the required treatment to remove it.
Removal of salivary gland stones can be performed in a number of ways. If the stone is small enough, it may be possible for the gland to force it out. NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen may be prescribed to reduce swelling and allow the stone to be flushed out. If your dentist recommends this approach, you should make sure to stay well hydrated. They may also provide specialised massage to work the stone out without damaging the gland.
If a stone is firmly stuck within a gland, it may be possible to remove it using shockwave therapy. During this procedure, your dentist will use specialised equipment to send a low-frequency sound pulse into the affected gland, which can cause the stone to vibrate and shatter into smaller pieces that can be expelled easily. This treatment is painless and non-invasive.
If shockwave therapy is not effective, you may have to have the stone removed surgically, a procedure that can be performed by the dentist themselves or a dental surgeon who they will refer you to. The surgeon will take care to make the procedure as minimally invasive as possible, either by widening the opening of the duct slightly or making a small incision below the stone so it can be removed manually. This minimally invasive approach will minimise post-operative pain, and the surgery site will usually heal fully within a few days or weeks.