Which glands become inflamed and why?
There are three pairs of large salivary glands in the body: parotid - in front of and below the ear, submandibular - under the lower jaw, sublingual - under the tongue. The parotid gland is more often affected by viruses and dehydration, and the submandibular gland by salivary stone disease: its secretion is thicker, and the duct goes from bottom to top, so stones form there more often. Inflammation can be bacterial, viral or non-infectious - in autoimmune diseases and after radiation therapy.
- Bacterial - due to stagnation of saliva and dehydration
- Viral - mumps, influenza, cytomegalovirus
- Obstructive - due to stone or narrowing of the duct
- Chronic recurrent, including in children
- Autoimmune - with Sjögren's syndrome
Symptoms
The main symptom is swelling and bursting pain in the gland area, which noticeably intensifies before and during meals, when saliva production increases sharply. With bacterial inflammation, fever, redness of the skin and an unpleasant salty taste are added: cloudy saliva or pus may be released from the duct. With a stone, swelling appears and then goes away. Dry mouth, swelling of several glands at once and dry eyes more often indicate a systemic cause.
- Swelling near the ear or under the jaw
- Pain that gets worse when eating
- Redness and tenderness of the skin over the gland
- Unpleasant taste and odor from the mouth
- Dry mouth
- Fever and weakness
Diagnostics
The doctor examines and feels the gland from the outside and from the side of the mouth, evaluates the mouth of the duct and the nature of the saliva released during a light massage. The main imaging method is ultrasound of the salivary glands: this shows swelling, abscess, dilation of the duct and most stones. A general blood test helps to understand whether there is bacterial inflammation. In case of chronic course and suspected tumor, CT, sialography or puncture biopsy are additionally used. The dentist evaluates the condition of the teeth as a source of infection.
- Inspection and bimanual palpation of the gland
- Assessment of secretion during duct massage
- Ultrasound of the salivary glands
- General blood test
- CT or sialography for relapses
- Biopsy for suspected tumor
Treatment
The basis of treatment is restoration of saliva flow. The doctor recommends drinking plenty of fluids, acidic foods and chewing gum without sugar as salivary agents, warm compresses and gentle massage of the gland along the duct. For bacterial inflammation, antibiotics are prescribed; for pain and fever, antipyretics and analgesics are prescribed; The doctor selects specific medications. If an abscess has formed, it is opened and drained. The stone is removed through a duct, endoscopically or surgically; with long-term recurrent inflammation, sometimes it is necessary to remove the gland itself.
- Drinking plenty of fluids and a salivary diet
- Warm compresses and gland massage
- Antibiotics as prescribed by a doctor
- Opening and draining the abscess
- Removing stone from the duct
- Removal of the gland for persistent chronic inflammation
Prevention and prognosis
Acute sialadenitis with timely treatment goes away in one to two weeks. The tendency to recur remains if stones, narrowing of the duct or dry mouth persist. To reduce your risk, it is important to drink enough fluids, especially in hot weather and temperatures, take care of your teeth, treat tooth decay, and not smoke. Older adults and those taking diuretics, antidepressants, or allergy medications should discuss dry mouth with their doctor. Children are protected from mumps by routine vaccination.
- Drinking enough throughout the day
- Regular oral hygiene and caries treatment
- Quitting smoking
- Chewing sugar-free gum to stimulate saliva
- Controlling medications that cause dry mouth
- Vaccination of children against mumps
