Saliva is an important secretion produced by the salivary gland present in the oral cavity. Salivary duct stones are uncommon, but when present can cause pain and swelling in mouth and salivary gland. From glands, saliva flows into mouth through small connecting tube which we call salivary duct. Saliva keeps the mouth moist, lubricated and protects the teeth from carries to some extent.
Stones in salivary duct blocks flow of saliva leading to pain and dryness of mouth besides many other problems. Mineral calcium phosphate and calcium carbonate present in saliva can crystallize to form stones.The exact reason for formation of salivary duct stone is not known, but chronic inflammation and injury to the salivary gland is suspected. Small stone may pass out on its own, but moderate and large size stone needs surgical removal.
What Causes Stones In The Salivary Duct?
Before we know the cause, let us understand few important facts of salivary gland.
There are 3 major salivary glands and few minor located bilaterally in jaw. The three major are parotid salivary gland, submandibular gland and sublingual gland. Each parotid gland is situated on either side of cheek.Saliva secreted by this gland enters into mouth through parotid duct. Submandibular gland is located in lower jaw and sublingual gland is below the tongue.
Salvia has various functions. It keeps the mouth moist and lubricated. It mixes with the food and helps in swallowing of food. The digestive enzyme in saliva metabolizes starch present in food. It has some amount of antibacterial quality which helps to protect the teeth from caries.
The exact cause for formation of salivary stones in not known. But certain factors predispose its development. It is more commonly seen in people between the ages of 30 to 60 years. Salivary duct stones are more common in males. Stones in the duct are mostly composed of minerals present in saliva such as calcium phosphate and calcium carbonate. Minerals crystallize to form stones.
Inadequate secretion of saliva leads to more concentration of minerals which can crystallize to form tiny stones.
Certain medicines such as anti allergic, anti cholinergic, anti depressants reduce secretion of saliva. This leads to dryness of mouth and high concentration of minerals in the saliva. Too much of minerals can crystallize to develop stones in the duct and the gland.
- Injury in the duct and salivary gland.
- Infection in salivary gland such as mumps.
- Diseases such as hyperparathyroidism cause high concentration of calcium in saliva. Increased calcium in saliva may develop into stones.
- Dehydration often and for long duration can concentrate saliva.
- If you do not eat food in enough quantity saliva production is reduced and this may lead to formation of stones in the salivary duct.
Symptoms Of Salivary Duct Stones
In many people salivary duct stone does not produce any symptoms as the stone is small in size. Symptoms develop when the stone becomes large and blocks flow of saliva.
The primary symptom of salivary duct stone is pain in mouth especially before and while eating food. This is because sight and smell of food increases salivary secretion from the gland. However, due to large stone in the duct, the flow is obstructed. Saliva reverses back into the gland causing pain and swelling of the gland.
It also leads to pain and tenderness in mouth and face. Due to lack of saliva mouth becomes dry. Patient experiences difficulty in swallowing food.
Stagnation of saliva in salivary duct leads to secondary bacterial infection. Pain in mouth, neck, and face, fever, tenderness, foul smell and taste, is present when the duct is infected.
How To Get Rid Of Salivary Duct Stones?
Small stone in salivary duct may in many people pass out on its own. When present the first thing is to correct the underlying cause which may be the precipitating factor. For example if you are frequently dehydrated after playing games or after gym, start drinking enough water and prevent dehydration.
If you are taking certain medicines that lowers secretion of salvia, avoid them and tell your doctor to recommend some other alternative medicines which does not produce dryness of mouth. Small stone may come out of the duct with gentle massage in the affected area or gargling warm water daily.
Treatment of large stone is to get rid of it with surgical procedure. But surgery has its own cons as sometimes the nerves around the gland may be damaged doing the procedure. Nowadays ESWL (extracorporeal shock wave lithotripsy) is performed. In this procedure high energy sound waves focused on stone breaks it into tiny pieces which gradually comes out from the duct.
Antibiotics may be needed for treating bacterial infection. Homeopathic medicines such as Ars Alb, Belladona, Lycopodium, Nux vom are found to be useful. These medicines must be taken after consulting homeopathic practitioner.