Salivary stones: Your questions answered

Salivary stones, or sialolithiasis, are calcifications that can block the flow of saliva to the mouth.

Here to provide an expert insight into salivary stones, including causes, symptoms and removal options is Mr Satish Madhavarajan, leading consultant oral and maxillofacial surgeon.

What are salivary stones? Are they dangerous?

Salivary stones are similar to kidney stones. The main difference is that salivary stones form in the salivary glands; we all have three major salivary glands and multiple small salivary glands in the mouth. The large salivary glands produce saliva. Sometimes, when saliva is sluggish, salivary stones can start to form, blocking the tubes or the pipes that carry saliva from the glands into the mouth.

If the salivary stones block saliva or the salivary tubes, people can experience significant swelling and pain when eating or before eating, which causes distress. This is what prompts most people to see their doctor or an oral maxillofacial surgeon.

Salivary stones are not dangerous as such (meaning that they are not a cause of death), but they need to be treated if they are causing obstruction, in order to relieve the flow of saliva back into the mouth. Infections can also develop in the salivary glands as a result of the salivary stones and in some immunocompromised people, these infections can go on to become serious conditions, such as sepsis.

What are the main causes of salivary stones?

There are several causes for the formation of salivary stones.

One of the main reasons is dehydration and reduced fluid intake, which causes the salivary glands to dry up. When the salivary glands are dry, small stones may form, which block the tubes that come from the salivary glands into the mouth.

There can also be narrowing of the salivary tubes itself, either due to scarring or simply a process of narrowing, which causes obstruction. Bacteria can then settle into the areas where there is sluggishness in the flow of saliva, which causes calcium deposits to form on the small areas of bacteria. Salivary stones may then form.

How are salivary stones treated? Do they need to be removed?

Salivary stones cause pain and obstruction, which can lead to very painful swelling of the salivary glands. If salivary glands cause blockage, then they need to be removed.

If people experience swelling of the salivary glands, the first thing to do is to keep oneself well hydrated and to massage the salivary glands. This can sometimes spontaneously dislodge very small salivary stones.

If the salivary stones are larger, there are other methods of treatment, which could either be surgery or a sialendoscopy.

During a saliendoscopy, tiny cameras are placed into the salivary tubes, and small salivary stones - the size being three to four millimetres - are retrieved.

Salivary stones that are larger than three to four millimetres in size need to be removed surgically. The surgical procedure is performed mostly inside the mouth under general anaesthetic, but some stones may be removed under local anaesthetic if they are easily accessible.

How do salivary stones differ from tonsil stones?

Tonsil stones are entirely different. Tonsils capture food particles and bacteria, and stones develop around them. In most cases, when tonsil stones grow large enough, they can discharge by themselves or they may need to be removed surgically. Even though tonsil stones might look alarming, they are harmless.

Salivary stones, on the other hand, are formed either deep in the salivary glands or in the tubes. They need to be removed by a specialist, because only very small salivary stones come out spontaneously.

Are there any home remedies for treating salivary stones? If so, what are they?

Unfortunately, there are no home remedies to remove salivary stones once they are formed, but keeping oneself well hydrated by taking plenty of fluids - up to 2-2.5 litres a day – can help.

If a small enough salivary stone remains after trying to ease it with hydration, massaging the salivary glands may dislodge the stone. This can be done at home, but if in doubt, people should seek help from their doctor, who will then refer them to a specialist, such as an oral and maxillofacial surgeon.

If you are concerned about salivary stones, and require expert assistance for their removal, do not hesitate to visit Mr Madhavarajan’s Top Doctors profile today.