formation of stones within the ducts of the major salivary glands: parotid, submandibular, and sublingual glands
In some cases, sialoliths can obstruct the salivary ducts, leading to inflammation, superimposed bacterial infection termed sialadenitis
Risk factors:
Hypercalcemia
Gout
Smoking
decreased fluid intake
decreased salivary production (eg: diuretic use)
Symptoms
Intermittent facial Swelling and pain often associated with eating
Small hard rock palpable in gland or visible at os
Differentials
Cellulitis
Poor dentition and dental abscess formation
Infection of the buccal or masticator space
Herpes zoster
Neoplasm
Diagnosis
Usually Clinical
Xray: usually stones are radio-opaque (80% submandibular gland, 60% parotid gland)
Other options: USS scan, CT , Sialography
Management
conservative measures
massaging the salivary gland
nonsteroidal anti-inflammatory drugs (NSAIDs)
sialogogues (lemon juice)
Discontinue anti-cholinergics
Often comes and goes
Sialadentitis : Acute infection
Dicloxacillin 500mg QID
If not improving – ENT
Patient info
Patients should be informed that sialolithiasis has an excellent prognosis and resolve with conservative management in most cases.
Patients require education on common initial symptoms such as glandular swelling and pain with meals that suggest they have formed a new sialolith.
While sialolithiasis is usually idiopathic, the formation of stones can be secondary to an obstructing process such as ductal stenosis or neoplasm.
Patients should be educated about the need to inform their clinician of recurrent or worsening symptoms that would indicate a need for a more advanced imaging workup or referral to a head and neck specialist.