Salivary glands are located in the mouth. There are three pairs of large salivary glands. Parotid glands are found in front of and just below each ear. Submandibular glands are below the jaw. Sublingual glands are under the tongue. There are also hundreds of smaller glands. These glands make saliva (spit) and empty it into the mouth through openings called ducts. Saliva makes food moist, which helps with chewing and swallowing and the digestion of food. Saliva also keeps the mouth clean and healthy because it contains antibodies that kill germs.

Causes

Obstruction

Small stones that form in the gland ducts may obstruct the flow of saliva. The gland may swell and become painful and infected. Small constrictions or twists in the duct system of the large salivary glands can also decrease salivary flow.

Infection

When saliva pools behind an obstruction in a duct, the gland can become infected. Infection of the lymph nodes from a sore throat or cold can also cause a secondary infection in the salivary glands.

Tumors

Tumors usually appear as painless enlargements in one of the salivary glands. Malignant (cancerous) tumors often grow quickly, may or may not be painful, and may cause loss of movement in the affected side of the face.

Other Disorders

Diseases such as HIV-AIDS, and autoimmune disorders such as Sjögren’s syndrome and rheumatoid arthritis, can make the salivary glands inflamed and painful. Diabetes may also cause enlargement of the salivary glands. Alcoholics may have salivary gland swelling, usually on both sides. Some medications also cause decreased saliva and dry mouth as a side effect.

Symptoms

Problems with salivary glands can cause them to become irritated and swollen. You may have symptoms such as:

  • a bad taste in your mouth
  • difficulty opening your mouth
  • dry mouth
  • pain in your face or mouth
  • swelling of your face or neck or under your tongue

Diagnosis

A doctor uses your medical history, a physical examination, and laboratory tests to make a diagnosis of a salivary disorder.

If your doctor suspects your pain and inflammation are the result of an obstruction in one of the glands, he or she may order X-rays or ultrasound to identify where the obstruction is and what might be causing it.

If a mass is found in the salivary gland, your doctor will suggest a CT scan or an MRI to get a better look at the problem. Your doctor might also use a fine needle aspiration biopsy to explore further. A lip biopsy of minor salivary glands may be needed to identify certain autoimmune diseases, such as Sjögren’s syndrome.

Treatment

Salivary disorders are treated according to what is causing them, using medical or surgical treatments. If the salivary disorder is caused by systemic disease (diseases that involve the whole body) then that problem is treated first. This may require a visit to an ENT specialist. If the problem is due to salivary gland obstruction, your doctor might use a probe and dilate the duct to remove the obstructive stone.

Helpful Tips

  • Drink plenty of fluids throughout the day and take a water bottle with you wherever you go.
  • Keep your mouth clean. Rinse your mouth before and after meals with plain water and brush your teeth after meals.
  • Take small bites, and chew your food well.
  • Suck on lemons or sour candy or chew gum to stimulate saliva.
  • Avoid caffeine, alcohol, and tobacco.
  • Use over the counter saliva substitutes to add moisture to your mouth.
  • Massage swollen salivary gland firmly as often as possible.