Salivary gland disease
Salivary glands produce all the saliva that keeps our mouths moist. Most – around 70% – of all our saliva comes from the submandibular glands, which are just under the tongue at the front of the bottom of the mouth. The parotid glands, which are near the top teeth, produce 25% and the rest is secreted by the sublingual glands, which lie right under the tongue. Each of the three pairs of major salivary gland connects to the mouth by a thin tube, or duct.
Salivary gland stones
A common cause of salivary gland disease is a blocked salivary gland duct. This is usually due to a salivary gland stone. These tiny but solid calcium deposits are termed sialoliths. If one of them breaks free from the main gland and passes into the salivary gland duct, it can get half way and then get stuck.
A blocked duct means that no saliva can escape and the gland can become swollen and painful.
If bacteria build up and start growing in the blocked off gland, this can escalate into a serious infection that can spread into the blood.
Other causes of swollen salivary glands
- Viral infections – these often cause salivary glands to swell. This can happen if you get ‘flu, mumps or cytomegalovirus infections.
- Salivary gland cysts – these are benign growths inside the gland that can have various causes.
- Salivary gland tumours – benign tumours and cancers can form in the salivary gland itself or in the duct.
- Sjögren’s syndrome – an autoimmune disease that is common in patients with lupus, rheumatoid arthritis or scleroderma.
Sometimes one of the salivary glands can enlarge but no reason can be found and the gland is not painful.
Some terms explained
- Sialadenitis = salivary gland infection
- Sialolithiasis = recurrent salivary gland stones
- Sialadenosis = painless salivary gland swelling with no discernible cause
Salivary gland tumours
Not all salivary gland tumours are cancerous. Some are benign but they may need treatment as they cause swelling in the gland. The three recognised non-cancerous tumours that occur in the salivary glands are:
- Warthin’s tumour – this affects the parotid gland and is usually seen in older men.
- Pleomorphic adenoma – also affects the parotid gland, is slow growing and more common in women. It presents as a lump, just below the earlobe, and is usually painless.
- Benign pleomorphic adenoma – this usually affects the submandibular gland or any one of the 1000 tiny minor glands.
Cancerous tumours that arise in the salivary glands are not very common at all, but when they are diagnosed they are usually in people in their 50s and above.
Treating salivary gland disease
Although some salivary gland stones can be treated using ultrasound to break them up and infections are treated with antibiotics, many other salivary gland problems need surgery.
Mr Cascarini performs salivary gland surgery to remove stones, cysts, benign tumours and salivary gland cancers.