Salivary Gland Disorders

Salivary gland disorders are usually caused by blocked salivary glands, which means saliva cannot be released as normal. They can cause a variety of symptoms, including pain, a bad taste in your mouth, and sometimes a fever.

What are salivary gland disorders?

The salivary glands produce saliva in your mouth. There are 3 pairs of large salivary glands, which include:

  • the parotid glands – the largest of the large glands, found in front of, and just below, each ear

  • the submandibular glands – found below the jaw

  • the sublingual glands – found under the tongue

You also have hundreds of smaller glands all around your mouth. Each gland makes saliva (spit) and empties it into your mouth through openings called ducts. 

Saliva makes the food you eat moist, which helps you chew, swallow, and digest food. It also keeps your mouth clean and healthy by containing antibodies that kill germs.

Sometimes, the salivary glands become damaged and stop producing enough saliva, or produce too much. Disorders that can affect the salivary glands include:

  • salivary gland malfunction

  • salivary gland stones

  • salivary gland infection

  • salivary gland swelling

Our ear, nose and throat (ENT) specialists see patients with salivary gland disorders in our purpose-built ENT Health centre, where they offer the most advanced care in both diagnostics and treatment.

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Symptoms of salivary gland disorders vary depending on the specific type of disorder. The main ones to look out for include:

  • painful lumps and swelling – this might worsen when you eat

  • salivary gland stones – often white and hard, usually the size of a pea

  • a discharge – that leaves a very bad taste in your mouth

  • symptoms of an infection – such as fever, chills, general weakness, headache, muscle aches, joint pain, and no appetite

  • swelling on both sides of the face – making it hard to open your mouth fully

  • a painless lump (cyst) – this can grow large enough to make it hard to eat

  • a tumour – can be found in your cheek, under your chin, on your tongue or on the roof of your mouth, and can sometimes be painful

  • dry eyes

  • dry mouth – making it hard to eat

Most problems in the salivary glands happen when the ducts become blocked, which means saliva can’t drain into the mouth. There are many reasons why the salivary ducts may become blocked, such as:

  • sialolithiasis – a condition that causes tiny salivary stones to form in the glands. Some of these stones (sialoliths) block the ducts and stop the flow of saliva. This can cause swelling and a pain that might get worse when you eat

  • sialadenitis – a painful infection of a salivary gland triggered by bacteria. It can become a severe infection if left untreated. It might cause a tender, painful lump in your cheek or under your chin, a foul-tasting discharge that moves from the duct into your mouth, as well as fever, chills, and general weakness

  • viral infections – such as mumps, flu, Coxsackie viruses, echovirus, and cytomegalovirus, which can make the salivary glands enlarge

  • cysts – these can develop in the salivary glands after injuries, infections, salivary stones or tumours

Tumours may also cause salivary gland disorders. Most of these are benign (noncancerous), but they can be cancerous in some cases. Tumours affecting the salivary glands include:

  • pleomorphic adenomas – the most common parotid gland tumour, which grows slowly and is benign. It begins as a painless lump at the back of the jaw, just below the earlobe

  • Warthin's tumour – the second most common benign tumour of the parotid gland

  • cancerous (malignant) tumours – these are rare in the salivary glands. They usually grow fast, but some are slow-growing

Other causes of salivary gland disorders include:

  • Sjögren’s syndrome – a condition that causes swelling of the salivary glands, joint pain, dry eyes, and a dry mouth

  • sialadenosis – painless swelling of the parotid glands on both sides of your face

  • dehydration – this thickens saliva, can cause salivary stones, and a blocked duct 

  • eating less over time – which can lower the mouth’s demand for saliva, leading to salivary stones and blocked ducts

  • medicines – such as antihistamines, antidepressants, sedatives, blood pressure medications, psychiatric medications, and other medicines that decrease saliva production

  • cancer treatments – such as chemotherapy, head and neck radiation, or radioactive iodine for the treatment of thyroid cancer

Salivary gland disorder risk factors

Anyone can develop a salivary gland disorder, but you might be more likely to get one if you:

  • are dehydrated, not eating enough, or have an eating disorder, like anorexia

  • have had recent surgery, a chronic illness, or cancer

  • take medicines that have the side effect of reduced saliva production

  • have Sjögren's syndrome

  • have been exposed to radiation

  • smoke

  • are older – ageing can cause the mouth to become drier, but elderly people are also more likely to take medications that cause dry mouth

  • are overweight or obese

  • are pregnant or breastfeeding

  • are an alcoholic with liver cirrhosis

  • have kidney failure or thyroid problems

  • have gout

  • have an autoimmune disease, such as rheumatoid arthritis or lupus

  • have HIV

If you have any symptoms of a salivary gland disorder, we recommend making an appointment with one of our consultants in our outpatient ENT centre. At a consultation, your specialist will ask about your symptoms, your medical history, and check for swellings around your head, neck, and the inside of your mouth.

You may also need further tests, such as:

  • blood tests – to check for inflammation, infection, and autoimmune conditions

  • an ultrasound scan of the neck

  • an X-ray – to spot a stone in one of the salivary ducts

  • an MRI or CT scan – to find out the size of a lump or cancerous growths in the salivary ducts

  • diagnostic therapeutic sialography – where a radio-dense dye is injected into a major duct opening to see if there are any blockages. This procedure can also be used to remove small stones, flush out debris or unblock a duct

  • a biopsy – when a small amount of tissue or fluid is removed from a minor salivary gland, if cancer is suspected, or to identify an autoimmune disease

Salivary gland disorders can’t always be avoided, but you can lower your risk by:

  • keeping your mouth moist and avoiding dehydration – drink plenty of fluids throughout the day

  • keeping your mouth clean – with regular toothbrushing and flossing

  • not smoking or using other tobacco products

  • avoiding medications that reduce saliva production

  • eating a healthy diet

Some salivary gland disorders resolve on their own with pain relief and taking on more fluids, while others need medical treatment. If a salivary gland disorder is left untreated, it can become a medical emergency, especially if you’re elderly. For example, severe sialadenitis can cause difficulty breathing or swallowing.

If you have any symptoms of a salivary gland disorder, including a fever, see a doctor or specialist as soon as you can.

Treatment for salivary gland disorders depends on the cause. These may include:

  • surgery – to remove an obstructive stone, a benign tumour, or to drain a cyst

  • radiation therapy and/or chemotherapy – if the tumour is cancerous

  • antibiotics – used to treat salivary gland infections, such as sialadenitis

  • treating and managing the underlying condition – such as Sjögren’s syndrome

At Welbeck, our ENT specialists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment.

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London

1 Welbeck Street
Marylebone
London
W1G 0AR

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Frequently asked questions

Salivary stones sometimes fall out on their own, but if they don’t, a specialist may need to remove them for you.

A blocked salivary gland can last anywhere from a few hours to weeks, depending on the cause. Symptoms may settle on their own with at-home treatments, but if they last for over a week, or you have signs of infection like a fever, see a doctor or a specialist as soon as possible.

A blocked salivary gland can be painful or painless, depending on the cause. Salivary stones cause dull pain in your mouth that comes and goes, swelling, as well as redness and a fever. While a blocked salivary gland caused by a cyst is often painless, you may find it hard to eat.

Smoking increases the risk of many salivary gland disorders. This is because the chemicals in tobacco affect the quality of your saliva and can reduce its flow, leading to dry mouth and salivary gland problems, like salivary stones and Warthin tumours.

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