Saliva & Salivary Gland Disorders

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Overview

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 chewing and swallowing and the digestion of food. Saliva also keeps the mouth clean and healthy because it contains antibodies that kill germs.

If the salivary glands are damaged or aren’t producing enough saliva it can affect taste, make chewing and swallowing more difficult, and increase the risk for cavities, tooth loss, and infections in the mouth.

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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.

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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
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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.

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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 a specialist. If the problem is due to salivary gland obstruction, your doctor might use a local anesthetic to numb the area so that they can probe and dilate the duct to remove the obstructive stone.

If a tumor has developed within the salivary gland, your doctor may recommend its removal. You may be referred to an otolaryngologist (commonly known as an ear, nose, and throat doctor) who performs surgery.  Most tumors in the parotid gland area are benign (noncancerous). If a tumor is cancerous, it will be surgically removed and the area treated with radiation therapy afterwards.

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Helpful Tips

Removal of a salivary gland doesn’t affect overall saliva production, but radiation therapy often causes dry mouth, which can increase your risk for cavities and mouth infections. Here are some tips to keep your mouth moist:

  • 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.
  • Avoid foods that stick to the roof of the mouth like peanut butter or soft bread.
  • Take small bites, and chew your food well.
  • Suck on sugarless candy or chew sugarless gum to stimulate saliva.
  • Avoid commercial mouthwashes, alcoholic and acidic drinks, and tobacco.
  • Use over the counter saliva substitutes to add moisture to your mouth.
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Additional Resources

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Last Reviewed on
February 2018