Salivary duct calculus

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Salivary duct calculus is a concretion of mostly calcium mineral salts (calculus) that forms within the ducts. This calculus (sialolith - pronounced SIGH-al-low-lith) is a salivary gland stone consisting of layers of calcified organic matter - calcium phosphate and carbon, with traces of magnesium, chloride and ammonium. Sialoliths are not related to kidney stones. The resulting blockage and inflammation (sialitis) causes immense pain on eating when saliva production increases and infection of the salivary gland may ensue. Pain may be further be intensified when eating sour or tart foods or candies. Other symptoms are dry mouth; bad taste in mouth; and local swelling. The causes are not known, but keeping adequate hydration seems a sensible precaution, especially in hot climates or periods of strong exercise.

The majority (perhaps 90%) form in the submandibular gland but the other glands can create them too.

Treatment

If located near the exits of the gland ducts, they may be squeezed out by finger pressure. They are difficult to visualize with xrays and sometimes CT scans or ultrasound are needed. If they are deeper, then surgery may be required. Inflammation and infection are treated with prednisone and antibiotics. If the infection destroys the gland, it may have to be removed entirely.

References

• Patient UK leaflet Salivary Gland Stones (Salivary Calculi)
• Medline (Salivary Gland Disorders)