What Is a Salivary Stone?

A salivary stone occurs when calcium builds up in your glands and creates a stone-like mass. While forming, it can block the duct leading from your glands to the inside of your mouth. This process inhibits saliva flow to your mouth, and a (sometimes painful) bulge can form. Also known as sialolithiasis, the discomfort can be felt in the neck, face, or mouth and worsens before or during meals. Occurring more in men than women, sialolithiasis is the most common disease of the salivary glands, affecting approximately 1 out of 1,000 adults – usually between ages 30 to 60.

According to Merck Manuals, approximately 80% of salivary stones occur below the jaw in the submandibular glands but may also appear, although less frequently, in the two other major salivary glands: parotid and sublingual.

The exact cause of salivary stone formation is unclear. It's believed that calcium salts from saliva begin to form when these minerals sit stagnantly rather than moving through the glands during the secretion of saliva as they should. Merck Manuals notes that most salivary stones are composed of calcium phosphate, magnesium and carbonate. A salivary stone also has a nidus or central spot for organic and non-organic compounds to accumulate onto. As this formation grows, it turns into a stone-like deposit.

While it's mostly unknown why some individuals are more susceptible to salivary stones than others, there are several risk factors, including:

• Gender (being male)
• Age (30-60 years old)
• Dehydration
• Malnutrition
• Smoking
• Gum disease
• Anticholinergic medicine
• Trauma to the inside of the mouth

Decreasing bacteria that builds up in your mouth can keep salivary glands healthy and help prevent salivary stones.

Along with staying hydrated, quitting smoking, and considering any saliva medication protocol that may inhibit saliva production, a vigorous oral care routine is imperative. Brush your teeth twice daily, clean between your teeth with floss, a water flosser, or another interdental cleaning tool once a day, and follow with a mouthwash to rinse away any hard-to-reach bacteria.

Small bumps or discolorations on the floor of your mouth, sides of your cheek, or jaw, could be signs of a developing sialolith. These bumps can cause discomfort or swelling. Treatment is dependent on the size, shape, number, hardness, and location of the salivary stone.

For smaller stones, a dental professional may recommend drinking more water, placing a warm compress on the enlarged area, or taking an anti-inflammatory or over-the-counter pain killer until the salivary stone passes. They may also be able to dislodge your stone by massaging it. Other small stones may simply pass on their own. Sucking on a lemon or sour candy can help encourage saliva flow and dislodge the stone, so don't be surprised if your dental professional recommends doing so every two to three hours – it's not every day your dentist recommends candy!

Dental professionals may remove larger stones through an endoscopic procedure known as a sialendoscopy, which opens the duct and breaks down the calcium mass. According to Johns Hopkins Medicine, this minimally invasive surgery is performed by an otolaryngologist to get rid of larger stones, as well as find and capture stones that may have broken into fragments deep within the salivary gland. In rare cases, a very large or oddly shaped stone may require more invasive surgery.

While stones can pass on their own, you should make an appointment with your dental professional is recommended if you think you have one. Along with removing your salivary stone, your dental professional may examine you to rule out other saliva-related issues, like a salivary gland infection or tumor.

Knowing the potential risk factors for developing a salivary stone can help mitigate the chances of developing one again. And while some factors (like your age) are out of your control, maintaining a rigorous oral care routine, attending regular dental checkups, staying hydrated, quitting smoking, and communicating with your dental professional about your medications are great ways to be proactive and stave off more salivary stones.

Keep in mind that if you do develop a painful salivary stone, your dental professional has several ways to treat it!

Oral Care Center articles are reviewed by an oral health medical professional. This information is for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your dentist, physician or other qualified healthcare provider.