Salivary Gland Stone Treatment Frequently Asked Questions

Dr. Atilla Şengör, a leading pioneer in sialendoscopy, answers top salivary gland stone treatment questions.

Are Salivary Gland Stones Dangerous?

Salivary gland stones are not as dangerous as cancer, with almost zero risk of malignancy. Patients may notice pain, swelling, or dry mouth, especially during meals. Blocked salivary ducts can cause inflammation and, in severe cases, serious abscesses. Abscesses may spread to nerves, veins, or vital neck structures, creating painful conditions. Since salivary gland stones grow about 1 mm per year, this risk gradually increases. Sialendoscopy cannot be performed during active inflammation, so early treatment is important.

How to Prevent Salivary Gland Stones?

The most common factor in patients is low fluid intake, smoking, and poor vegetable diet. Unlike kidney stones, calcium metabolism disorders are not linked to salivary stones. Gout is the only disease occasionally associated, with very few reported cases. I have only seen 3 cases in 21 years. Drinking plenty of fluids and quitting smoking improves saliva secretion and overall gland health. A balanced diet is recommended, but existing stones are not reduced by these measures. Specialist evaluation is necessary for current stones, ideally using sialendoscopy for treatment. After removal, these preventive measures help reduce the risk of new stone formation.

Is There a Method Other Than Sialendoscopy for Salivary Gland Stone Removal?

Alternative methods exist, but each has limitations and risks compared to sialendoscopy. Before sialendoscopy, stones were removed through oral canal incisions, called sialodochotomy or sialolithotomy. These incisions can remove stones felt in the mouth or cheek, but deeper stones are often missed. Oral incisions may cause duct narrowing or complete blockage if not repaired, though nerve injury is rare. Complete removal of the salivary gland was once common, but it carries higher risks, including nerve or vessel damage and saliva loss. ESWL (extracorporeal shock wave lithotripsy) breaks stones with sound waves but cannot remove fragments, which may block the duct. Sialendoscopy allows direct visualization, safe stone removal, and gland preservation, avoiding most complications. Most salivary gland stones (over 80%) require crushing; sialendoscopy alone is insufficient for high success. Since 2007, I have used intraductal crushing inside the duct, reducing risks and unnecessary surgery. Gland removal is still an option if sialendoscopy is unavailable, expertise is limited, or stones cannot be reached. Whenever possible, organ-preserving stone removal is preferred with proper equipment and trained specialists. These details address one of the most frequent salivary gland stone treatment questions patients raise about alternatives.

Does the Salivary Gland Work After the Stone is Removed?

Salivary gland swelling shows the gland is still producing saliva, even if blocked by a stone. Some patients are told long-standing stones mean the gland is nonfunctional and gland removal is necessary. However, swelling is direct proof that the gland is working; a nonfunctional gland would not swell. Scientific studies confirm many removed glands are close to normal or improving on histopathology. Experiments show that when ducts are reopened, stem cells differentiate into saliva-producing cells. My observations since 2004 confirm that patients’ glands recover well after stone removal. Salivary secretion usually improves within weeks or months. Patients can be confident their gland function improves and is preserved after treatment.

Does Salivary Gland Stone Recur?

It is very rare for a stone completely removed with sialendoscopy to recur. During sialendoscopy, we enlarge and preserve the salivary duct opening, allowing sediments to pass naturally. Patients with multiple stones should follow measures that reduce stone formation, including drinking plenty of fluids, not smoking, and eating a balanced diet. Patients should watch for swelling, pain, or infection in the affected gland, which may indicate a new stone. Despite precautions, some patients may experience recurring stones and require repeat sialendoscopy. Overall, recurrence is uncommon, and proper follow-up helps ensure timely treatment.

How to Relieve Salivary Gland Swelling?

If swelling occurs only while eating, it usually indicates a small salivary gland stone. Swelling may sometimes be painful, but inflammation always causes pain and requires urgent attention. As stones grow, swelling can become constant and may indicate more severe obstruction. Slowly developing swelling unrelated to meals may suggest a benign or malignant tumor. Patients should consider any swelling important and see a doctor for proper evaluation. Simple measures like gentle massage or hydration can help, but only under a doctor’s guidance. Rapidly developing or severe swelling may signal infection, which can be serious and require hospital care. Deep neck infections are rare but possible complications of untreated salivary gland infections. Imaging and tests help determine the cause and appropriate treatment.

Is Salivary Gland Swelling Dangerous?

Salivary gland swelling can be serious depending on its cause. Stones or duct narrowing often lead to swelling, which may become painful or infected if untreated. Rapid swelling, redness, or fever indicates urgent inflammation, sometimes causing abscess or deep neck infection. Slowly developing swelling unrelated to meals may suggest a benign tumor or salivary gland cancer, which can threaten nearby structures. Early medical evaluation is essential to determine the cause and prevent complications. Sialendoscopy treats stones and duct issues, while tumors require surgery. Patients should take all swellings seriously and seek a doctor promptly.

What Makes Salivary Glands Swell?

Salivary gland swelling can have many different causes, from simple blockages to more serious conditions. Salivary gland swelling can result from duct blockage or parenchymal disease. Recurrent swelling is most commonly caused by salivary gland stones, followed by duct narrowing. Mucus plugs, foreign objects, kinks, or external pressure can also obstruct saliva flow. Low fluid intake, fasting, diet, smoking, medications, vomiting, and gout may worsen mucus thickening. Chronic inflammation, sialocele, ranula, or megaductus can compress ducts and cause swelling. Swelling location corresponds to the affected gland: parotid, submandibular, or sublingual. Tumors and masses in the parenchyma are serious but less common. Bacterial or viral infections, such as mumps or juvenile recurrent parotitis, often cause acute swelling. Autoimmune diseases like Sjögren’s or IgG4-related disease may affect multiple glands. Medical or dental procedures, including oral surgeries, radiotherapy, and terminated sialendoscopy, can cause swelling. Rarely, pneumoparotitis from wind instrument use introduces air into the ducts and causes cheek swelling. Because the causes are diverse, persistent or recurrent swelling should always be evaluated by a specialist.

By reviewing these salivary gland stone treatment questions, patients can better understand their options and make informed decisions.