SALIVARY GLAND DISORDERS

General Information

DEFINITION--Infections are caused by an infectious organism other than the virus that causes mumps. A tumor is an abnormal growth in the salivary gland. Most salivary gland tumors are benign and require several years to develop. Even malignant tumors rarely spread to distant body parts. Salivary duct stone is a tiny hard particle that forms in a salivary gland duct (usually a salivary gland under the tongue). Chemicals in the saliva cause crusting in the duct.

BODY PARTS INVOLVED--Salivary glands and ducts.

SEX OR AGE MOST AFFECTED--Adults of both sexes.

SIGNS & SYMPTOMS

Infection:

• Pain and swelling of parotid (behind ear) or sublingual (under tongue) salivary glands.
• Pain and swelling of lymph glands in the neck (below jaw); fever.
• Bitter pus in the mouth from infected gland.

Tumor:

• A soft, painful swelling or firm mass above the angle of either jaw or in the floor of the mouth.

Stones:

• Pain and swelling in the salivary gland (between ear and jaw), especially with meals.
• Redness and tenderness in the floor of the mouth and under the jaw.
• Swollen, tender lymph glands in the neck or under the jaw; fever (if infection is present).

> Infections--

Bacterial infection caused by staphylococci or another bacteria.

• Tumors--Unknown.
• Stones--Chemical change of unknown cause in salivary-gland secretions.

RISK INCREASES WITH

• Adults over 60; smoking; dehydration.
• Poor oral hygiene; poor nutrition; dentures.
• Recent or chronic illness.
• Use of drugs that cause a dry mouth.

HOW TO PREVENT--

Some disorders can't be prevented, but the risk can be minimized by:

• Not smoking and keeping the mouth healthy.
• Visit your dentist regularly for checkups.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Laboratory studies.
• For tumors--X-rays of the salivary glands and chest, MRI, CT scan, ultrasound (See Glossary), technetium 99 (radioisotope scan method).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Infections are treated with antibiotics.
• Tumors are treated with surgery to remove the tumor and lymph glands in the neck, if malignant cells have spread.
• Surgery to remove the stone-generally under local anesthesia.

> Infections--

Complete, permanent blockage of the salivary gland duct (will require surgery).

• Tumors--Infection at the surgical site; disfigure-ment after surgery; spread to other organs.
• Stones--Recurrence of the stone. If it recurs, a surgeon can permanently open the duct so saliva drains from the gland into the mouth.

PROBABLE OUTCOME--

• Infections--Usually curable in 2 weeks with treatment. If the gland becomes blocked with a stone or scar tissue, surgery is necessary before the infection can clear.
• Tumors--Benign tumors are usually curable with surgery alone; malignant salivary tumors are usually curable with surgery, radiation treatment and anticancer drugs.
• Stones--Many stones pass spontaneously. Others are usually curable with surgery.

How To Treat

GENERAL MEASURES--

• Apply warm or cool soaks (see Soaks in Appendix), whichever feels better.
• After surgery, keep the mouth clean with salt-water mouthwashes. At least 3 or 4 times a day, rinse the mouth with a solution of 1 teaspoon salt in 8 oz. of warm water.

MEDICATION--

• Your doctor may prescribe: Antibiotics to fight bacterial infection. Pain relievers. Anticancer drugs, if surgery and radiation treatment don't destroy a malignant tumor.
• For minor pain, you may use non-prescription drugs such as acetaminophen.

ACTIVITY--No restrictions.

DIET--

• With infections, usually no special diet. Drink at least 6 to 8 glasses of fluid a day.
• After surgery, a liquid diet (see Liquid Diet in Appendix) will be necessary until mouth heals.

Call Your Doctor If

• The infection does not improve in 4 days or symptoms worsen or fever persists.
• After surgery, signs of infection develop in your mouth, including increased warmth, redness, pain or tenderness and swelling.
• New, unexplained symptoms develop.