Salivary Glands Issues

Salivary glands produce saliva to keep your mouth moist and help with chewing, swallowing and digestion. The main salivary glands are found in front of the ears (parotid glands), under the jaw (submandibular glands) and under the tongue (sublingual glands).

Salivary gland lumps and swelling can occur for several reasons. In many cases, they are caused by a blocked salivary duct, often due to a salivary gland stone (sialolithiasis). This can lead to swelling and pain, particularly around mealtimes when saliva production increases.

At the Royal Buckinghamshire Hospital, we provide consultant-led assessment to identify the cause of salivary gland swelling and recommend the most appropriate treatment plan.

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Types of Salivary Gland Lumps and Stones

Salivary gland lumps and swellings may be caused by different conditions, including:

• Salivary stones (sialolithiasis)
  Hard deposits that block a salivary duct, commonly affecting the submandibular gland.
• Salivary gland infection (sialadenitis)
  Infection and inflammation, sometimes linked to blockage.
• Cysts
  Fluid-filled swellings that can occur in salivary ducts or glands.
• Benign tumours
  Non-cancerous growths, more common in the parotid gland.
• Malignant tumours
  Less common but require urgent assessment if suspected.

Not all salivary gland lumps are stones, so proper examination is important.

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Common Causes of Salivary Gland Lumps and Stones

Common causes and contributing factors include:

• Dehydration or reduced saliva flow
• Salivary duct blockage (often by a stone)
• Repeated infections or inflammation
• Certain medications that cause dry mouth
• Previous injury or scarring affecting the salivary duct
• In some cases, underlying medical conditions that reduce saliva production

Salivary stones form when minerals in saliva build up and harden within a duct.

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Symptoms of Salivary Gland Lumps and Stones

Symptoms depend on the cause, but commonly include:

• A lump or swelling in the cheek, jaw or under the tongue
• Pain or discomfort, often worse when eating or drinking
• Swelling that comes and goes (often linked to mealtimes)
• Dry mouth or reduced saliva
• Bad taste in the mouth
• Tenderness in the gland area
• If infection occurs:
  • Redness and warmth over the area
  • Fever or feeling unwell
  • Pus or discharge into the mouth

If the swelling is persistent, increasing, or associated with other symptoms, assessment is recommended.

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Diagnosis at Royal Buckinghamshire Hospital

Your consultant will assess the cause of the lump or swelling and recommend appropriate tests. Diagnosis may include:

• Review of symptoms and triggers (including whether swelling worsens with meals)
• Examination of the mouth, salivary ducts and gland area
• Checking for signs of infection or blockage
• Imaging where appropriate, such as:
  • Ultrasound scan to detect stones or abnormal lumps
  • CT or MRI scanning in selected cases for further detail
• If needed, a fine needle aspiration (FNA) test may be recommended to examine cells from a lump

Your consultant will explain findings clearly and advise on the next steps.

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Treatment & Management

Treatment depends on the cause and severity of symptoms.

Self-care for suspected stones (mild cases)

For small stones or mild blockage, your consultant may recommend:

• Drinking plenty of fluids
• Gentle massage of the gland
• Warm compresses to the affected area
• Sucking sugar-free sour sweets (to stimulate saliva flow)
• Pain relief as appropriate

Medical treatment

If infection or inflammation is present, treatment may include:

• Antibiotics (if bacterial infection is suspected)
• Anti-inflammatory medication
• Hydration support and symptom control

Procedures to remove a stone or treat blockage

If symptoms persist or blockage is significant, treatment may involve:

• Removal of a stone from the duct (where accessible)
• Referral for specialist techniques such as salivary duct endoscopy (sialendoscopy)
• In some cases, surgery may be considered if stones are recurrent or the gland is severely affected

Treatment for lumps not caused by stones

If a lump is suspected to be a cyst or tumour, your consultant will explain the safest treatment pathway, which may include monitoring, further investigation, or surgical removal where required.

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When to seek urgent help

Seek urgent medical advice if you experience:

• Rapidly increasing swelling with severe pain
• Fever, chills, or feeling significantly unwell
• Difficulty opening your mouth
• Difficulty swallowing or breathing
• Redness and heat spreading across the face or neck

These symptoms may indicate an infection that needs urgent treatment.

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If you have a lump, swelling or pain in the salivary gland area — especially if it worsens around mealtimes — contact Royal Buckinghamshire Hospital for assessment and guidance. There is no need to be registered with the hospital, or live locally.

If you have insurance which covers consultations, we can in most cases invoice the insurer directly. Where you are paying directly, any costs will always be discussed.