What to know about salivary gland infections
Salivary gland infections most commonly develop in the two main glands, which are located in the front of the ear (the parotid gland) and under the chin (the submandibular gland).
A salivary gland infection, also called sialadenitis, can cause a blockage in the saliva ducts due to inflammation. This can lead to pain, tenderness, and swelling.
In this article, we discuss the types, causes, and treatments of salivary gland infections.
Causes of salivary gland infections
The submandibular gland is susceptible to salivary gland infections.
A salivary gland infection occurs when bacteria or viruses infect a gland that produces saliva.
People can get a salivary gland infection from having:
- a reduced flow of saliva due to medical conditions, such as dry mouth
- poor oral hygiene which increases the growth of bacteria, such as Staphylococcus aureus or Haemophilis influenzae
- a blockage in their salivary glands from a tumor, abscess, or salivary gland stone
- severe dehydration, which may be due to illness or surgery
Blockages in the salivary glands can cause inflammation, making the glands more vulnerable to infection.
Also, inflamed salivary glands tend to produce less saliva, which flows more slowly than usual. As a result of this, the saliva sometimes pools in the glands, allowing the concentration of bacteria or viruses within the saliva to increase.
Some of the more common causes of salivary gland obstructions include:
- salivary gland stones
- kinks in the salivary ducts
- abnormally formed salivary glands
Bacteria tend to cause more salivary gland infections than viruses do. But some of the more common viruses known to cause of salivary gland infections include:
Types of salivary gland infection
People of all ages, including newborn babies, can develop salivary gland infections. They are especially common in older adults and people with chronic illnesses.
There are three pairs of major salivary glands, with one of each pair located on either side of the face. Any of these six glands can develop an infection. The major salivary glands are the:
- Parotid glands, which are inside the cheek and extend from the top of the ear into the jaw. These are the largest salivary glands.
- Submandibular glands, which are behind the lower jawline under the tongue and chin. These are the second largest salivary glands.
- Sublingual glands, which are on either side of the tongue deep under the floor of the mouth. These are the smallest of the major salivary glands.
The parotid and submandibular glands tend to become infected most often.
Most salivary gland infections are acute or develop suddenly. Infections related to obstructions or narrowed tubes may develop over time.
People may experience pain and swelling in the neck area.
Most of the symptoms of salivary gland infections only last around a week, though some minor swelling may linger for a few weeks.
Acute salivary gland infections rarely cause additional complications.
The specific symptoms of a salivary gland infection may differ between people and will depend on their location and severity.
The symptoms usually affect parts of the head or neck and may cause:
- skin redness
- gradual swelling around the area
- pus in the mouth
- a terrible taste in the mouth that does not go away with good dental hygiene
- trouble or pain opening the mouth, chewing, or swallowing
For many people, symptoms become worse after eating.
People with tumors that cause obstructions may develop a hard, firm, immobile lump in the affected area.
Seek emergency medical attention if the symptoms:
- are very severe
- interfere with eating, drinking, swallowing, or breathing
- are very painful
- last longer than two weeks
- do not get any better with primary care, such as hydration and good oral hygiene
Many salivary gland infections resolve on their own without the use of medications.
The best way to treat salivary gland infections depends on the cause.
People with bacterial infections will usually need to take antibiotics.
There are no specific antiviral medications, but there are medications that can help reduce or manage symptoms of herpes, influenza, and HIV.
When blockages, such as stones or tumors, cause salivary gland infections, a doctor may recommend surgery to resolve the problem.
People may also need surgery to repair or remove kinks or narrowed tubes that affect the flow of saliva.
People with salivary gland infections triggered by underlying medical conditions will require additional specialized treatment.
If a person has an infection caused by a large abscess, a doctor may need to open and drain the abscess.
For people taking medications linked to salivary gland infections, a doctor may need to switch their medication or change the dosage.
Aside from medications, there is a variety of home remedies that may help the body clear salivary gland infections. People can try:
- boosting fluid intake to treat dehydration
- massaging the impacted area several times daily if caused by obstruction to encourage the flow of saliva
- sucking on sugarless lozenges or sour hard candy to encourage the production of saliva
- consuming sour foods and drinks that promote the production of saliva, such as lemonade, pickles, or sauerkraut
- applying a warm compress to the affected area for 10 to 15 minutes several times daily
- using mouth rinses and washes containing carboxymethylcellulose, a saliva substitute
An ultrasound may be necessary to look at the blockage in more detail.
To diagnose salivary gland infections, a doctor will often ask a person questions about their symptoms, review their medical history, and perform a physical exam of the area.
Where a tumor or growth has caused the infection, a doctor may also take a sample to send to a lab for testing.
If there is a blockage in the salivary gland, a doctor may also order imaging tests to get a better view of the area, such as a:
- computed tomography (CT) scan
- magnetic resonance imaging (MRI) scan
- salivary endoscopy (sialoendoscopy)
- sialography, involves injecting a dye into the salivary glands that shows up on X-ray scans
Risk factors for salivary gland infections
A wide range of lifestyle factors, medications, and medical conditions can reduce the flow of saliva and trigger salivary gland infections, such as:
- breathing through the mouth too much
- anti-Parkinson medications
- being immunosuppressed
- being over the age of 65 or a newborn
- recent surgery
- radiation therapy or chemotherapy of the mouth, head, or neck
- radioactive iodine therapy of the thyroid
- diabetes mellitus
- Sjogren's syndrome
- rheumatoid arthritis (RA)
- lymph node infections
- kidney failure
In many cases, there are no specific ways to prevent salivary gland infections entirely.
However, a few lifestyle tips may help reduce the risk of infections forming. These include:
- staying hydrated and sipping on fluids throughout the day
- brushing the teeth two times daily
- flossing daily
- rinsing out the mouth with water after eating or drinking sweetened or carbonated drinks or foods
- getting a dental cleaning every six months
- chewing on sugarless gum or suck on sugarless hard candies
- limiting alcohol intake
- avoiding tobacco products
- eating foods in small bites to encourage saliva production
Overall the outlook for salivary gland infections is excellent in most cases.
A majority of salivary gland infections clear up on their own or with the aid of medications, self-care, and at-home remedies.
People with severe or chronic salivary gland infections will need ongoing medical care, especially if the infection is related to underlying medical conditions.
Always talk with a doctor about head and neck symptoms of any kind that are severe, last for more than two weeks, do not respond to primary care or interfere with the mouth opening and closing.