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Salivary gland infections

Parotitis; Sialadenitis

 

Salivary gland infections affect the glands that produce spit (saliva). The infection may be due to bacteria or viruses.

There are 3 pairs of major salivary glands:

  • Parotid glands: These are the 2 largest glands. One is located in each cheek over the jaw in front of the ears. Inflammation of 1 or more of these glands is called parotitis, or parotiditis.
  • Submandibular glands: These 2 glands are located just under both sides of the lower jaw and carry saliva up to the floor of the mouth under the tongue.
  • Sublingual glands: These 2 glands are located just under the front most area of the floor of the mouth.

All of the salivary glands empty saliva into the mouth. The saliva enters the mouth through ducts that open into the mouth in different places.

Causes

 

Salivary gland infections are somewhat common, and they can return in some people.

Viral infections such as mumps often affect the salivary glands. (Mumps most often involves the parotid salivary gland). Mumps is a rare problem today because of the MMR vaccine.

Bacterial infections are most often the result of a:

  • Blockage from salivary duct stones
  • Poor cleanliness in the mouth (oral hygiene)
  • Low amounts of water in the body, most often while in the hospital
  • Smoking
  • Chronic illness

 

Symptoms

 

Symptoms include:

  • Abnormal tastes, foul tastes
  • Decreased ability to open the mouth
  • Dry mouth
  • Fever
  • Mouth or facial "squeezing" pain, especially when eating
  • Redness over the side of the face or the upper neck
  • Swelling of the face (particularly in front of the ears, below the jaw, or on the floor of the mouth)

 

Exams and Tests

 

Your health care provider or dentist will do an exam to look for enlarged glands. You may also have pus that drains into the mouth. The gland is most often painful.

A CT scan, MRI scan or ultrasound may be done if the doctor suspects an abscess or to look for stones.

 

Treatment

 

In some cases, no treatment is needed.

Treatment from your provider may include:

  • Antibiotics if you have a fever or pus drainage, or if the infection is caused by bacteria. Antibiotics are not useful against viral infections.
  • Surgery or aspiration to drain an abscess if you have one.

Self-care steps you can take at home to help with recovery include:

  • Practice good oral hygiene. Brush your teeth and floss well at least twice a day. This may help with healing and prevent an infection from spreading.
  • Rinse your mouth with warm salt water rinses (one half teaspoon of salt in 1 cup of water) to ease pain and keep the mouth moist.
  • Stop smoking if you are a smoker, to speed up healing.
  • Drink lots of water and use sugar-free lemon drops to increase the flow of saliva and reduce swelling.
  • Massaging the gland with heat.
  • Using warm compresses on the inflamed gland.

 

Outlook (Prognosis)

 

Most salivary gland infections go away on their own or are cured with treatment. Some infections will return. Complications are not common.

 

Possible Complications

 

Complications may include:

  • Abscess of salivary gland
  • Infection returns
  • Spread of infection (cellulitis, Ludwig's angina)

 

When to Contact a Medical Professional

 

Call your provider if:

  • You have symptoms of a salivary gland infection.
  • You've been diagnosed with a salivary gland infection and symptoms get worse.
  • Get medical help right away if you have a high fever, trouble breathing, or swallowing problems.

 

Prevention

 

In many cases, salivary gland infections cannot be prevented. Good oral hygiene may prevent some cases of bacterial infection.

 

 

References

Elluru RG. Physiology of the salivary glands. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 83.

Jackson NM, Mitchell JL, Walvekar RR. Inflammatory disorders of the salivary glands. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 85.

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    Head and neck glands

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    • Head and neck glands

      Head and neck glands

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    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Salivary gland infections

           
             

            Review Date: 8/5/2015

            Reviewed By: Sumana Jothi MD, specialist in laryngology, Clinical Instructor UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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