Salivary Gland Infection

What is Salivary Gland Infection

Salivary gland infection is an infection in one or more of the glands that produce saliva. You have six major salivary glands. Each gland has a duct that carries saliva into your mouth. Saliva keeps your mouth moist and breaks down the food that you eat. It also helps prevent tooth decay.

Two salivary glands are located just in front of your ears (parotid). The ducts for these glands open up inside your cheeks, near your back teeth. You also have two glands under your tongue (sublingual) and two glands under your jaw (submandibular). The ducts for these glands open under your tongue. Any salivary gland can become infected. Most infections occur in the parotid glands or submandibular glands.

What are the causes?

This condition may be caused by bacteria or viruses.

  • The bacteria that cause salivary gland infections are usually the same bacteria that normally live in your mouth.
    • A stone can form in a salivary gland and block the flow of saliva. As a result, saliva backs up into the salivary gland. Bacteria may then start to grow behind the blockage and cause infection.
    • Bacterial infections usually cause pain and swelling on one side of the face. Submandibular gland swelling occurs under the jaw. Parotid swelling occurs in front of the ear.
    • Bacterial infections are more common in adults.
  • The mumps virus is the most common cause of viral salivary gland infections. However, mumps is now rare because of vaccination.
    • This infection causes swelling in both parotid glands.
    • Viral infections are more common in children.

What increases the risk?

The following factors may make you more likely to develop a bacterial infection:

  • Not taking good care of your mouth and teeth (poor oral hygiene).
  • Smoking.
  • Not drinking enough water.
  • Having a disease that causes dry mouth and dry eyes (Mikulicz syndrome or Sjogren syndrome).

A viral infection is more likely to occur in children who do not get the MMR (measles, mumps, rubella) vaccine.

What are the signs or symptoms?

The main sign of a salivary gland infection is a swollen salivary gland. This type of inflammation is often called sialadenitis. You may have swelling in front of your ear, under your jaw, or under your tongue. Swelling may get worse when you eat and decrease after you eat. Other signs and symptoms include:

  • Pain.
  • Tenderness.
  • Redness.
  • Dry mouth.
  • Bad taste in your mouth.
  • Difficulty chewing and swallowing.
  • Fever.

How is this diagnosed?

This condition may be diagnosed based on:

  • Your signs and symptoms.
  • A physical exam. During the exam, your health care provider will look and feel inside your mouth to see whether a stone is blocking a salivary gland duct.
  • Tests, such as:
    • An X-ray to check for a stone.
    • An ultrasound, CT scan, or MRI to look for an abscess and to rule out other causes of swelling.
    • A culture and sensitivity test. In this test, a sample of pus is taken from the salivary gland with a swab or by using a needle (aspiration). The sample is tested in a lab to determine the type of bacteria that is growing and which antibiotic medicines will work against it.

You may need to see an ear, nose, and throat specialist (ENT or otolaryngologist) for diagnosis and treatment.

How is this treated?

Viral salivary gland infections usually clear up without treatment. Bacterial infections are usually treated with antibiotic medicine. Severe infections that cause difficulty with swallowing may be treated with an IV antibiotic in the hospital.

Other treatments may include:

  • Probing and widening the salivary duct to allow a stone to pass. In some cases, a thin, flexible scope (endoscope) may be inserted into the duct to find a stone and remove it.
  • Breaking up a stone using sound waves.
  • Draining an infected gland (abscess) with a needle.
  • Surgery to:
    • Remove a stone.
    • Drain pus from an abscess.
    • Remove a badly infected gland.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

To relieve discomfort

  • Follow these instructions every few hours:
    • Suck on a lemon candy to stimulate the flow of saliva.
    • Put a warm compress over the gland.
    • Gently massage the gland.
  • Rinse your mouth with a salt-water mixture 3–4 times a day or as needed. To make a salt-water mixture, completely dissolve ½–1 tsp of salt in 1 cup of warm water.

General instructions

  • Practice good oral hygiene by brushing and flossing your teeth after meals and before you go to bed.
  • Drink enough fluid to keep your urine pale yellow.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have pain and swelling in your face, jaw, or mouth after eating.
  • You have persistent swelling in any of these places:
    • In front of your ear.
    • Under your jaw.
    • Inside your mouth.

Get help right away if:

  • You have pain and swelling in your face, jaw, or mouth, and this is getting worse.
  • Your pain and swelling make it hard to swallow or breathe.

Summary

  • A salivary gland infection is an infection in one or more of the glands that produce saliva. You have six major salivary glands. Each gland has a duct that carries saliva into your mouth.
  • Any salivary gland can become infected. Most infections occur in the glands just in front of your ears (parotid glands) or the glands under your jaw (submandibular glands).
  • This condition may be caused by bacteria or viruses.
  • Salivary gland infections caused by a virus usually clear up without treatment. Bacterial infections are usually treated with antibiotic medicine.
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