What are salivary gland stones, and how do I remove them?

Written by: Miss Katherine George
Edited by: Top Doctors®


Salivary glands produce the saliva in our mouths, helping to lubricate and protect our teeth as well as helping us speak and eat. We have many salivary glands all producing saliva. Some are very small, just a few millimetres in diameter, and we call these the minor salivary glands. There are also 3 pairs of larger glands, known as major salivary glands which have a complex system of ducts, through which the saliva flows.



How are salivary gland stones formed?


As the saliva is supersaturated with minerals such as calcium, stones can form within the major salivary gland duct system, sometimes over many years. When the stone is large enough to block a duct within a major salivary gland this can cause symptoms of pain during mealtimes and swelling.


How are salivary gland stones removed?


Currently many doctors advocate surgery to remove the salivary gland when a stone is diagnosed. However, minimally invasive techniques, where the stone is removed and the gland preserved are often possible.

With the minimally invasive procedure, there is less down time and often treatment can be carried out in the outpatient department with no need for admission into a hospital bed. Scars are avoided as are risks to the nerves that supply movement to the muscles of the face and tongue as well as the nerve that supplies sensation to the tongue.


What is a sialendoscopy?


Sialendoscopy is fundamental to minimally invasive salivary stone removal and involves the use of a very small, micro-endoscope. This is a fine tube, with a camera at one end and a light source at the other, which can be placed directly into the salivary gland duct inside the mouth. The procedure is carried out with some local anaesthetic, similar to an injection that may be given by the dentist.


How long does it take to remove salivary gland stones?


Treatment time varies depending upon the complexity of the case but is usually about 1 hour. Sialendoscopy allows the inside of the ducts to be examined and if a stone is present this can often be removed by a fine wire basket placed through the micro endoscope into the duct.

If the stone is too large to be removed in this way, it is often possible to break the stone into smaller parts, a procedure known as lithotripsy. These smaller fragments can then be removed by baskets or are sometimes small enough to flush out of the gland with the saliva on their own.

If you are concerned about salivary gland stones, make an appointment with an oral and maxillofacial surgeon.

By Miss Katherine George
Oral & maxillofacial surgery

Miss Katherine George is an highly-regarded consultant oral and maxillofacial surgeon based in London. Having qualified with distinction in her medical degree, Miss George has won multiple academic and clinical awards and prizes throughout her career. Following her higher surgical training she completed a fellowship in Cosmetic & Reconstructive Surgery with a focus on facelift and facial rejuvenation. 

Miss George also has advanced training in salivary gland disease management, and was the first person in the world to use intracorporeal lithotripsy to break salivary gland stones to avoid invasive surgery. This is an advanced technique that is still not widely available. Miss George is one of the few surgeons in the UK that is able to offer minimally invasive salivary gland surgery, and is part of a specialist salivary gland team. She is the surgical lead for salivary gland surgery for the British Association of Oral and Maxillofacial surgeons. 

Alongside her clinical practice, Miss George is also an advanced trauma life support instructor, and has written numerous peer-reviewed articles for medical journals.

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