Brief overview
- Symptoms: Pain, swelling, tenderness, and fever, among others.
- Causes: Decreased saliva production, poor oral hygiene, medications, autoimmune diseases, etc.
- Diagnosis: Medical history, physical examination, further examinations such as ultrasound, magnetic resonance imaging or endoscopy.
- Therapy: Depending on the cause, for example with antibiotics, analgesic and anti-inflammatory medications
What is salivary gland inflammation?
By salivary gland inflammation (sialadenitis, sialoadenitis), physicians understand an inflammation of the large salivary glands of the head. These include:
- Parotid glands (Glandula parotidea): they produce a watery secretion.
- Submandibular glands (glandula submandibularis): they produce a mucous watery secretion.
- Sublingual glands (glandula sublingualis): They produce a mucous secretion.
Inflammation of the parotid gland
You can find everything important about inflammation of the parotid gland in the article Parotitis.
What are the symptoms?
A distinction is made between acute and chronic salivary gland inflammation. Acute sialadenitis often manifests with the following sudden onset symptoms (when caused by bacteria):
- Pain
- swelling of the gland
- Sensitivity to pressure
- Hard, coarse consistency
- Hot, red skin over the gland
- Fever, chills
- Swelling of lymph nodes
Pus may be discharged into the oral cavity via the excretory ducts. The swelling as well as the pain of the gland increase during eating, because chewing stimulates saliva production. In about 80 percent of cases, inflammation of the salivary gland occurs on only one side.
Salivary gland inflammation: symptoms of an acute viral infection
Salivary gland inflammation: Signs of chronic inflammation
Chronic, recurrent sialadenitis progresses slowly and in episodes. The gland is painfully swollen. Purulent or milky-grainy secretions may be discharged. Most often, chronic salivary gland inflammation is unilateral. It may also change from one side to the other.
How long does salivary gland inflammation last?
Causes and risk factors
The causes of salivary gland inflammation are varied. While children are more likely to suffer from inflammation of the parotid gland caused by the contagious mumps virus, older people are more likely to suffer from recurrent bacterial salivary gland inflammation. In general, sialadenitis may have the following causes:
- Poor oral hygiene, rotten teeth, inflammation of the oral mucosa
- Certain medications such as antidepressants, diuretics, antihistamines, beta-blockers, calcium antagonists
- Autoimmune diseases such as Sjögren’s syndrome or Heerfordt’s syndrome
- Radiation therapy of the head and neck region or radio-iodine therapy for thyroid disease
- Disturbances of the salt and water balance
- Chronic diseases like diabetes mellitus or AIDS
Viruses usually cause salivary gland inflammation by entering the gland through the blood. Typical pathogens include the Eppstein-Barr virus, cytomegalovirus, mumps virus and influenza virus.
Salivary gland inflammation: Diagnostics
- How long have you had the symptoms?
- Are there any triggers that aggravate the symptoms?
- Do you suffer from a chronic disease such as AIDS, diabetes mellitus or rheumatism?
- Do you take medication on a regular basis?
- Have you had radiation treatment to the head or neck?
Physical examination
In the next step, your doctor will swab your saliva and examine it for pathogens. A blood sample may also be helpful. The so-called inflammation parameters can be determined in the laboratory. These include the C-reactive protein, the erythrocyte sedimentation rate and the number of white blood cells (leukocytes). Your doctor uses these values to determine whether there is inflammation in your body.
Further examinations
During endoscopy, the doctor pushes a tiny camera through the excretory ducts of the glands. This allows the doctor to visualize the ducts and glands, take tissue samples and perform irrigation.
Treatment
Antibiotics, on the other hand, are not effective against viruses. In the case of virus-related salivary gland inflammation, only the symptoms can be treated (symptomatic therapy). For example, the doctor prescribes painkillers that also have an anti-inflammatory or antipyretic effect, such as ibuprofen or paracetamol.
Home remedies have their limits. If the discomfort persists for a long time, does not get better or even gets worse, you should always consult a doctor.
In addition, it is important to pay attention to good oral hygiene, drink plenty of fluids and prefer soft foods.
If an autoimmune disease is the cause of salivary gland inflammation, your doctor may prescribe glucocorticoids (cortisone). They suppress the immune system and thus inhibit the inflammatory reaction.
In the case of salivary stones that cannot be eliminated by conservative therapy (for example, acid sweets, massages), surgical intervention may be necessary.
Course of the disease and prognosis
With timely and proper treatment of salivary gland inflammation, it usually heals within a few days without consequences.
If bacterial purulent salivary gland inflammation remains untreated, a purulent capsule (abscess) may form. This may eventually break through into the oral cavity, ear canal or through the neck tissue to the outside. If the triggering bacteria enter the bloodstream, a potentially life-threatening blood poisoning (sepsis) develops.
If chronic salivary gland inflammation is left untreated, it is possible that the gland tissue will scar or regress.
The risk of salivary gland inflammation can be reduced by sufficient fluid intake and thorough oral hygiene. Acidic sweets and drinks as well as sugar-free chewing gum stimulate the flow of saliva, which also has a preventive effect. A vaccination helps against salivary gland inflammation caused by the mumps virus.
