Salivary gland inflammation is an inflammatory disease of the salivary gland caused by bacteria or viruses, or caused by a salivary stone. The medical name is sialadenitis or sialoadenitis. Typical symptoms of salivary gland inflammation are swelling in that area and severe pain.
What is salivary gland inflammation?
Salivary gland inflammation is a very painful swelling of the major salivary glands. It can be unilateral or bilateral and is usually caused by viruses, bacteria, or salivary stones. Almost all of the saliva in a person’s mouth is produced by six major salivary glands, which are arranged in pairs. The daily amount of saliva produced by an adult is estimated at 1.5 to 2 liters. These are the sublingual, parotid and mandibular salivary glands. Furthermore, some small salivary glands exist in the pharynx, on the carriage mucosa as well as on the lips. However, these are much less frequently affected by disease. Mostly older persons suffer from the disease. However, salivary gland inflammation also occurs more frequently in people with immune deficiency.
Causes
Salivary gland inflammation is usually triggered by bacteria or viruses. Thus, mumps and the Coxsackie A viruses are typical causes of this disease. Furthermore, salivary stones are often responsible for salivary gland inflammation. They cause saliva to back up, as they affect the excretory duct of the affected gland. As a result, a secretion is accumulated, which is an optimal breeding ground for bacteria. These in turn can cause inflammation. In addition, tumors, constrictions and scars can be responsible for salivary gland inflammation. Inflammation of the oral mucosa, which is caused by insufficient oral hygiene, is also a typical cause. Furthermore, medications that reduce salivary flow as a concomitant effect can promote salivary gland inflammation.
Symptoms, complaints and signs
In salivary gland inflammation, which in most cases occurs only on one side, the gland swells, becomes hard, and hurts. These symptoms may be noticeable even before the inflammation has developed. If the gland is inflamed, the overlying skin becomes red and feels hot. If pus forms, it often drains into the oral cavity or can be pushed out through the gland opening. On palpation of the gland, the secretion can be felt as a shifting mass. The symptoms worsen when eating. Chewing food stimulates the production of saliva. However, since the glandular ducts are obstructed by the salivary stone, the saliva cannot drain and thus presses on the inflamed and swollen tissue. As a result of the blockage, the gland continues to swell. Patients feel sick and groggy, sometimes accompanied by fever and chills. The lymph nodes may also swell. When the parotid gland is affected, chewing is very painful and the mouth is difficult to open. In the acute form of the disease, the symptoms start suddenly. Chronic inflammation, on the other hand, develops rather slowly and comes in episodes. It can occur sometimes on the right and sometimes on the left side. Pus can also form in the chronic form. Salivary stones also occur, which are completely asymptomatic.
Diagnosis and course
The diagnosis of salivary gland inflammation is made after a thorough examination of the salivary gland by the physician. Usually, he first palpates the gland, often finding pus in the mouth. In the laboratory, the pus as well as the blood are analyzed to determine the reasons for the salivary gland inflammation. Furthermore, an ultrasound examination may prove useful to look for a stone, tumor or abscess. In some cases, a computed tomography or magnetic resonance imaging scan is performed. In cases of chronic salivary gland inflammation, fine needle aspiration may also be considered. Another diagnostic method is a so-called sialography. For this, the physician injects a contrast medium into the duct of the salivary gland in order to make the gland visible on an X-ray. If salivary gland inflammation is prolonged, complications such as abscesses or tissue atrophy can occur.
Complications
If left untreated, salivary gland inflammation can lead to the formation of an abscess.This can penetrate into the oral cavity, the auditory canal or through the throat tissue and break open to the outside. If the bacteria get into the blood, blood poisoning can develop, which in the most severe case leads to organ failure and thus to the death of the affected person. Rarely, inflammation can lead to facial paralysis. In men, the disease can affect reproductive ability. Untreated chronic salivary gland inflammation can also lead to scarring of the glandular tissue. As a result, the glands harden and saliva production permanently decreases, favoring oral infections and other complications. Autoimmune reactions against the cells of the salivary glands are also conceivable – resulting in secondary diseases such as Sjögren’s syndrome and ultimately destruction of the glands. Very rarely, salivary gland inflammation is caused by a tumor, which can have serious consequences if left untreated. Adverse events may also occur during treatment. Occasionally, prescribed antibiotics cause side effects or trigger allergic reactions. Surgery may be associated with bleeding, infection, and scarring. If complications are severe, the salivary gland must be completely removed.
When should you see a doctor?
Salivary gland inflammation should always be treated by a doctor. Serious complications can occur with this disease, which significantly complicate the daily life of the affected person. For this reason, a doctor should be consulted at the first signs of salivary gland inflammation. The earlier the diagnosis and treatment of this disease takes place, the better is usually the further course of the disease. A doctor should be consulted if the affected person suffers from a clear reddening of the skin or a severe rash. This usually also leads to the formation of pus and not infrequently also to a secretion flowing out. In many cases, the affected person also suffers from discomfort when chewing or swallowing. Swollen lymph nodes or very high fever can also indicate salivary gland inflammation. The affected person can hardly open his or her mouth anymore and therefore cannot eat food or drink liquids. Salivary gland inflammation can be treated by a general practitioner or by an ENT specialist. In most cases, there are no particular complications and also a complete cure of the disease.
Treatment and therapy
If salivary gland inflammation is based in a bacterial infection, therapy with antibiotics is advisable. Pain-relieving and anti-inflammatory drugs are taken if the disease is caused by viruses. So-called salivary lozenges can be used to increase saliva production, which serves to cleanse the salivary glands. Furthermore, salivary stones can be flushed out in this way. Classic saliva lickers are drinks, chewing gum and sweets. Furthermore, salivary stones can be destroyed by massaging the gland or by extracorporeal shock wave lithotripsy. In this procedure, ultrasonic waves are directed at the salivary stone so that it falls apart. They are usually subsequently flushed out by the flow of saliva. If this form of therapy is unsuccessful in treating salivary gland inflammation, the larger particles must be removed surgically. If an abscess is present, it must be split. Only in this way can the pus drain away. Complete removal of the salivary gland is only necessary if the inflammation is constantly recurring or if a tumor is suspected. If a malignant tumor has been diagnosed, the only suitable treatment method is removal of the diseased tissue and the salivary gland. In most cases, this is followed by radiation therapy. Accordingly, the appropriate treatment depends crucially on the causes of salivary gland inflammation.
Prevention
Salivary gland inflammation can only be prevented to a limited extent. Important measures of prevention are adequate fluid intake and thorough oral hygiene and dental care. Furthermore, increased production of saliva can be a preventive measure, as it cleanses the salivary glands and flushes out any salivary stones. This can be achieved by sucking acidic candies. If a salivary stone is diagnosed, it should be removed as a preventative measure. This can also prevent salivary gland inflammation.
Aftercare
The course of salivary gland inflammation depends on the causative factors and the treatment method chosen. Follow-up treatments and follow-up examinations should be differentiated accordingly. If salivary gland inflammation is caused by bacteria, it may subside and heal completely within a few days with proper medication. Follow-up treatment is not necessary in these cases. It becomes more problematic if the disease is due to autoimmune reactions, which are usually treated with glucocorticoids (cortisone). Aftercare treatments are then aimed at minimizing the side effects of the cortisone treatment, such as water retention in the tissues, and at adjusting one’s behavior to the fact that the immune system is somewhat suppressed and therefore the risk of infection increases. Salivary gland inflammation can also be triggered as a side effect of certain medications. There is then a risk of chronic salivary gland inflammation, which is difficult to combat. Effective aftercare treatment consists of finding an adequate substitute for the drug and making sure that the causative drug remains off-limits in the future. Drugs that have already been identified as possible causative agents of salivary gland inflammation include antidepressants, diuretics, and antihistamines, as well as beta blockers and calcium antagonists. In many cases, viruses such as the Eppstein-Barr virus, the mumps virus, and the influenza virus trigger the disease. There is no need for special follow-up after the viral infection is overcome.
What you can do yourself
To support the organism, the immune system should be stabilized, especially in inflammatory processes. With a balanced and healthy diet, sufficient exercise and the avoidance of harmful substances such as nicotine and alcohol, an improvement in one’s health can be achieved. In addition, sleep hygiene should be optimized. The daily rhythm should be adapted to the needs of the body and states of stress should be avoided. A good work-life balance should be established in everyday life. A harmony between the fulfillment of professional duties and the organization of leisure activities helps to maintain one’s health and contributes significantly to the improvement of impairments. In some cases, inflammatory processes can regress on their own with a healthy endogenous defense system. Necessary for this is sufficient rest and no situation of overexertion or strong emotional stress. If medical care is sought, the instructions of the physician must be followed. Independent discontinuation of prescribed medications can lead to an immediate worsening of the overall situation. Support in the run-up as well as in the healing process is good oral hygiene. The teeth should be cleaned thoroughly at least twice a day. In addition, regular participation in prophylaxis is highly recommended. Viruses and bacteria in the area of the mouth are removed in this way.
