Salivary Gland Inflammation (Sialadenitis): Drug Therapy

Therapeutic targets

In case of bacterial infection: cure.
Pain relief
Relief of xerostomia (dry mouth)

Therapy recommendations

Symptomatic therapy
- Analgesia (analgesics/painkillers).
  - Nonacid analgesics: Paracetamol
  - Antipyretics (antipyretic agents), if necessary.
  - If necessary, also antiphlogistics (drugs that inhibit inflammatory processes): acetylsalicylic acid (ASS), diclofenac, ibuprofen, indometacin.
Antibiosis – for bacterial infection.
- Indications:
  - Acute bacterial sialadenitis
  - Postoperative parotitis (parotid gland inflammation).
  - Chronic recurrent parotitis in the acute interval.
  - Chronic recurrent sialadenitis of the submandibular gland in the acute interval
  - Parotitis epidemica (mumps) with involvement of the CNS concomitant with prednisolone administration.
  - Supportive curative to surgical intervention.
  - Propagation tendency
  - Systemic manifestation
  - Endocarditis (endocarditis)-prone patients, regardless of the severity of infection.
  - Risk of exacerbation (marked worsening of the clinical picture) of a general disease.
  - Impaired immune defense (eg, cytostatic or systemic corticosteroid therapy, immunosuppression), regardless of the severity of infection.
  - Postoperative persistent (ongoing) inflammation despite adequate drainage.
Sialagoga – Via excitation of the parasympathetic nervous system, they lead to increased saliva production.
- Parasympathomimetics: Anetholtrithione, pilocarpine.
Saliva substitutes – They are intended to provide long-lasting moistening of the dental hard tissues as well as the oral mucosa.
- Additional desirable side effects of saliva substitutes include remineralizing potential, antimicrobial action, and relief of xerostomia.
- Saliva substitutes usually contain a wide variety of base substances as well as additives. Especially proven fluoride-containing mucin-based saliva substitutes with calcium and phosphate.
- Cave: With saliva substitutes based on carboxymethyl cellulose, there is a risk of demineralization of the dental hard tissue. An addition of calcium, phosphate and / or fluoride ions counteracts this.
Glucocorticoids
- Indications:
  - Chronic recurrent parotitis in the interval.
  - Heerfordt syndrome
  - Parotitis epidemica: with central nervous system involvement (prednisolone under antibiosis).
  - Vasculitic complications of chronic myoepithelial sialadenitis.
In the presence of cytomegaly or rheumatic diseases: see under the respective disease.