What is it?
Sialadenitis is inflammation of a salivary gland. The parotid gland in front of the ear and the submandibular gland under the jaw are the ones most often affected. The gland can swell within a few hours, it hurts when touched, and the skin over it may look stretched. Where saliva flow has dropped, it becomes easier for bacteria to reach the gland along the duct.
Inflammation caused by bacteria is usually one-sided and can worsen quickly. The most telling sign of this picture is cloudy, pus-filled discharge coming into the mouth from the duct opening when the cheek or the area under the jaw is pressed. In inflammation caused by viruses the swelling is more often on both sides, and the course is different.
Fluid loss, medicines that cause a dry mouth, older age, recent surgery and mouth care that has become hard to keep up all raise the risk. Infection can also develop in a gland that has a stone in its duct; in that case the blockage and the infection run together. In people whose immune system is suppressed, the picture is expected to move faster.
Signs
You will not necessarily have all of these at once.
Why does it happen?
- 01
Saliva flow dropping
When there is no flow rinsing the duct, bacteria from the mouth can travel up along it. Fluid loss, going a long time without eating and medicines that dry the mouth all slow this flow.
- 02
A stone or narrowing blocking the duct
When the way out of the gland is mechanically closed, stagnant saliva collects inside it. Still fluid suits bacterial growth; this is why a stone and inflammation are so often seen in the same gland.
- 03
Gland involvement caused by a virus
Some viruses affect the salivary glands directly; in this picture the swelling is usually on both sides and no pus comes from the duct. Making that distinction, and requesting tests if they are needed, is the doctor's job.
- 04
Conditions that strain your general health
The period after an operation, serious illness, older age and treatments that suppress the immune system upset both mouth care and saliva flow. Inflammation of the gland settles in more easily on this ground.
How does it progress?
- Acute bacterial
One-sided, with a fever
The gland swells within a short time and touching it is painful. Pus coming from the duct opening is the clearest sign of this type; fever and tiredness may go with it.
- Viral
Swelling on both sides
The swelling is usually seen in both glands at once and no pus comes from the duct. There may be fullness in front of the ear and more discomfort while chewing; the distinction is made by a doctor.
- With a blockage
Inflammation added on top of a stone
Redness, constant pain and discharge are added to swelling that used to come and go with meals. Here both the infection and the blockage need to be dealt with separately.
- Recurring
Repeated bouts in the same gland
Once the inflammation has settled the gland does not always go back to how it was; new bouts may come within months. Assessing the structure of the gland with imaging comes up at this point.
How is it treated?
This condition is not treated in dentistry. Once the signs are noticed inside the mouth, the place to go is the ear, nose and throat department; if there is a fever, swelling that is growing quickly or difficulty swallowing, the assessment needs to be made the same day in an emergency department. Examining the gland with two hands, seeing the discharge from the duct opening and directing you to that door is the dentist's role.
The steps to expect from the doctor you see are these: examination of the gland, blood tests and an ultrasound scan if needed, taking a sample of the discharge from the duct opening, and planning the medicines that suit the picture. Whether an antibiotic is needed, and which one is chosen, is settled by that assessment; do not use an antibiotic left over at home on your own decision.
If an abscess is thought to have formed inside the gland, draining it may come up; that is a procedure carried out in hospital. If a stone is found in the same gland, the blockage is expected to be dealt with separately once the inflammation has settled. Through all of this you can keep seeing your dentist, to maintain your mouth care and to ease the dryness in your mouth.
- Swelling of the face or under the jaw that grows quickly along with a fever
- Difficulty swallowing or breathing
- Not being able to open your mouth as wide as two fingers
- The skin over the swelling turning red and shiny, with throbbing pain
How is it prevented?
- Keep your water intake regular; fluid loss is the most common background to this condition.
- If you take a medicine that dries your mouth, tell your dentist, and do not stop it of your own accord.
- On the days you are unwell and have lost your appetite, keep up your brushing and your cleaning between the teeth.
- If you can describe swelling under the jaw that comes and goes with meals, have it assessed before an infection is added.
Frequently asked questions
- Is this the same thing as mumps?
- It is not the same thing. Mumps is caused by a virus and the swelling is usually on both sides; in inflammation caused by bacteria one gland is usually affected and pus can come from the duct. The distinction is made by a doctor, through examination and tests where they are needed; do not try to decide at home by looking at the swelling.
- Does a dentist treat this infection?
- No. Your dentist can examine the gland, see the discharge coming from the duct opening, assess background factors such as a dry mouth or a stone, and refer you to the ear, nose and throat department. If there is a fever and swelling that is growing quickly, the referral is made to an emergency department the same day.
- Will the swelling go away on its own?
- In some milder cases the swelling may go down, but waiting for that is not a safe course. A fever being added, the pain increasing and the discharge turning to pus all show that the picture is getting worse. With these signs a doctor needs to be seen without delay.
This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.