What does this mean?
There are dozens of lymph nodes under your jaw, along the sides of your neck and behind your ears. They are small filters that strain the fluid coming from your mouth, your teeth, your throat and the skin of your face. When an infection starts in the area, the defence cells inside a node multiply and the node grows over a few days. What you notice with your fingers is most often that enlarged filter. It is not the problem itself, it is the messenger telling you there is one.
What sets this symptom apart from others is how the gland feels and moves. A gland reacting to infection is sore when you touch it, slides under your finger, is not stuck to the skin, and has grown over less than a week. A lump that is hard, painless, will not move and stays the same for weeks is a separate topic and is assessed separately. A swelling under the jaw that grows as you start eating and settles once you have finished points to a salivary duct rather than a lymph gland.
Working out whether the source is in your mouth is a job for your dentist. Infection at the root tip of a decayed or broken tooth, the gum around a wisdom tooth that is coming through, and advanced gum disease can all enlarge the glands on the same side. Until the source is treated, the gland is most often not expected to settle, and an antibiotic on its own does not give a lasting result.
Behind a swollen gland there is most often an infection close by, and whether it comes from a tooth, the gum, a salivary gland or the throat is told apart by an examination and, where needed, an X-ray.
Likely causes
What helps at home?
- Do not keep prodding the gland to test it through the day. Constant pressure both adds to the swelling and makes it harder for you to judge whether it is really growing.
- Keep a short note of when the swelling started, whether its size has changed and whether you have had a temperature. At the appointment that is more use than describing it from memory.
- Do not start left-over antibiotics on your own judgement. An antibiotic given before the source is found can shrink the swelling for a while and delay the cause being seen.
- Do not squeeze the swelling, try to burst it or open it up. And do not stop brushing the teeth on that side, because letting the cleaning slip makes the infection at the source worse.
- If you have a temperature alongside the swelling, or you are shivering
- If you are struggling to open your mouth, it hurts to swallow, or your voice has changed
- If the swelling is growing quickly, or the skin over it is red and hot
- If the swelling has not gone down for more than three weeks, or has become hard and fixed in place
- If you also have unexplained weight loss or night sweats over the same period
Frequently asked questions
- Will a swollen gland settle on its own?
- A gland that has swollen in response to an infection is expected to go down within two to four weeks once the source has gone. It is also usual for it not to return completely to how it was in that time, and to stay slightly enlarged and still findable by hand for a while longer. If it is not going down, or carries on growing, the cause should be looked at again.
- I have no toothache. Can the source still be a tooth?
- It can. A tooth that has lost its nerve can carry infection at the root tip without giving any pain, and advanced gum disease can stay silent for a long time. That is why a swollen gland is looked at with an examination inside the mouth, and an X-ray is most often asked for. The absence of pain does not mean the source is not in your mouth.
- Do I need to start an antibiotic?
- That decision belongs to the clinician who examines you. An antibiotic does not remove the source: for an inflamed tooth the real answer is root canal treatment, taking the tooth out, or gum treatment. It is common for a swelling to ease for a while on an antibiotic given without touching the source, and then to come back.
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.