Salivary Glands

Information about the salivary glands

The salivary glands are found in and around the mouth, throat and face
The largest or major salivary glands are the parotid, submandibular, and sublingual glands
The salivary glands secrete saliva into the mouth, through tubes that drain the saliva, called salivary ducts
The parotid ducts drain near the upper teeth, the submandibular ducts under the tongue, and the sublingual glands through many ducts in the floor of the mouth
Besides the major salivary glands, there are many tiny glands called minor salivary glands located in the lips, inner cheek area (buccal mucosa), and in the linings of the mouth and throat

Salivary glands produce the saliva which moistens the mouth, initiates digestion, and help protect tooth decay
As a good health measure, it is important to drink lots of liquids daily
Dehydration is a risk factor for salivary gland disease

Obstruction to the flow of saliva most commonly occurs in the parotid and submandibular glands, usually because a salivary gland stone has formed
Symptoms of a blocked salivary gland typically occur when eating – saliva production starts to flow, but cannot exit the ductal system, leading to swelling of the involved gland and significant pain, sometimes with an infection
Unless a salivary gland stone totally obstruct saliva flow, the major glands will swell during eating and then gradually subside after eating, only to enlarge again at the next meal
Infection can develop in the pool of blocked saliva, leading to more severe pain and swelling in the glands

The most common salivary gland infection in children is mumps, which involves the parotid glands – while this is most common in children who have not been immunized, it can occur in adults
Salivary gland infection commonly occurs secondary to blockage by a salivary gland stone
The salivary glands may also become swollen due to a secondary infection from nearby lymph nodes
These lymph nodes are the structures in the upper neck that often become tender during a common sore throat – in fact, many of these lymph nodes are actually located on, within, and deep in the substance of the parotid gland or near the submandibular glands
Occasionally salivary gland swelling is due to a tumour

A ranula is a type of mucocoele found on the floor of the mouth
Ranulas present as a swelling consisting of collected mucin from a ruptured salivary gland duct

Salivary gland enlargement may also occur in autoimmune diseases such as Sjögren’s syndrome where the body’s immune system attacks the salivary glands causing significant inflammation
Dry mouth or dry eyes are common
This may occur with other systemic diseases such as rheumatoid arthritis
Diabetes may cause enlargement of the salivary glands, especially the parotid glands
Alcoholics may have salivary gland swelling, usually on both sides

Benign and malignant salivary gland tumours usually show up as painless enlargements of these glands
Tumours rarely involve more than one gland and are detected as a lump in the face, on the palate, floor of mouth, cheeks, or lips
An otolaryngologist-head and neck surgeon should check these enlargements
Malignant tumours of the major salivary glands can grow quickly, may be painful, and can cause loss of movement of part or all of the affected side of the face
These symptoms should be immediately investigated

Treatment of salivary gland diseases falls into two categories: medical and surgical
Selection of treatment depends on the nature of the problem

When salivary gland problems are due to systemic diseases (diseases that involve the whole body, not one isolated area), then the underlying problem must be treated – this may require consulting with other specialists
If the disease process relates to salivary gland obstruction and subsequent infection, your doctor will recommend increased fluid intake and may prescribe antibiotics

If a mass has developed within the salivary gland, removal will usually be recommended – most masses in the parotid gland area are benign (noncancerous)
When surgery is necessary, great care is taken to avoid damage to the facial nerve within this gland – the facial nerve moves the muscles face including the mouth and eye
For parotid gland cancer, it may be possible to surgically remove the parotid gland and preserve most of the facial nerve – radiation treatment is then often recommended starting 4 to 6 weeks later

The same general principles apply to masses in the submandibular area or in the minor salivary glands within the mouth and upper throat
Benign diseases are best treated by conservative measures or surgery, whereas malignant diseases may require surgery and radiation treatment
An ENT – head and neck surgeon can effectively direct treatment

The submandibular salivary glands are located under the angle of the jaw on each side of the neck
They produce saliva which passes into the mouth through a narrow tube (duct)
The duct may be block by stones which leads to pain and swelling in the neck and mouth
A lump in the submandibular gland may also be due to a benign or malignant tumour
Benign diseases are best treated by conservative measures or surgery, whereas malignant diseases may require surgery and postoperative irradiation
If the lump in the vicinity of a salivary gland is a lymph node that has become enlarged due to cancer from another site, then a different treatment plan will be needed

The parotid salivary gland is situated in the face, in front of and below the ear
Swelling in the parotid gland is often due to infection or a benign or malignant tumour
The facial nerve which supplies the facial muscles runs through the parotid gland. The facial muscles control movement of the face, including mouth and eye
If a lump has developed within the parotid gland, removal is usually recommended
Most lumps in the parotid gland area are benign (noncancerous)
When surgery is necessary, great care is taken to avoid damage to the facial nerve within this gland

No, removal of a salivary gland does not produce a dry mouth, called xerostomia
However, radiation therapy to the mouth can cause the unpleasant symptoms associated with reduced salivary flow – your doctor can prescribe medication or other conservative treatments that may reduce the dryness in these instances

Salivary gland diseases are due to many different causes
These diseases are treated both medically and surgically
Treatment is readily managed by an ENT – head and neck surgeon with experience in this area