Submandibular Stones
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1- Introduction
2- Anatomical Overview
3- Causes
4- Treatment
Introduction
Submandibular stones, also known as submandibular sialolithiasis, are hardened deposits that can form in the salivary glands located beneath the lower jaw, known as the submandibular glands. These stones are typically composed of minerals like calcium and can vary in size. When they block the flow of saliva from the gland into the mouth, they can lead to symptoms such as swelling, pain, and difficulty eating.
Anatomical Overview
Submandibular stones, or sialoliths, are mineralized deposits that can form within the ducts of the submandibular salivary glands, which are located beneath the lower jaw on either side of the mouth. These glands are one of the major salivary glands and are responsible for producing saliva, which plays a crucial role in digestion and oral health. The submandibular ducts, also known as Wharton’s ducts, run from the submandibular glands to the floor of the mouth, where they release saliva.
When these ducts become blocked by a stone, it can disrupt the flow of saliva, leading to symptoms such as swelling, pain, and tenderness in the affected gland. The exact cause of submandibular stones is not always clear but may be related to factors such as dehydration, reduced saliva production, or the composition of saliva.
Diagnosis of submandibular stones often involves imaging studies such as ultrasound, CT scans, or sialography, which is a special type of X-ray that focuses on the salivary glands.
Causes
- Dehydration: Reduced fluid intake can lead to concentrated saliva, which is more likely to form stones.
- Salivary gland issues: Conditions that affect the function of salivary glands, such as Sjögren’s syndrome, can increase the risk of stone formation.
- Saliva composition: Imbalances in the minerals and other substances in saliva can contribute to stone formation.
- Trauma: Injuries to the face or mouth area can sometimes trigger the formation of salivary stones.
- Anatomy: Anatomical variations or abnormalities in the salivary ducts can make it easier for stones to form or become lodged.
- Medications: Some medications can reduce saliva production or alter its composition, increasing the risk of stone formation.
- Infection: Infections in the salivary glands or ducts can lead to inflammation and blockages that contribute to stone formation.
Treatment
Hydration: Drinking plenty of fluids can help to flush out smaller stones and prevent dehydration, which can contribute to stone formation.
Saliva stimulation: Chewing on sour candies or gums, or using a saliva-stimulating medication, can help increase saliva flow and potentially dislodge small stones.
Massage: Massaging the affected gland gently from the outside of the mouth may help to push the stone out of the duct.
Warm compress: Applying a warm compress to the affected area can help to reduce pain and swelling and may also help to soften the stone.
Sialogogues: These are medications that stimulate saliva flow and can help to push the stone out of the duct.
Surgical removal: If the stone is large or causing severe symptoms, surgical removal may be necessary. This can be done using various techniques, including sialendoscopy (using a small camera to locate and remove the stone) or traditional surgery.
Antibiotics: If there is an associated infection, antibiotics may be prescribed to help clear the infection.