Salivary Gland Diseases

Author: Op. Dr. Javidan Asafov · ENT / Otolaryngology Specialist · Last medical review: 24.09.2026

Where are the salivary glands and what do they do?

We have three pairs of major salivary glands: the parotid in front of and below the ear, the submandibular beneath the jawbone and the sublingual under the tongue, plus hundreds of minor glands in the lining of the lips, cheeks and palate. Together they produce roughly one to one and a half litres of saliva a day, which starts digestion, protects the teeth from decay, keeps the mouth moist and makes speaking comfortable. Salivary gland diseases fall into three main groups: blockage of the duct (stones), infection, and lumps.

Salivary gland stones (sialolithiasis)

Minerals in saliva can crystallise inside the duct and form a stone; about 80% of stones occur in the submandibular gland. The typical complaint is a gland that suddenly swells and hurts during or just after a meal, settles within hours and flares again at the next meal. If the duct blocks completely, infection follows. The diagnosis is made by examination and ultrasound. For small stones, drinking plenty of water, stimulating saliva with sour sweets or lemon, warm compresses and massaging the gland forwards may help the stone pass on its own. Stones that do not pass are removed through a small incision inside the mouth or with a very fine camera introduced into the duct (sialendoscopy); the gland itself is removed only in recurrent cases that cannot be solved any other way.

Salivary gland infection (sialadenitis)

The gland becomes suddenly swollen, painful and red, sometimes with pus draining into the mouth. Dehydration, poor oral hygiene, older age and certain medicines reduce the flow of saliva and set the stage for bacterial infection; a stone in the duct raises the risk further. The best-known viral cause is mumps, now rare thanks to vaccination, which usually produces swelling of both parotid glands. Bacterial infection is treated with antibiotics, plenty of fluids, pain relief and measures that increase saliva flow; an abscess, if it forms, is drained. Frequently recurring infections prompt a search for an underlying stone or duct narrowing.

Lumps and tumours of the salivary glands

A painless, slowly growing swelling in front of the ear or under the jaw that does not settle within weeks is treated as a tumour until proven otherwise. About 80% of parotid lumps are benign, most often pleomorphic adenoma or Warthin tumour. The likelihood of malignancy is higher in the submandibular gland and higher still in the minor glands. Ultrasound and fine-needle aspiration biopsy are the basis of diagnosis; MRI is added when needed. These lumps are never sampled by cutting into them, because that risks spreading tumour cells. Benign tumours are also removed: they keep growing, and a small proportion turn malignant over the years. Surgery means parotidectomy with preservation of the facial nerve for the parotid, and removal of the whole gland for the submandibular gland; for malignant tumours, neck dissection and radiotherapy may be added.

Dry mouth and other causes

Autoimmune conditions such as Sjögren’s syndrome, many medicines (for blood pressure, depression or allergy) and previous radiotherapy to the head and neck reduce saliva production, leading to dry mouth, tooth decay and recurrent gland infections. Treatment targets the underlying cause; artificial saliva products, sugar-free gum and regular dental care ease the symptoms.

When to see an ENT specialist

A swelling that lasts longer than two weeks or keeps growing, painful swelling that recurs with meals, redness and fever over the gland, pus in the mouth, or a lump accompanied by facial weakness, numbness or difficulty opening the mouth should be assessed without delay. A lump with facial weakness is particularly important, as it is a warning sign of a malignant tumour.

This article is for general information; please consult your physician for diagnosis and treatment.