Salivary Gland Disorders occur as a result of salivary duct obstruction, mucoceles and ranulas from trauma, previous head and neck radiation and tumors within the glands themselves. There are two main types of salivary glands, the major and the minor salivary glands. The major salivary glands consist of the parotid, submandibular and sublingual salivary glands. These large glands supply the majority of the saliva in the mouth. The minor salivary glands are located throughout the mouth and the inner surfaces of the lips. Salivary gland disorders can occur in any of the major or minor salivary glands and can occur at any age.
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Figure 1:
Radiograph of a well functioning major salivary gland with no obstruction of salivary flow.
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Salivary Gland Obstruction occurs when a stone becomes lodged in the duct of a major salivary gland. A salivary duct transports saliva from the salivary gland into the mouth. Stones can form in these ducts just as they can form in the kidneys or gallbladder. An obstructed salivary gland will become painful and inflamed. A hardening of the gland may be palpable in the neck or cheek. Treatment of this condition is based on the patient’s symptoms, the level of obstruction and the salivary gland involved.
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Figure 2:
A CT scan demonstrating a large stone obstructing the duct of the submandibular gland in the floor of the mouth.
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Mucoceles present as a bluish bump between 0.5 and 2 cm in diameter, are most commonly found on the inner portion of the lower lip. They result from an injury, usually accidentally biting the lower lip, which results in damage to a minor salivary gland. These small blue bumps may increase and decrease in size. They are often not painful, but may burst and reform. Treatment is simple and is directed at removing the damaged minor salivary gland.
Ranulas are bumps located in the floor of the mouth adjacent to the tongue. They range in size from small (1 cm) to very large and occur due to damage/obstruction of the sublingual glands. These bumps also may increase and decrease in size. They are often not painful, but may cause elevation of the tongue and/or a palpable bump in neck. Treatment is simple and is directed at removing the obstruction and/or sublingual salivary gland.
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Figure 4:
A Ranula in the floor of the mouth at the base of the tongue.
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Dry Mouth occurs due to many different causes. Causes of dry mouth include many commonly prescribed medications, autoimmune diseases such as Sjogren’s Disease, chronic obstruction of major salivary glands and previous head and neck radiation. Treatment is aimed at identifying the causes of dryness and increasing salivary gland function.
Salivary Gland Tumors are very rare occurrences. Treatment involves removal of the affected gland.