Sialadenitis is an infection of the salivary gland, which can be a bacterial or viral infection affecting the salivary duct or the gland. Sialadenitis can occur as a result of decreased saliva flow or inflammation or blockage of the salivary duct. Our mouth is continuously flushed with saliva which helps in digestion, breaking down of food and in keeping the mouth clean. Saliva also helps in washing away any food particles or bacteria along with controlling the quantity of the good and bad bacteria in the mouth.

If there is any reduction of the saliva causing any hindrance in it freely travelling throughout the mouth, then it causes decrease in flushing out of the bacteria and food particles. This can lead to Sialadenitis.

Sialadenitis

Treatment for Sialadenitis comprises of antibiotics and rarely surgery.

Types of Salivary Glands

  • There are three major pairs of salivary glands which can cause sialadenitis and these are located on each side of our face. The largest one is the Parotid gland, which is present inside each cheek. They are situated just above the jaw and in front of our ears. When parotid gland is infected, then this condition is known as parotitis.
  • The second major pair of salivary gland is submandibular glands, which are present on both the sides of the jaw just beneath the jawbone.
  • The third major pair of salivary glands is the sublingual glands, which are situated on the bottom of the mouth just under the tongue.
  • Other than these, there are hundreds of minor salivary glands which deposit saliva via ducts around our mouth.

Causes of Sialadenitis

A bacterial infection is the most common cause of sialadenitis, especially the Staphylococcus aureus bacteria. Other species of bacteria include Haemophilus influenzae, Streptococcus viridans, Escherichia coli and Streptococcus pyogenes. Sialadenitis or the infection occurs as a result of decreased saliva production. This commonly occurs due to inflammation or blockage of the salivary gland duct. There also are certain medical conditions and viruses which also lead to reduction in the production of the saliva causing Sialadenitis and these are:

  • HIV (Human Immunodeficiency Virus).
  • Mumps is a contagious viral infection, which commonly occurs in children who have not received immunization.
  • Parainfluenza types 1 & 2 and Influenza A.
  • Herpes virus.
  • Mucous blocking the salivary duct can cause Sialadenitis.
  • A stone in the salivary duct which is crystallized minerals which form in the salivary ducts.
  • A tumor.
  • Sjogren’s syndrome, which is an autoimmune condition which occurs as a result of dry mouth can cause Sialadenitis.
  • Sarcoidosis is a medical condition where patches of inflammation develop all over the body.
  • Malnutrition or dehydration.
  • Inadequate oral hygiene.
  • Cancer treatment of the head and neck, such as radiation.

Risk Factors for Sialadenitis

  • Having inadequate oral hygiene can lead to Sialadenitis.
  • Age above 65 years.
  • Lack of immunization against mumps.
  • AIDS or being HIV-positive.
  • Diabetes.
  • Sjogren’s syndrome.
  • Malnutrition.
  • Bulimia.
  • Xerostomia, a condition where there is dry mouth.
  • Alcoholism.

Signs & Symptoms of Sialadenitis

The symptoms of sialadenitis are similar to symptoms of other medical conditions also. The following are the common symptoms indicating sialadenitis.

  • A persistent foul or abnormal taste in the mouth.
  • Not being able to completely open the mouth.
  • Pain or discomfort when opening the mouth or eating.
  • Mouth dryness is a common sign and symptom of Sialadenitis.
  • Pus in the mouth.
  • Pain in the mouth.
  • Facial pain.
  • Facial swelling or swelling in the neck.
  • Presence of swelling or redness over the jaw, anterior to the ears, below the jaw or in the base of the mouth.
  • Fever or chills, signs which indicate infection.
  • Serious symptoms requiring emergency treatment include increased fever, difficulty in swallowing or breathing and worsening symptoms.

Complications of Sialadenitis

  • Complications of a sialadenitis are quite uncommon; however, there is always a possibility. If Sialadenitis or the infection is left untreated, then there is accumulation of pus, which can form an abscess in the salivary gland.
  • If the patient is suffering from parotitis, then there is severe swelling of the neck, which can cause destruction of the affected glands.
  • If the sialadenitis occurs as a result of a benign tumor, then it can cause enlargement of the glands. Malignant tumors grow rapidly and lead to absence of movement in the involved side of the face.
  • Complications can also occur if the initial bacterial infection extends from the salivary gland to other areas of the body, such as cellulitis or Ludwig’s angina.

Investigations for Sialadenitis

Visual examination helps in determining if the patient is suffering from a sialadenitis. If the patient has pain or pus in the affected gland, then it indicates a bacterial infection. Additional testing is done to confirm the diagnosis and to find out the underlying cause. The following tests are done for diagnosis of Sialadenitis:

  • Ultrasound.
  • Computed tomography (CT) scan.
  • Magnetic resonance imaging (MRI).
  • Biopsy can also be done of the affected salivary glands and ducts and the sample fluid or tissue is sent to the laboratory to test for bacteria or viruses.

Treatment of Sialadenitis

Treatment for Sialadenitis depends on the underlying cause, the severity of the infection, and any additional symptoms which the patient may have, such as pain or swelling.

  • In case of bacterial infection causing Sialadenitis, antibiotics are used for treat fever or pus.
  • If there is any abscess, then fine needle aspiration is done to drain it.
  • Warm compresses help in relieving pain associated with Sialadenitis.
  • Over-the-counter pain killers help in relieving pain associated with Sialadenitis.
  • Surgery is usually not required for most of the cases of sialadenitis. However, surgery may be needed in cases of chronic or recurring infection. Although a rare occurrence, surgery may comprise of removing a part or all of parotid salivary gland or the submandibular salivary gland.

Home Remedies for Sialadenitis

  • If you are suffering from Sialadenitis then it is important to daily drink eight to 10 glasses of water with a lemon in it. This will help in stimulating the saliva and keeping the glands clear.
  • Application of warm compresses to the affected gland is also beneficial home remedy for Sialadenitis.
  • The affected gland should be gently massaged.
  • The mouth should be rinsed with lukewarm salt water as that can be an effective home remedy for Sialadenitis.
  • Sucking on sour lemons or free lemon candy, which is sugar free also helps in encouraging the flow of the saliva and in reducing swelling associated with Sialadenitis.

Prevention of Sialadenitis

There is no specific way to prevent most of the cases of sialadenitis. The risk of developing sialadenitis can be reduced by maintaining good oral hygiene and drinking plenty of fluids. Patient should floss and brush his/her teeth twice daily.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: August 17, 2015

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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