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Salivary Gland Problems

Checked: 20-08-2021 by Rob Adams Next Review: 20-08-2023

Overview

There are CKS guidelines on:

Salivary Gland Tumours

If there is a parotid or submandibular gland swelling that is persistent and/or unexplained, then submit a 2WW referral - see Head and Neck - 2WW page

Salivary Gland Stones (sialolithiasis)

See CKS guidelines on salivary gland calculus.

Stones can form in the salivary gland ducts, most commonly affecting the submandibular gland.

Characteristically, swelling and tenderness worsens when the person is eating due to an increase in saliva production. Symptoms may last for a few minutes or hours before settling. If symptoms last for a few days, suspect secondary infection. Self- care can encourage the stone to pass and help to manage symptoms, but most patients will require referral for removal of the stone.

Secondary bacterial infection can be a complication and if suspected should be treated with broad spectrum antibiotics.

Persistent gland enlargement and inflammation can result in a permanently swollen salivary gland (chronic obstructive sialadenitis).

Referral should be made via eRS to oral and maxillofacial surgery, the urgency depending on clinical judgement.

Alternatively consider advice and guidance.

Salivary gland infection (sialadenitis)

Parotitis can be caused by infective and non-infective causes including bacterial infection and Mumps.

Please also see CKS for further information on the differential diagnosis of parotitis:

What else may cause parotitis?

If bacterial infection is suspected then consider treating with broad spectrum antibiotics.

Referral

Consider using the oral and maxillofacial advice and guidance service.

If a referral is required then this should be made via eRS to Oral and Maxillofacial Surgery.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

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