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Salivary gland infections

Definition

Salivary gland infections are viral or bacterial infections of the saliva-producing glands.

There are three pairs of major salivary glands.

• The two largest are the parotid glands, one in each cheek over the jaw in front of the ears. Inflammation of one or more of these glands is called parotitis, or parotiditis.
• Two submandibular glands are at the back of the mouth on both sides of the jaw.
• Two sublingual glands are under the floor of the mouth.

All of the salivary glands empty saliva into the mouth through ducts that open at various locations in the mouth.

Alternative Names

Parotitis; Sialadenitis

Causes, incidence, and risk factors

Salivary gland infections are somewhat common, and they can return in some people.

Viral infections such as mumps often affect the salivary glands (mumps most often causes parotiditis). Mumps is a rare infection today because of immunization with the MMR vaccine.

Bacterial infections usually result from a blockage (such as salivary duct stones) or poor oral hygiene. They can be seen in people who are dehydrated and in the hospital.

Symptoms

• Abnormal tastes, foul tastes
• Decreased ability to open the mouth
• Dry mouth
• Fever
• Mouth or facial pain, especially when eating
• Redness over the side of the face or the upper neck
• Swelling of the face (particularly in front of the ears, below the jaw, or on the floor of the mouth)

Signs and tests

An examination by the health care provider or dentist will show that the salivary glands are enlarged. Pus may drain into the mouth. The gland may be painful, most often if there is an infection caused by bacteria.

A CT scan or ultrasound may be done if the doctor suspects an abscess.

Treatment

In some cases, no treatment is needed.

If there is pus or a fever, or if the infection is caused by bacteria, antibiotics may be prescribed. Antibiotics are not effective against viral infections.

If there is an abscess, surgery to drain it or aspiration may be done.

Practice good oral hygiene. Brushing your teeth and flossing thoroughly at least twice per day may help with healing and prevent an infection from spreading. If you are a smoker, stop smoking to help with recovery.

Warm salt water rinses (1/2 teaspoon of salt in 1 cup of water) may be soothing and keep the mouth moist.

Drink lots of water and use sugar-free lemon drops to increase the flow of saliva and reduce swelling. Massaging the gland with heat may help.

Support Groups

Expectations (prognosis)

Most salivary gland infections go away on their own or are cured with treatment. Some infections will return. Complications are not common, but they may occur.

Complications

• Abscess of salivary gland
• Infection returns
• Spread of infection (cellulitis, Ludwig's angina)

Calling your health care provider

Call your health care provider if:

• You have symptoms of a salivary gland infection
• You've been diagnosed with a salivary gland infection and symptoms get worse, especially if your fever increases or you have breathing or swallowing difficulty (these may be emergency symptoms).

Prevention

In many cases, salivary gland infections cannot be prevented. Good oral hygiene may prevent some cases of bacterial infection.

References

Elluru RG. Physiology of the salivary glands. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010:chap 84.

Rogers J, McCaffrey TV. Inflammatory disorders of the salivary glands. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010:chap 86.