If you notice swelling in your ear or jaw, you may have a problem with your salivary glands that should be evaluated by your dentist.
“Swelling is quite common in the minor salivary glands in the lower lip,” said Petros Yoon, DDS '15, assistant professor of diagnostic sciences and surgical dentistry at the University of Colorado School of Dental Medicine. “It’s often caused by bite trauma, which blocks the gland duct and makes it ‘balloon.’”
Everyone has a variety of salivary glands in their mouth. They produce saliva and help with overall oral health and digestion.
Types of salivary glands
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Ballooning of the minor salivary gland is called a mucocele, which is by far the most common type of swelling, according to Yoon. Mucoceles can grow large and become painful. Although they can resolve spontaneously, they sometimes require surgery.
“I recently had a patient with a mucocele on the lower left lip, and he kept biting it,” Yoon said. “It was swollen enough that he had secondary bite trauma that caused an ulceration, so we removed the mucocele.”
Mucoceles are different from canker sores, which are shallow ulcers that do not swell.
Enlargement of the parotid, submandibular and sublingual glands are less common and should be followed closely. It’s important to observe whether the glands are symmetrical. If one side feels larger than the other, or you notice lumps or bumps that don’t improve within a few weeks, you should see your dentist or medical provider.
Swollen or enlarged parotid glands can be caused by a variety of factors. These include bacterial or viral infections like the mumps, a blocked salivary duct or salivary gland stones. The latter, called sialoliths, are similar to kidney stones. Autoimmune disorders like Sjogren disease, which attack the body’s salivary glands, as well as both benign and malignant tumors, can also cause swelling, according to Yoon.
A blocked sublingual salivary gland can sometimes cause swelling of the floor of the mouth, called a ranula, he added.
Medical or dental providers begin with a palpation exam — pressing on the mouth, jaw or neck — and a thorough head and neck exam to check for abnormalities. They will also collect some of your saliva to look at consistency and color. Healthy saliva should be clear and watery, whereas cloudy, sticky saliva may indicate an infection. Salivary gland stones are diagnosed by X-ray, ultrasound or, sometimes, during a palpation exam. Biopsies also may be done to rule out a benign or malignant tumor.
If infection is causing the swollen glands, dentists will recommend antibacterial or antiviral therapy. An oral surgeon or otolaryngologist (an ear, nose and throat doctor) can remove salivary gland stones. If the gland stones are small, sugar-free lozenges or lemon drops can help stimulate saliva to flush them out. Mucoceles can be removed, especially if they’re prone to repeated bite injury. Ruling out autoimmune diseases or malignancy may require surgical removal or a biopsy, Yoon noted.
“Persistent swelling of the salivary glands should not be ignored,” he added. “It needs to be evaluated by a dentist or physician.”