Overview:
Sialadenitis refers to an infection in the salivary gland. It develops when harmful bacteria or viruses build up in the salivary glands. Sialadenitis can also stem from a blockage in the salivary duct, causing inflammation. Salivary gland infections are most commonly developed in the parotid gland that is in front of the ear and the submandibular gland, which is located under the chin.
What Is Sialadenitis?
Sialadenitis refers to a condition that is characterized by inflammation of one or more of the salivary glands. The term “sial” refers to saliva, “aden” refers to a gland, and “itis” refers to inflammation. Sialadenitis can be acute or chronic and is usually associated with pain, tenderness, and localized swelling of the affected area.
Sialadenitis usually affects a single parotid gland and is most commonly reported in individuals between the ages of 50 to 60 years. However, it can occur at any age. It can even be seen in a newborn. It is otherwise known as salivary gland inflammation or adenitis.
Acute sialadenitis is usually caused by a bacterial infection which is characterized by rapid onset of pain and swelling, and chronic sialadenitis is characterized by intermittent recurrent episodes of tender swelling.
What Causes Sialadenitis?
What exactly causes sialadenitis is still not clear. The following conditions play a role in causing sialadenitis:
Salivary Gland Stone Formation:
The condition is mostly associated with the formation of salivary gland stones. Salivary glands secrete saliva through the small ducts present in the mouth, helping with the lubrication inside of the mouth, and it also moistens and softens the food. The antibacterial properties of the saliva and its speedy flow nature through the ducts help in preventing infections. And there are a plethora of factors such as dehydration, illnesses, or certain medications that can reduce the salivary flow causing the deposits to settle on the walls of the salivary duct blocking the path of the salivary flow, thereby slowing down the flow of saliva. Eventually, these deposits result in the formation of salivary stones; a condition referred to as sialolithiasis.
These salivary stones, over time, can block the duct allowing the bacteria to move from the mouth into the salivary ducts causing inflammation of the salivary ducts.
Drugs that reduce the salivary flow are:
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Antihistamines.
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Diuretics.
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Psychiatric medications.
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Beta-blockers.
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Barbiturates.
Bacteria or Viruses:
Sialadenitis is usually caused by bacteria or viruses. And most commonly, sialadenitis is caused by bacterial infections caused by Staphylococcus aureus. Other bacteria that contribute to the development of sialadenitis include Streptococci, Coliforms, and various other anaerobic bacteria.
Sialadenitis is less commonly caused by viruses compared to bacteria. Some of the viruses that can play a role in the development of sialadenitis include mumps virus, HIV (human immunodeficiency virus), coxsackievirus, parainfluenza type I and type II, herpes, and influenza virus.
The risk factors that increase the risk of developing sialadenitis include:
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Poor oral hygiene.
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People with dry mouths (Sjogren’s syndrome).
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Those who have had radiation therapy to the oral cavity.
How Do I Know If I Have Sialadenitis?
The following signs and symptoms are noticed in the case of sialadenitis:
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Swelling of one or more salivary glands, which represents swelling in the cheek and the neck region.
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Tenderness and redness in the affected area.
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Fever, particularly when the inflammation leads to infection.
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Chills.
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Decreased saliva.
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Dry mouth (xerostomia).
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Pain while chewing.
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Pus discharge into the mouth.
How Is Sialadenitis Diagnosed?
Sialadenitis is diagnosed by a combination of thorough medical history and complete physical examination. In most cases, sialadenitis is diagnosed during the physical examination of the face and neck. However, a few diagnostic tests may be recommended to determine the underlying cause. Some of these include:
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Complete Blood Count (CBC):
This diagnostic test is done to examine the presence of infection.
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Culture Sensitivity Tests:
The discharge from the salivary duct is cultured, and an antibiotic sensitivity test is done to check if there is a bacterial infection.
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Sialendoscopy:
This is an endoscopic procedure done to examine the salivary gland ducts.
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Dental X-rays:
Dental X-rays help determine obstruction in the salivary gland.
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Computed Tomography (CT) or Ultrasound:
This helps determine blockages in the salivary gland due to salivary stone formation or tumors.
How Is Sialadenitis Treated?
Sialadenitis is treated based on the underlying cause of the infection.
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If the infection is caused by bacteria, then antibiotics will be the treatment of choice. When the infection does not respond to antibiotic therapy, then the abscess is drained.
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If the virus is the underlying cause, then the treatment includes antiviral medications.
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Besides that, since sialadenitis is caused due to decreased salivary flow, the patients are requested to drink plenty of fluids or eat foods that increase the salivary flow, like candies or lemon juice.
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Warm compresses and gland massage are recommended to improve the flow of saliva.
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In recurring cases of sialadenitis or in case of a chronic condition, or when the infection does not start to respond to hydration and intravenous (IV) antibiotic therapy, surgery is recommended. Surgical incision, drainage of the salivary gland will be done, and if salivary stones are blocking the glands, then the stones will also be removed surgically. Sialendoscopy is a minimally invasive procedure used to manage small salivary stones, whereas in the case of large salivary stones open surgery procedure is suggested. In a few cases, surgical removal of the entire gland or superficial parotidectomy or submandibular gland excision is recommended.
What Is the Outlook for Sialadenitis?
The overall prognosis of sialadenitis depends on the etiology. However, with proper treatment, the symptoms of acute sialadenitis resolve within a week. And in most cases, sialadenitis resolves with conservative medical management, and the complications are not very common but can occur.
Conclusion:
Sialadenitis can be in different forms: acute or chronic, and the symptoms may vary from person to person depending on the severity of the condition. So contact a dentist when your symptoms do not respond to home care treatment and interfere with eating, chewing, and swallowing. However, acute sialadenitis rarely causes additional complications.