Medically reviewed by Drugs.com. Last updated on Jan 18, 2021.
Broken jaw: Injuries could cause a fracture or dislocation of the lower jaw, thus causing swelling and pain. Joint pain: If the child has joint problems, such as juvenile arthritis, then the pain could occur in various joints of the body, including the jaw (8). Pain may worsen during eating. Symptoms may include: A tender, painful lump in the cheek or under the chin. A foul-tasting discharge of pus from the duct into the mouth. In severe cases, fever, chills and general weakness. Viral infections – The first symptoms often include: Fever. Jaw pain, which sometimes radiates to other areas of the face, is a common concern. It can develop due to sinus infections, toothaches, issues with the blood vessels or nerves, or other conditions.
- Health Guide
What are Salivary Gland Disorders?
The salivary glands make saliva and release it into the mouth.
There are three pairs of relatively large, major salivary glands:
Parotid glands. Located in the upper part of each cheek, close to the ear. The duct of each parotid gland empties onto the inside of the cheek, near the molars of the upper jaw.
Submandibular glands. Under the jaw. They have ducts that empty behind the lower front teeth.
Sublingual glands. Beneath the tongue. They have ducts that empty onto the floor of the mouth.
In addition to these major glands, 600 to 1,000 very tiny, minor salivary glands are scattered throughout the mouth and throat. They are located under the moist skin that lines the:
Inner lips
Inner cheeks
Palate
Back of the throat
Back portion of the tongue
Pharynx
Sinuses
Some of the most common salivary gland disorders include:
Sialolithiasis (salivary gland stones).Tiny, calcium-rich stones sometimes form inside the salivary glands. The exact cause of these stones is unknown. Some stones may be related to:
Dehydration, which thickens the saliva
Decreased food intake, which lowers the demand for saliva
Medications that decrease saliva production, including certain antihistamines, blood pressure drugs and psychiatric medications
Some stones sit inside the gland without causing any symptoms. In other cases, a stone blocks the gland's duct, either partially or completely. When this happens, the gland typically is painful and swollen, and saliva flow is partially or completely blocked. This can be followed by an infection called sialadenitis.
Sialadenitis (infection of a salivary gland). Sialadenitis is a painful infection that usually is caused by bacteria. It is more common among elderly adults with salivary gland stones. Sialadenitis also can occur in infants during the first few weeks of life.
Without proper treatment, sialadenitis can develop into a severe infection, especially in people who are debilitated or elderly.
Viral infections. Systemic (whole-body) viral infections sometimes settle in the salivary glands. This causes facial swelling, pain and difficulty eating. The most common example is mumps.
Cysts (tiny fluid-filled sacs). Babies sometimes are born with cysts in the parotid gland because of problems related to ear development before birth. Later in life, other types of cysts can form in the major or minor salivary glands. They may result from traumatic injuries, infections, or salivary gland stones or tumors.
Benign tumors (noncancerous tumors). Most salivary gland tumors occur in the parotid gland. The majority are benign. The most common type of benign parotid tumor usually appears as a slow-growing, painless lump at the back of the jaw, just below the earlobe. Risk factors include radiation exposure and possibly smoking.
Malignant tumors (cancerous tumors). Salivary gland cancers are rare. They can be more or less aggressive. The only known risk factors for salivary gland cancers are Sjogren's syndrome and exposure to radiation. Smoking also may play some role.
Sjogren's syndrome. Sjogren's syndrome is a chronic autoimmune disorder. The body's immune defenses attack different parts of the body, including the salivary glands, the lacrimal glands (glands that produce tears), and occasionally the skin's sweat and oil glands.
Most people with this disease are women who first develop symptoms during middle age. In about half of cases, the illness occurs together with rheumatoid arthritis, systemic lupus erythematosus (lupus), scleroderma or polymyositis.
Sialadenosis (nonspecific salivary gland enlargement). Sometimes, the salivary glands become enlarged without evidence of infection, inflammation or tumor. This nonspecific enlargement is called sialadenosis. It most often affects the parotid gland, and its cause remains unknown.
Symptoms
Symptoms vary, depending on the specific type of salivary gland disorder:
Sialolithiasis. The most common symptom is a painful lump in the affected gland. Pain may worsen during eating.
Sialadenitis. Symptoms may include:
A tender, painful lump in the cheek or under the chin
A foul-tasting discharge of pus from the duct into the mouth
In severe cases, fever, chills and general weakness.
Viral infections – The first symptoms often include:
Fever
Headache
Muscle aches
Joint pain
Poor appetite
Malaise
These symptoms are followed by swelling in the parotid glands, usually on both sides of the face. It may difficult to fully open the mouth.
Cysts – A cyst causes a painless lump. It sometimes grows large enough to interfere with eating.
Tumors – A slow-growing lump is the most common symptom of both cancerous and noncancerous salivary gland tumors. The lump is sometimes painful. This lump may be found in the cheek, under the chin, on the tongue or on the roof of the mouth.
Sjogren's syndrome – The main features of Sjogren's syndrome are swelling of the salivary glands, dry eyes and a dry mouth.
Sialadenosis – This condition typically causes painless swelling of the parotid glands on both sides of the face.
Diagnosis
You will describe your symptoms. The doctor will review your:
Medical history
Smoking history
Current medications
Diet
The doctor also may ask whether you:
Have recently been hospitalized for surgery. Decreased intake of food and liquids after surgery can increase the risk of salivary gland stones and infections.
Have ever received radiation treatments for cancer of the head or neck
Were ever diagnosed with mumps or immunized against mumps
Have recently been exposed to anyone with the flu or another viral illness
Have any autoimmune condition, such as rheumatoid arthritis
Next, your doctor will examine your head and neck, including the area inside your mouth. The doctor will press gently on areas of your cheeks to feel for swelling of the parotid gland. He or she also will feel under your jaw for enlarged salivary glands. Tell your doctor if there is any tenderness during the exam.
Depending on your symptoms, history and physical findings, the doctor may order one or more of the following tests:
Blood tests. To look for a high white blood count that would suggest a bacterial infection. Other blood tests might include testing for Sjogren's syndrome, nutritional deficiencies and viral infections.
X-rays. To detect salivary gland stones.
Magnetic resonance imaging (MRI) or computed tomography (CT) scans. These tests can detect tumors and stones that are not visible on X-rays.
Fine-needle aspiration. This test uses a thin needle to remove cells from the salivary gland to determine whether a tumor is cancerous.
Sialography. Dye is injected into the gland's duct so that the pathways of saliva flow can be seen.
Salivary gland biopsy. This is removal of a small piece of tissue to diagnose a cyst, tumor, or Sjgren's syndrome.
Salivary function test. To help diagnose Sjogren's syndrome.
Eye tests. To look for evidence of Sjogren's syndrome.
Expected Duration
How long a salivary gland problem lasts depends on the specific disorder.
Sialolithiasis. Small stones sometimes pass out of the duct on their own. However, larger stones usually stay in the gland until they are removed.
Sialadenitis. Symptoms usually begin to subside within 48 hours of treatment with antibiotics.
Viral infections. With mumps, symptoms usually last about 10 days.
Cysts. A small, shallow cyst can be a short-term problem that drains on its own. Large cysts often grow larger until they are removed surgically.
Tumors. Tumors last until they are removed.
Sjogren's syndrome. This is a lifelong illness.
Sialadenosis. Sialadenosis related to a medical problem generally persists as long as the medical problem does.
Prevention
You can lower your risk of viral infections of the salivary glands. To do so, get immunized against mumps and influenza.
There are no specific guidelines to protect against other types of salivary gland disorders. However, it is helpful to:
- Avoid smoking.
- Eat a healthy diet.
- Drink six to eight glasses of water daily to avoid dehydration.
- Practice good oral hygiene, with regular tooth brushing and flossing.
Treatment
The treatment varies, depending on the disorder:
Sialolithiasis. If the stone is located near the end of the duct, your doctor may be able to press it out gently. Deeper stones can be removed with surgery.
Sialadenitis. Treatment includes:
Drinking fluids or receiving fluids intravenously
Antibiotics
Warm compresses on the infected gland
Encouraging saliva flow by chewing sour, sugarless candies or by drinking orange juice
If these methods do not cure the infection, surgery can drain the gland.
Viral infections. These infections almost always go away on their own. Treatment focuses on relieving symptoms through:
Rest
Drinking fluids to prevent dehydration
Taking acetaminophen (Tylenol) to relieve pain and fever
Cysts. A small cyst may drain on its own without treatment. Larger cysts can be removed using traditional surgery or laser surgery.
Benign tumors. Noncancerous tumors usually are removed surgically. In some cases, radiation treatments are given after surgery to prevent the tumor from returning.
Malignant tumors. Smaller, early stage, low-grade tumors often can be treated with surgery alone. However, larger, high-grade tumors usually require radiation following surgery. Inoperable tumors are treated with radiation or chemotherapy.
Sjogren's syndrome. The main symptom related to the salivary glands is a dry mouth. Options include:
Medication to stimulate more saliva secretion, such as pilocarpine (Salagen) and cevimeline (Evoxac)
Sugarless gum and candy to stimulate saliva production
Avoiding medications that can make dry mouth worse
Not smoking
Good oral hygiene is a must. People with Sjogren's have teeth and gum problems because of low saliva secretion.
Sialadenosis. Treatment is aimed at correcting any underlying medical problem. Once the medical problem improves, the salivary glands should shrink to normal size.
When To Call a Professional
Contact your doctor or dentist if you develop a persistent lump or swelling anywhere in your neck, jaw, cheek, tongue or hard palate.
Call your doctor or dentist immediately if the lump:
Is painful, red or tender
Occurs together with fever and chills
Interferes with your ability to open your mouth, speak, chew or swallow
Pain In Left Jaw
Prognosis
The outlook depends on the disorder:
Sialolithiasis. If a stone is removed promptly, the prognosis is usually excellent. About one in five people have stones return.
Sialadenitis. With prompt antibiotic treatment, the prognosis is usually very good. The highest risk of complications is in elderly people and those with chronic, debilitating illnesses.
Viral infections. Most people recover fully without complications.
Cysts. In most cases, the prognosis is good. Cysts develop again in some people. But these usually can be removed without complications.
Benign tumors. The prognosis is usually very good. However, tumors develop again in some people as late as 10 to 15 years after the first tumor was removed.
Malignant tumors. The prognosis is usually best for parotid tumors. It is poorest for:
Cancers of the sublingual or minor salivary glands
Cancers that have invaded the nearby facial nerve
Bulky cancers that have spread
Sjogren's syndrome. The prognosis varies. Some people have only mild symptoms. Others have more severe forms of the illness that affect the quality of life.
Sialadenosis. Once any underlying illness is treated, the salivary glands usually return to their normal size.
External resources
Occasional Lower Jaw Pain
National Institute of Dental and Craniofacial Research
National Institutes of Health
http://www.nidcr.nih.gov/
American Academy of Otolaryngology – Head and Neck Surgery
http://www.entnet.org/
American Association of Oral & Maxillofacial Surgeons
http://www.aaoms.org/
Sjogren's Syndrome Foundation
http://www.sjogrens.org
National Cancer Institute (NCI)
U.S. National Institutes of Health
http://www.nci.nih.gov/
American Cancer Society (ACS)
http://www.cancer.org/
Sporadic Jaw Pain
Further information
Lower Jaw Pain
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