The salivary glands perform an important function in producing saliva in the mouth and throat. Saliva is produced by three major paired salivary glands (parotid, submandibular, and sublingual glands) as well as hundreds of minor salivary glands that reside in the mouth and throat. Saliva serves to lubricate food in preparation for its passage through the digestive system. Saliva also contains important immune elements which contribute to the body’s defenses against pathogens that may enter the body in food or air. Furthermore, saliva contains important enzymes which begin the process of food degradation for digestion.
Salivary gland diseases can be divided into three major categories: infections, tumors, and rheumatologic states of low salivary flow. Infections of the salivary glands can occur spontaneously or as a result of dehydration and are typically seen in patients taking multiple medications. Salivary stones can also occur in dehydrated patients, blocking the salivary ducts leading to the mouth and causing secondary infections of the salivary glands. Salivary infections are manifest by pain and swelling of the affected gland.
Tumors of the salivary glands are usually identified by the patient as a painless mass in front of the ear, in the neck, or in the mouth and throat. A majority of salivary tumors are benign, but all salivary tumors need to be evaluated by a Head and Neck Surgeon in order to determine the nature of the lesion. The evaluation of salivary masses may include an imaging study such as ultrasound or CT scanning. Surgery is the mainstay of treatment in a majority of salivary tumors.
Sjögren’s Syndrome is a rheumatologic condition associated with dry mouth and dry eyes. Sjögren’s Syndrome is diagnosed by removing a minor salivary gland (usually 1-2 millimeters) from the inner lip in conjunction with office ultrasonography of the neck. Both of these procedures can be performed in the office. Sjögren’s Syndrome is treated with a variety of medicines including drugs that promote salivary flow and steroids. A Rheumatologist will work together with an Otorhinolaryngologist in the management of patients with Sjögren’s Syndrome.