chronic

Salivary gland stone (sialolithiasis)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Anatomy, Head and Neck, Submandibular Gland - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK542272/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD66.03 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against2 documents

No dose - referral pathway, no medicine given in primary care
Salivary gland stone (sialolithiasis) - disease-level clinical article (sialolithiasis-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (1)

Swelling on one side of a salivary gland, felt as a neck lump, with sudden pain that gets worse while eating is the usual complaint [neck lump]

Signs — what you find (3)

The affected gland looks swollen compared to the other side on exam
A large stone may be visible in the mouth as an oval or round white-to-yellow object
A stone that is not visible can often still be felt along the path of the duct or gland

Tests (7)

Plain occlusal X-rays catch large stones but miss small ones, and only about 8 in 10 stones show up on X-ray at all
Injecting contrast into the duct for X-ray imaging is the traditional gold-standard test, though it carries radiation and contrast-reaction risk
A non-contrast CT scan detects calcified stones well and quickly, but shows the duct system poorly
Adding IV contrast to the CT gives a better look at the ducts and soft tissue with less overall radiation
MRI of the salivary ducts avoids radiation and contrast but is slower, costlier, and less available
Direct scope viewing of the duct gives an accurate diagnosis and can remove the stone at the same time
On ultrasound a stone looks like a bright spot with a shadow behind it, and detection is best for stones over 2 to 3 mm

If not this — what else fits (5)

Gland inflammation or infection without a stone can look the same as sialolithiasis
A tumor of the salivary gland is on the differential for gland swelling
Skin and soft-tissue infection of the face can mimic gland swelling
Dental decay leading to an abscess can present with similar facial swelling
Shingles affecting the face is included among conditions that can resemble this presentation

SourceStatPearls "Sialolithiasis" - disease-level clinical article

Presentation findings are traced to the source above.

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line

Adult dose and duration

A calcified stone blocking a salivary duct (usually submandibular) causes painful swelling that worsens with eating. GP advises hydration, sialogogues (e.g. sour sweets), gland massage, and analgesia; gives antibiotics if the gland is infected; refers to ENT/maxillofacial for stone removal if it does not resolve. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Cautions

No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
RED FLAG - Specific physical examination signs indicating superimposed infection requiring antibiotic therapy (cervical adenopathy, purulent discharge from duct, periductal erythema) are omitted
RED FLAG - Complications of chronic untreated obstruction include permanent gland fibrosis and atrophy.
RED FLAG - Facial swelling with fever or pus, suggesting suppurative sialadenitis, signs of abscess, or recurrent stones.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.