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Salivary Gland Disease and Tumors

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What is salivary gland disease?

The salivary glands produce saliva to moisten the mouth, to help protect teeth from decay and to digest food. The three major salivary glands are the parotid gland, submandibular gland (also called the submaxillary gland) and sublingual glands. Saliva drains into the mouth through small tubes called ducts.

  • The parotid gland makes 25 percent of the saliva and drains into the mouth near the upper teeth.
  • The submandibular gland makes 70 percent of the saliva and drains into the mouth from under the tongue.
  • The sublingual gland makes 5 percent of the saliva and drains into the floor of the mouth.

In addition, 600-1,000 tiny glands (the minor salivary glands) are located in the lips, inner cheek, and the lining of the mouth and throat.

The most common problems in the salivary gland occur when the ducts become blocked and saliva cannot drain.

Problems with the ducts

Sialolithiasis (sigh a lo THIGH a sis) is a condition in which tiny salivary stones form in the glands. The stones, called sialoliths, are made of calcium.

Some stones do not cause any symptoms, but some block the ducts. The saliva flow is partially or completely stopped. The gland might enlarge, and an infection can develop.

Sialadenitis (sigh a la dent I tis) is a painful infection of a salivary gland. Staphylococcus, streptococcus, Haemophilus influenzae or anaerobic bacteria are usually the cause. The condition is common with elderly people who have salivary gland stones, but infants can develop sialadenitis during the first few weeks of life.

Sialadenitis can become a severe infection if not treated properly.

Viral infections such as mumps, flu, Coxsackie viruses, echovirus and cytomegalovirus can make the salivary glands enlarge.

Cysts can develop in the salivary glands after injuries, infections, stones or tumors. Sometimes babies are born with cysts in the parotid gland because of a problem with early development of the ears.

Tumors

Most salivary tumors are benign (noncancerous), but they can also be cancerous. Most salivary tumors grow in the parotid gland.

Pleomorphic adenomas are the most common parotid tumor. It grows slowly and is benign. A pleomorphic adenoma begins as a painless lump at the back of the jaw, just below the earlobe. These are more common in women.

Benign pleomorphic adenomas can also grow in the submandibular gland and minor salivary glands, but less often than in the parotid.

Warthin’s tumor is the second most common benign tumor of the parotid gland. It is more common in older men.

Cancerous (malignant) tumors are rare in the salivary glands and usually occur between ages 50 to 60. Some types grow fast, and some are slow-growing.

Other salivary gland conditions

Sjögren’s syndrome is chronic disease. White blood cells attack the moisture-producing glands such as the salivary glands, the tear-producing glands, and sometimes the sweat and oil glands. Middle-aged women are most affected. Sjögren’s syndrome is frequently seen in people who have rheumatoid arthritis, lupus, scleroderma and polymyositis.

Sialadenosis is a painless enlargement of the salivary gland without a known cause. The parotid is usually the affected gland.

What causes salivary gland disease?

The exact cause of stone formation is not known, but certain factors might contribute to the condition:

  • Dehydration, which thickens the saliva
  • Decreased food intake, which lowers the demand for saliva
  • Antihistamines, blood pressure medications, psychiatric medications and other medication that can decrease saliva production

What are the risk factors for salivary gland disease?

Factors that increase the risk to develop sialadenitis:

  • Dehydration, malnutrition, eating disorders
  • Recent surgery, chronic illness, cancer, prematurity
  • Antihistamines, diuretics, psychiatric medications, blood pressure medications, barbiturates
  • History of Sjögren’s syndrome
  • Air blowing occupations (trumpet playing, glass blowing)

Risk factors for pleomorphic adenomas:

  • Radiation exposure
  • Smoking

Risk factors for salivary gland cancers:

  • Sjögren’s syndrome
  • Exposure to radiation
  • Smoking

Sialadenosis is more likely to develop in people who are:

  • Obese
  • Pregnant or breastfeeding
  • Malnourished or have eating disorders
  • Alcoholics with liver cirrhosis
  • Having kidney failure or thyroid problems

What are symptoms of salivary gland disease?

Sialolithiasis usually begins as a painful lump under the tongue. The stone blocks the flow of saliva, so pain might increase while eating.

Sialadenitis creates a painful lump in the cheek or under the chin. Foul-tasting pus drains into the mouth. Fever can occur.

Generalized viral infections cause fever, headache, muscle aches and joint pain in the entire body. If the virus settles in the parotid glands, both sides of the face enlarge in front of the ears.

A mucocele, a common cyst on the inside of the lower lip, can burst and drain yellow mucous. Other cysts can hinder eating, speaking or swallowing.

With tumors, a cancerous or noncancerous lump can grow in the roof of the mouth, in the cheek, on the tongue or under the chin. It often glows slowly and is painful.

Sjögren’s syndrome causes decreased moisture in glands. Dry mouth, tooth decay, mouth sores, enlarged salivary glands, sialoliths and recurrent salivary gland infections are possible symptoms. The syndrome also effects moisture in the eyes, which might cause chronic eye infections, corneal ulcers and vision loss.

Sialadenosis is usually painless, but the paratoid glands enlarge.

How is salivary gland disease diagnosed?

Your doctor will ask questions about your symptoms and medical history. During the physical, the doctor will examine your head, neck and the inside of your mouth for lumps or areas of pain.

The doctor might order:

  • An X-ray, CT scan or MRI to look for stones or tumors
  • A fine needle biopsy to determine if a tumor is cancerous
  • Salivary function tests, eye tests and blood tests to diagnose Sjögren’s syndrome
  • A sialogram X-ray that uses dye to look for problems in the salivary ducts

How is salivary gland disease treated?

Small stones might pass out of the duct without treatment. A doctor might be able to remove a stone by pressing on it if the stone is close to the opening of a duct.

Ultrasound waves can be used to shatter large stones into small pieces.

Deep or large stones are more difficult. If they cannot be removed and symptoms of pain or infection persist, the entire salivary gland may need to be removed.

Bacterial infections require taking antibiotics and extra fluid either by mouth or intravenously. Warm compresses are placed on the infected gland. Chewing sour candies encourages the flow of saliva. Surgery may be needed to drain the gland.

Antibiotics do not help cure a viral infection. The body must use its own defense system to clear itself of a virus. Bed rest, increased fluids, and acetaminophen for fever are the best ways to help the body cure itself.

Small cysts may drain without treatment. Large cysts might need surgery.

Benign tumors usually require surgical removal. Some are treated with radiation to keep them from coming back.

Malignant tumors require surgery if possible. Some tumors need surgery only; others require radiation and chemotherapy in addition to surgery. Radiation and chemotherapy are also used for tumors that are inoperable.

Prescribed medications help decrease dry mouth.

Parotidectomy

Parotidectomy is the removal of the parotid gland, the largest salivary gland. The paratoid is usually removed because of a tumor, a chronic infection or a blocked saliva gland. Most parotid gland tumors are not cancerous.

The nerve that closes the eyes, wrinkles the nose and moves the lips grows through the middle of the parotid gland. Small branches of the nerve might need to be trimmed if the gland is large and the surgeon cannot remove it. Decreased motion of facial muscles might occur while the nerve recovers from surgery. If facial movement does not completely return, rehabilitation can help restore facial movements.

Surgeons think of the gland as two separate lobes: a superficial lobe and a deep lobe. The facial nerve separates the two lobes. The parotid gland can usually be removed without permanent damage to the facial nerve. A facial nerve monitoring machine, called a facial nerve stimulator, allows the surgeons to monitor the nerve during the operation.

Benign tumors usually need only the superficial lobe removed. But if a benign tumor is deep in the gland, the deep lobe might need to be partially or completely removed.

In most cases, the entire gland is removed if the tumor is cancerous. If the tumor is small and low-grade (does not spread and does not grow quickly), the surgeon might be able to remove only the superficial lobe.

General anesthesia is required for a parotidectomy.

During the operation, the surgeon will determine the amount of tissue that should be removed. After the gland or section is taken, it is sent to a pathologist.

The pathologist slices a thin section, freezes it, colors it with special dyes, and examines it under a microscope. This procedure is called a frozen section. The frozen section is used to determine if the tumor is cancerous or benign, and the specific type of tumor. The most common type of cancer tumor in the head and neck is called squamous cell carcinoma.

After surgery

After surgery you might feel:

  • Numbness of the earlobe and incision site from the scar
  • Weak face muscles

Nerves that link to the saliva-producing areas in the parotid gland sometimes link with the nerves that control sweating in the skin. This might cause sweating of the skin at meal time (Frey’s syndrome).

A rare condition, called a salivary fistula or sialocele, can develop and cause saliva to leak through the skin.

Submandibular Sialadenectomy

A submandibular sialadenectomy is used for chronic infections, stones and tumors. Submandibular gland tumors are often malignant, in which case entire gland needs to be removed.

Many other glands in the mouth make saliva, so the mouth will still have enough saliva after the submandibular gland is removed.

Sublingual gland surgery

The incision for sublingual gland surgery is through the mouth. No incision is made in the face or neck.

Key points

  • The most common problems in the salivary gland occur when the ducts become blocked and saliva cannot drain.
  • Causes include dehydration, smoking and exposure to radiation.
  • Most salivary tumors are noncancerous, and small blockages may pass without treatment. Severe cases may require the removal of a salivary gland. 

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

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Why Is My Tongue Swollen?

Allergic reaction (not life-threatening)

When the body encounters a harmful substance, it responds with inflammation and swelling that can be protective. In many individuals, the body responds this way to substances that are not normally harmful, like foods or pollen. This is the basis of allergy, or Type 1 Hypersensitivity.

Rarity: Common

Top Symptoms: swollen face, swollen lips, lip numbness, hives, red swollen bumps or patches with a pale center, lip redness

Symptoms that never occur with allergic reaction (not life-threatening): shortness of breath, throat itching

Urgency: Primary care doctor

Hypothyroidism

Hypothyroidism, or “underactive thyroid,” means that the thyroid gland in the neck does not produce enough of its hormones. This causes a slowing of the body’s metabolism.

The condition can occur due to autoimmune disease; any surgery or radiation treatment to the thyroid gland; some medications; pregnancy; or consuming too much or too little iodine. It is often found among older women with a family history of the disease.

Common symptoms include fatigue, constantly feeling cold, weight gain, slow heart rate, and depression. If left untreated, these and other symptoms can worsen until they lead to very low blood pressure and body temperature, and even coma.

Diagnosis is made through a simple blood test.

Hypothyroidism is easily managed with daily oral medication. The patient usually starts feeling better after a couple of weeks and may even lose some extra weight. It’s important for the patient to be monitored by a doctor and have routine blood testing so that the medication can be kept at the correct levels.

Rarity: Rare

Top Symptoms: fatigue, depressed mood, difficulty concentrating, weight gain, muscle aches

Urgency: Primary care doctor

Swelling caused by use of an ace inhibitor

ACE Inhibitors are drugs used to prevent, treat or improve symptoms in conditions such as high blood pressure, coronary artery disease, heart failure and diabetes. In rare cases, these drugs can cause an allergic reaction that can be life-threatening.

Rarity: Common

Top Symptoms: shortness of breath, swollen face, trouble swallowing, swollen lips, swollen tongue

Symptoms that never occur with swelling caused by use of an ace inhibitor: hives, red swollen bumps or patches with a pale center

Urgency: Hospital emergency room

Gingivitis

Gingivitis is the inflammation of the gums. It is typically caused by poor dental hygiene and the buildup of bacteria. Its hallmark symptoms are swollen, discolored, bleeding gums. The main risk factors for the development of the disease are increasing age, smoking, and dry mouth. It is both treatable and …

Angioedema

Angioedema is a condition which can cause swelling and puffiness of the face, mouth, tongue, hand or genitals. It is often related to an allergic reaction to food, medicines or insect bites.

Rarity: Rare

Top Symptoms: nausea or vomiting, abdominal cramps (stomach cramps), diarrhea, swollen face, hand swelling

Urgency: Hospital emergency room

Salivary duct stone (sialolithiasis)

A salivary duct stone is the most common disorder of the salivary glands (where you make spit). They can range in size from tiny particles to stones that are several centimeters in length.

Rarity: Uncommon

Top Symptoms: swelling on one side of the face, swollen jaw, painful face swelling, spontaneous jaw pain, painful jaw swelling

Urgency: Phone call or in-person visit

Nephrotic syndrome

Nephrotic syndrome is a disorder of the kidneys that results in too much protein excreted into your urine. It is usually associated with damaged kidneys specifically damage to the kidneys’ filters, called glomeruli.

Kidney damage and nephrotic syndrome primarily include albuminur. ..

Anaphylaxis

Anaphylaxis is a life-threatening condition most commonly caused by an allergic reaction. In anaphylaxis, two types of immune cells — mast cells and basophils — are suddenly activated and release numerous inflammatory substances that cause blood vessels to dilate and become leaky, which can lead to low …

Causes, Symptoms and Treatment Options

Medically reviewed by Drugs.com. Last updated on Nov 1, 2020.

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.   Other parts of the body may be affected, including the joints, lungs and nervous system.

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.  Joint pain is also common.
  • 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 Sjogren’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. Benign tumors usually last until they are removed.  Cancerous tumors last until they are surgically removed (with or without radiation treatment).
  • 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:
  • 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)
    • Eye drops to reduce inflammation and increase tear production, such as cyclosporine (Restasis)
    • Tear duct plugs to improve eye lubrication
  • 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

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

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/

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Salivary Stones | Johns Hopkins Medicine

Salivary stones, also called sialolithiasis, are hardened mineral deposits that form in the salivary glands. The condition is more likely to affect people age 30 to 60 and men are more likely to get salivary stones than women.

Of all salivary gland stones, 80 percent form in the submandibular salivary glands, but they can form in any of the salivary glands, including:

  • The parotid glands on the side of the face, near the ears

  • The sublingual glands under the tongue (uncommon)

  • The minor salivary glands in the inside of the cheek or lips, under the tongue and beneath the palate (rare)

What causes salivary stones?

The cause is not known, but several factors are associated with salivary stone formation:

  • Dehydration, due to inadequate fluid intake, illness, or medications such as diuretics (water pills) and anticholinergic drugs

  • Trauma to the inside of the mouth

  • Smoking

  • Gum disease

Salivary Stones: Symptoms

Salivary stones cause swelling, pain or both in the salivary gland. Symptoms get worse when the person is eating or anticipating eating. A dentist might notice symptom-free salivary stones on a person’s x-ray during routine exams.

The symptoms can come and go over a period of weeks, or be persistent. If the stone moves or grows in a way that blocks the duct of the gland, symptoms may worsen, a sign that the gland is becoming infected, a condition called sialadenitis.

Salivary Stones: Diagnosis

The doctor will take a medical history and examine the person by gently feeling the salivary glands inside of the mouth.

If a stone is detected, the doctor may recommend imaging to rule out other conditions such as:

Imaging studies, including computed tomography (CT) and ultrasound, can detect salivary stones and distinguish them from other problems.

Salivary Stones: Treatment

Most salivary gland stones resolve with conservative treatment. Patients will get instructions on applying moist heat and gentle massage to the salivary gland. Staying well-hydrated is important. Lemon drops or other tart candies can help stimulate salivation.

Ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce pain and swelling. If the doctor notices evidence of infection, an antibiotic may be prescribed.

It is important to let the doctor know about use of dehydrating medications such as antihistamines and anticholinergic medicines.

Surgical Treatment

If conservative therapy does not improve a salivary stone, an otolaryngologist may remove it with a minimally invasive procedure called sialendoscopy.

After giving the patient local or general anesthesia, the surgeon makes a small incision inside the mouth near the affected gland and inserts a slender tube called a sialoendoscope. The surgeon can use small instruments inserted through this tube to capture and remove the stone if possible. Sialendoscopy can also help doctors locate and capture small stones or fragments deep within the salivary gland.

If a salivary stone is very large or irregularly shaped, more invasive open surgery techniques may be necessary. These procedures can usually preserve the salivary gland.

Reviewed by Dr. David Eisele from the Department of Otolaryngology-Head and Neck Surgery.

Salivary Gland Swelling, Uncertain Cause

Salivary glands make saliva in response to food in your mouth. Saliva is mostly water. It also has minerals and proteins that help break down food and keep the mouth and teeth healthy. There are 3 pairs of salivary glands:

  • Parotid glands. In front of the ear.

  • Submandibular glands. Below the jaw.

  • Sublingual glands. Below the tongue.

Each gland has a tube (duct) that carries saliva from the gland into the mouth. 

The salivary glands can sometimes get swollen. Causes can include:

Certain medicines can affect salivary flow. This can lead to swollen glands. Tell your healthcare provider about all of the medicines you take.

Tests are being done to find the cause of the swelling. These may include blood tests, X-ray, ultrasound, CT scan, or injecting dye into the duct to look for blockage. Treatment depends on the exact cause of the swelling.

Home care

  • If the area is painful, you can take over-the-counter medicines, such as acetaminophen or ibuprofen, unless you were prescribed another medicine. Wetting a cloth with warm water and putting it over the affected gland for 10 to 15 minutes at a time can also help ease pain.

  • To help prevent blockages and infections:

    • Drink 6 to 8 glasses of fluid per day (such as water, tea, and clear soup) to keep well-hydrated.

    • If you smoke, ask your healthcare provider for help to quit. Smoking makes salivary gland stones more likely.

    • Maintain good dental hygiene. Brush and floss your teeth daily. See your dentist for regular cleanings.

Follow-up care

Follow up with your healthcare provider, or as advised. See your healthcare provider for further exams and testing. If you have been referred to a specialist, make an appointment right away.

When to get medical advice

Call your healthcare provider if any of the following occur:

  • More pain or swelling in the gland

  • Inability to open mouth or pain when opening mouth

  • Fever of 100.4°F (38ºC) or higher, or as directed by your provider

  • Redness over the gland

  • Fluid (pus) draining into the mouth

  • Trouble breathing or swallowing

  • Any new symptoms

Prevention

Here are steps you can take to help prevent an infection:

  • Keep good handwashing habits.

  • Don’t have close contact with people who have sore throats, colds, or other upper respiratory infections.

  • Don’t smoke, and stay away from secondhand smoke.

  • Stay up to date with of your vaccines.

About tongue cancer | Tongue cancer

Tongue cancer is a type of head and neck cancer. Symptoms can include a patch, spot or lump on your tongue that doesn’t go away. The main risk factors are smoking, drinking a lot of alcohol and infection with the HPV virus.

The tongue

There are two parts to your tongue:

  • the oral tongue
  • the base of the tongue

Cancer can develop in either part.

The oral tongue is the part you see when you poke your tongue out at someone. This is the front two thirds of your tongue. Cancers that develop in this part of the tongue come under a group of cancers called mouth (oral) cancer.

The base of the tongue is the back third of the tongue. This part is very near your throat (pharynx). Cancers that develop in this part are called oropharyngeal cancers (pronounced oar-o-farin-gee-al).

What are the types of tongue cancer?

The most common type of tongue cancer is squamous cell carcinoma (SCC). Squamous cells are the flat, skin like cells that cover the lining of the mouth, nose, larynx, thyroid and throat. Squamous cell carcinoma is the name for a cancer that starts in these cells.

What are the symptoms of tongue cancer?

The symptoms of tongue cancer might include:

  • a red or white patch on the tongue that won’t go away
  • a sore throat that doesn’t go away
  • a sore spot (ulcer) or lump on the tongue that doesn’t go away
  • pain when swallowing
  • numbness in the mouth that won’t go away
  • unexplained bleeding from the tongue (that’s not caused by biting your tongue or other injury)
  • pain in the ear (rare)

It’s important to remember that these symptoms might be due to a less serious medical condition. But it’s best to check symptoms with your GP just to make sure.

The photos below give you an idea of what tongue cancers can look like, but remember that they might appear differently from this. Contact your GP or dentist if you notice anything abnormal.

This picture shows cancer on the side of the tongue.

And below is a picture of a red patch underneath the tongue.

What are the risks and causes of tongue cancer?

We don’t know the exact causes of most head and neck cancers, but several risk factors have been identified. 

Smoking tobacco (cigarettes, cigars and pipes) and drinking a lot of alcohol are the main risk factors for cancers of the head and neck in the western world. The HPV virus transmitted through sexual contact is another risk factor. 

Having a risk factors means that your risk is increased. But it does not mean that you will definitely develop cancer.

What are the stages of tongue cancer?

The stage of your cancer tells you how big it is and whether it has spread. It helps your doctor decide what treatment you need.

The stage of your cancer depends on:

  • how far your cancer has grown into local tissues
  • whether it has spread to nearby lymph glands
  • whether it has spread to any other part of the body

Doctors use different staging systems. The staging system they use for you depends on where your cancer starts:

Tongue cancer that starts in the front two thirds of your tongue (oral tongue) is staged as a mouth cancer.

Tongue cancer that starts in the back third of your tongue ( base of your tongue) is staged as oropharyngeal cancer.

What is the treatment for tongue cancer?

The treatment for tongue cancer depends on:

  • the stage of your cancer
  • where the cancer is on your tongue
  • your general health

Managing Your Salivary Gland Stones – Symptoms & Treatment

What Are Salivary Gland Stones?

The major salivary glands are the parotid (on both sides of the face), submandibular (under the jaw), and sublingual (under the tongue). These glands mainly make saliva to help digestion of food. Saliva drains into the bottom of the mouth, next to the upper teeth, and under the tongue through salivary ducts. Blockage of these ducts from calcified stones (calculi) is called sialolithiasis. Most stones are made of chemicals called calcium phosphate and calcium carbonate mixed with cell debris and mucus. Sialolithiasis usually affects people between 50 and 80 years old.

Salivary gland stones affect ducts to the submandibular gland in nearly 80% of cases, the parotid gland in 14%, and the sublingual gland in 6%. Stones in submandibular glands are large and usually occur as one stone when compared with stones in the parotid gland.

What Causes Salivary Gland Stones?

The cause is unknown. It’s not contagious or passed from parents to children.

What Are the Symptoms of Salivary Gland Stones?

The main symptoms are pain and swelling in the cheek and under the tongue. Pain becomes worse during and after eating. Other symptoms include salivary gland swelling and tenderness. If the gland becomes infected, fever and increased pain may occur.

How Are Salivary Gland Stones Diagnosed?

The health care provider usually makes a diagnosis from symptoms and a physical examination. Symptoms tend to come and go. These periodic painful attacks may be called salivary colic. The stone can sometimes be felt by an examining hand. If the health care provider feels a swollen mass, computed tomography (CT) may be done to see the mass and rule out other causes, such as tumors, dental abscesses, swollen lymph glands, lymphoma, sarcoidosis, and sialadenitis (salivary gland infection). Rarely, x-rays may be taken of the gland (sialography), after a dye is injected into the duct to confirm the diagnosis. The health care provider may also order blood tests.

How Are Salivary Gland Stones Treated?

The goal of treatment is to reduce pain and swelling. Therapy at first may be conservative, with heat (warm soaks) applied to the area, massage, and increased fluid intake. The health care provider may prescribe an antibiotic for infected glands.

A stone can sometimes be removed by squeezing them out by hand or by making a small cut in the opening to the duct. Stones that are hard to remove may need surgery, usually done by a surgical ear, nose, and throat specialist or a head and neck specialist.

DOs and DON’Ts in Managing Salivary Gland Stones:

  • DO drink plenty of fluids and take care of your mouth. Dehydration puts you at risk for having salivary gland stones.
  • DO call your health care provider if you have mouth pain, especially when eating citrus or spicy foods.
  • DO call your health care provider if you have a fever or you see a lump on the side of your mouth or in your neck.
  • DON’T eat citrus and spicy foods if you think that you have salivary gland stones. Both types of foods increase secretion of saliva and can make pain of a blocked gland worse.
  • DON’T forget that salivary gland stones most often affect the gland under the jaw.

FOR MORE INFORMATION

Contact the following sources:

  • American Academy of Otolaryngology—Head and Neck Surgery
    Tel: (703) 836-4444
    Website: http://www.entnet.org
  • American Dental Association
    Tel: (312) 440-2500
    Website: http://www.ada.org

Tongue swelling

Swelling of the tongue causes extreme discomfort in the patient. A swollen tongue makes it difficult to speak, swallow, and sometimes breathe. When it swells, it grows in size, swells, and sometimes does not even fit in the mouth. This is a rather dangerous condition, since a severely swollen tongue can block the airways, and a person can simply suffocate. We will tell you what the tongue swells from, what to do in this situation and how to treat it.

Contents of the article:

  • Probable causes
  • Swelling after puncture
  • Swollen tongue and lips with it
  • Swollen tongue and throat
  • What to do

Reasons

If a patient has a swollen tongue, the reasons can be very diverse, ranging from a banal trauma to a severe allergic reaction.Appropriate treatment is prescribed according to the cause.

If the tongue is swollen very quickly and at the same time greatly increased in size, then this may be a symptom of a severe allergic reaction. In this case, you should act immediately, since the sensation of a swollen tongue may precede the development of anaphylactic shock. If no action is taken, the patient may suffocate. Therefore, if you have a swollen tongue, allergies are the first reason to think about.

With allergies, patients usually complain of the following symptoms:

  • The tongue hurts and is swollen, as if it would not fit in the mouth;
  • swollen lips and tongue, difficulty speaking and swallowing;
  • swollen papillae on the tongue, and he himself became painful and sensitive;
  • swelling at the base, which makes it difficult to swallow and breathe properly.

Another reason why a patient has a swollen tongue may be injuries as a result of improper bite, cuts, scratches with hard pieces of food.In this case, the patient usually complains that his tongue is swollen on one left or right side, that is, on the side from which he was injured. In this case, it is important to ensure the cleanliness of the oral cavity and prevent bacteria from entering the wound in order to prevent the occurrence of an inflammatory process.

  1. If a patient has a swollen tongue on the sides, especially when teeth imprints are visible on the lateral surface, the doctor may suspect a thyroid disease. In this case, it is necessary to refer the patient to study the level of thyroid hormones.
  2. If a patient has swelling under the tongue, this may be the result of taking sublingual drugs – those that dissolve under the tongue (validol, engystol and a number of other drugs). In this case, the swelling under the tongue usually goes away on its own after you stop taking the drugs.
  3. Complaints about swelling under the tongue may also be if the patient injured the delicate epithelium with sharp pieces of food – for example, chips. In this case, the sensation will go away on its own after brushing your teeth or rinsing your mouth with a dental elixir or balm.
  4. Some infections can also lead to swelling of the tongue, in particular streptococcal infection, herpes virus, candidiasis, syphilis. In this case, it not only swells, but also hurts, and small rashes, dense white bloom or sores appear on the surface of the mucous membrane, depending on the condition and neglect of the disease.
  5. The most dangerous reason for a sore throat and a swollen tongue is cancer. It is quite rare, but you shouldn’t discount it.Therefore, if the patient has no apparent reasons for the swelling of the tongue, allergies are excluded, and his condition still does not improve, there is a reason to send such a patient for a consultation with an oncologist.

Swelling after puncture

Many patients complain that their tongue is swollen after piercing. In most cases, this swelling is not pathological. During the puncture, the tongue was injured, and slight swelling is completely natural and natural. Therefore, it is necessary to strictly adhere to the recommendations of the specialist who performed the puncture, keep the oral cavity clean, and rinse your mouth with antibacterial drugs.However, if the swelling does not go away within 4-5 days, and a purulent exudate forms at the puncture site, you should immediately consult a doctor, since various complications very often arise when piercing the tongue.

Normally, healing after a puncture occurs within two weeks. During this period, the tongue may swell, hurt, the patient may experience a feeling of discomfort, burning, soreness. In the future, all these unpleasant symptoms will disappear, and after two weeks the wound should heal without a trace, and the tumor should go away.

Swollen lips

As mentioned above, the tongue and lips at the same time are most often swollen with allergies. In this case, swelling occurs rapidly, literally in a matter of minutes. Along with the swelling of the tongue, the patient may experience other unpleasant symptoms, such as a runny nose, sneezing, mild cough, vomiting, and abdominal pain. If you do not take any measures, then a little later other symptoms may appear, such as an increase in body temperature, a change in its color and sensitivity, and soreness and swelling of the tongue.

Many in such a situation get lost and do not know what to do if the tongue is swollen and, apparently, the patient has an allergic reaction. You should not panic, you need to act quickly and clearly. It is necessary to urgently call an ambulance, and before its arrival, give the patient an antihistamine, open the windows wide open and provide fresh air, exclude contact with the allergen (if known).

Swollen throat

If the tongue and throat are swollen at the same time, this condition is life-threatening for the patient.In the vast majority of cases, this condition occurs with anaphylactic shock (the strongest manifestation of allergies). Only an experienced doctor can remove the patient from the state of anaphylactic shock, therefore, at the first signs of swelling of the tongue and throat, an ambulance should be called immediately, especially if the patient has other dangerous symptoms, such as difficulty in swallowing, bluish color of the lips and nails, swelling of the eyes, etc. lips, the appearance of a small rash, low blood pressure, nausea, shortness of breath or choking.

What to do

If a patient has a swollen tongue, treatment primarily depends on the cause of the swelling. First of all, the cause should be determined; only an experienced doctor can do this. If the cause is known and it is not life-threatening (for example, a bite of the tongue or a burn with too hot food), then you can try to relieve unpleasant symptoms yourself. But if the cause of the swelling of the tongue is an allergic reaction, self-medication is life-threatening.

There are many ways to remove swelling using folk methods. However, all of them are suitable only for those cases when the cause of the swelling is microtrauma of the tongue.

You can rinse your mouth with decoctions of medicinal herbs – chamomile, sage, calendula, eucalyptus. You can use chlorhexidine baths and rinses, a variety of herbal balms and rinses. If the patient has a swollen tongue after tooth extraction, rinsing with herbal infusions will help. It should be remembered that in this case it is absolutely impossible to rinse the mouth with hot infusion, it will only increase the inflammation.

90,000 Cracks in the tongue – causes and treatments

Date of publication: 01/27/2021

As poets consider the eyes to be the mirror of the soul, so doctors are used to considering language as an organ that reflects the work of the body as a whole. Whatever you complain about, the doctor at the reception will definitely ask you to stick out your tongue and carefully examine it. And at the dentist’s appointment, special attention will be paid to the tongue. And all – because of glossitis. The word is beautiful, but the state is not. Glossitis is an inflammation of the tongue, one of the signs of which is the appearance of cracks.

Cracked tongue – causes

  1. Bacterial and viral infections
    This applies not only to infections in the oral cavity. Viruses and bacteria spread throughout the body, and an infection manifests itself in the tongue. Most often, cracks in the tongue are caused by the herpes virus.
  2. Anemia
    Iron deficiency can trigger glossitis. Iron carries a special protein called myoglobin, which is responsible for the health of muscle tissue.If there is not enough iron, all muscles are affected, including the tongue.
  3. Allergic reaction
    The body’s response to various allergens: food, medication, sometimes even toothpaste components – can cause inflammation.
  4. Oral injuries
    Burns, cuts, any mechanical injury become an environment where bacteria multiply, which means inflammation occurs.
  5. Vitamin deficiency
    It has been scientifically proven that a deficiency in B vitamins can lead to cracked tongue.

Types of glossites

Depending on the causes of inflammation, the following forms of the disease are distinguished:

Spicy

It develops quickly, with a pronounced allergic reaction – very quickly. In severe cases, the airway can be blocked.

Chronic

Inflammation develops as a result of prolonged exposure to a pathogen or irritant factor. With chronic diseases, regular exposure to objects with sharp edges, such as lollipops or nuts, the disease manifests itself weakly and can lead to serious consequences.This species is characterized by deep cracks in the tongue.

Atrophic

The papillae on the tongue atrophy, the surface becomes smooth, may crack. Causes discomfort in the mouth and changes in taste recognition.

Desquamative

It is also called geographical. The tongue is outlined with lines and grooves like a geographical map. The cause is often herpes, candidiasis, helminthic invasions. While some areas are recovering, inflammation moves to others, which is why it is also called migratory.Cracks on the tip of the tongue were cured – they appeared closer to the root, and so on for a long time.

Diamond

In this type, the cracks in the tongue look like a geometric figure. Cracks appear in the middle of the tongue, which is why it is sometimes called the middle tongue. Median glossitis is characterized by frequent relapses. Fungal infections are the most common cause.

Folded

Strictly speaking, folded glossitis is not a disease, but an innate property.The crack is located in the middle of the tongue, folds extend from it in both directions. In most cases, this deviation does not cause discomfort. But sometimes bacteria can build up in deep folds and cause inflammation.

Symptoms

Inflammation manifests itself in different ways, depending on the individual characteristics of the person and the underlying cause of the disease. Common symptoms include:

  • Unpleasant sensations in the mouth
  • Color change
  • Pain
  • Edema
  • Burning or itching
  • Surface change
  • Changing the size and shape of the papillae
  • Cracks
  • Difficulty swallowing
  • Problems with chewing
  • Gray patina
  • Difficulty speaking

Diagnostics and treatment methods

Cracks in the tongue are well studied, usually a visual examination is sufficient to make a diagnosis.To determine the cause of their occurrence, the doctor asks the patient about common diseases. In some cases, a blood test is indicated.

Treatment in the clinic

Before prescribing drugs and procedures, it is necessary to find out why cracks occur. After that, a plan is drawn up, which may include:

  • Treatment of general disease
  • Antifungal medicines
  • Iron tablets
  • Vitamins
  • Corticosteroids
  • Immunostimulants
  • Antihistamines

The surface of the tongue is disinfected with antiseptic solutions.Pain relievers are used to reduce pain.

In case of mechanical injuries as a result of unsuccessful prosthetics, it is recommended to replace the structure.

Expert opinion

Roman Vladimirovich Pak

orthopedic dentist

Experience: 24 years

Home remedies provide temporary relief, but do not address the cause of cracks.Launched inflammatory processes can lead to serious consequences in the form of abscesses and phlegmons. If you have cracks, consult your doctor.

Home remedies

Folk remedies are not able to eliminate the cause of cracks, especially if it is a common disease. In rare cases, the body can fight a bacterial infection on its own. Therefore, medicines from a home first aid kit can only be considered auxiliary. These include:

  • Rinses with broths of sage, chamomile
  • Lotion with sea buckthorn or olive oil
  • Propolis
  • Potato juice applications

Improperly selected folk remedies can reduce the effect of drug treatment. Be sure to consult your doctor.

Prevention

Brushing your teeth at least 2 times a day, using dental floss at least once a day, as well as regular visits to the dentist will help prevent cracks or find them in time. Taking care of your overall health will eliminate the main causes of glossitis. Quitting smoking, spicy, spicy foods also helps to avoid cracks in the tongue.

Where to go for help

It is best to go to multidisciplinary centers.They have a better technical and medical base. Doctors have more experience, simply because there are many patients. Large centers encourage dentists to regularly improve their qualifications.

Five of the best dental clinics

All clinics on the list are multidisciplinary. They are engaged in prevention, treatment, prosthetics and implantation.

Dental Center

Clinic address

General

Cerecon

Moscow, Prospect Andropov 8

Metro Technopark.

Working hours – round the clock

ROOT

Moscow, st. Rustaveli, 14 bldg. 9

Metro station Butyrskaya.

Working hours from 10:00 to 22:00

Alpha-Dent

Moscow, Beskudnikovskiy blvd, 24, bldg.1

Metro station Petrovskoe-Razumovskoe. All days of the week work.

MegaStom

Moscow, Bolshoy Kozlovsky per., 10, building 2

Metro Red Gate.

Closed on Sundays

Denta AMO

Moscow, st.Grekova, 9

Metro Medvedkovo

Open daily from 9 to 9.

90,000 Inflammation of the gums – causes and symptoms of gingivitis

Views: 138 817

Last update date: June 17, 2021

Average Read Time: 7 minutes

Contents:

Causes
Symptoms
How to relieve inflammation
Prevention

Gum disease is a problem that everyone faces to a greater or lesser extent.Some people act wisely: they visit a doctor in a timely manner, who identifies the disease and prescribes treatment. Others ignore the symptoms of inflammation and postpone a visit to the doctor until the problem turns into a disaster. Bad breath, bleeding gums, discomfort and pain make it necessary to seek the help of a specialist who discovers the need for complex and long-term treatment. To prevent gum disease, you need to know the causes and symptoms of the disease.

Up to table of contents

Reasons

Microbes .Inflammation can be caused by microorganisms that live almost everywhere, including the mucous membrane of the mouth and teeth. By themselves, they do not pose a threat: their growth and number are regulated by the body’s immune system in general and local immunity in particular. Microbes become dangerous when there are factors favorable to them.

Insufficient oral care . Irregular cleaning of teeth, ignoring the rules for the correct selection of a brush, paste and rinse – all this together leads to the fact that plaque (a breeding ground for bacteria) is constantly present on the teeth, which becomes an incentive for the reproduction of microbes.

Calculus . The vital activity of bacteria leads to the formation of substances that turn soft plaque into hard formations – tartar. From this moment, inflammation begins to develop: the gum is injured and falls, and bacteria gain access to deeper tissues.

Other reasons . Inflammation of the gums can be provoked by improperly installed prostheses and fillings, smoking, vitamin deficiency, diseases of the endocrine system and the gastrointestinal tract, impaired immunity and hereditary predisposition.

Up to table of contents

Symptoms

Signs of gum inflammation develop gradually and it is extremely important not to miss the onset of the disease: the further the pathological process goes, the more difficult and longer the treatment will be.

The phased development of inflammation looks like this:

Treatment of phlegmon of the oral cavity

Phlegmon of the oral cavity is an acute infectious disease. There is no clearly defined border of inflammation. The affected area ranges from a few centimeters to large areas.Pus does not accumulate in one place, but spreads through the tissue cells, gradually capturing the surrounding muscles and tendons.

Most often, phlegmon affects several areas:

  • the area under the tongue on both sides, pathology is often accompanied by inflammation of the lingual root,
  • space under the jaw, infection can spread to the chin area,
  • simultaneously both areas on both sides, as a result, the entire cellular space of the floor of the oral cavity is damaged.

Cellulitis can appear on any part of the body. But it is precisely when it occurs in the mouth that it poses the greatest danger.

Reasons

Oral phlegmon usually develops against the background of other dental diseases and injuries. The disease can be caused by:

  • injuries of the mucous membrane through which pathogens enter the cell tissue,
  • infectious lesions of the teeth, which include caries and pulpitis,
  • gum disease, including periodontitis, periodontal disease, periodontitis, some cysts and granulomas,
  • diseases of the jaw bones, such as osteomyelitis or periostitis,
  • complicated tooth extraction, which led to negative side reactions.

If treatment is not started on time, the disease can lead to even more serious complications. Gradually, it will spread to the periopharyngeal space, neck, and posterior maxillary region.

Symptoms

In the initial stages of the disease, there are practically no symptoms. In rare cases, the patient feels discomfort under the tongue. Pronounced signs appear later, they include:

  • stiffness and swelling of the lower jaw,
  • pain in the neck and root of the tongue,
  • severe swelling of the tongue,
  • facial swelling, asymmetry and unhealthy skin tone in the affected area,
  • putrid breath,
  • general weakness, increased heart rate and respiration, increased sweating, chills,
  • high body temperature,
  • violation of respiratory, chewing, swallowing, speech functions,
  • increased salivation and the appearance of gray plaque on the tongue.

Phlegmon of the oral cavity, detected at an early stage, is much easier to cure. With late diagnosis, surgery is indispensable.

Treatment

Treatment of phlegmon of the oral cavity at the initial stages is carried out with the help of antibiotics. The drugs are administered intravenously.

In the later stages, surgical treatment is necessary, since there is a high risk of airway obstruction by inflamed tissues. The main purpose of the operation is drainage pumping of fluid from the affected tissues.The procedure allows you to reduce the size of a purulent-inflammatory formation.

An incision for access to the pathological focus is made from the side of the oral cavity or from the outside. It depends on the degree of tissue damage. If the development of the disease has already entailed serious breathing difficulties, a tracheotomy is performed first, and then an operation is performed. Further treatment includes broad-spectrum antibiotics. They destroy pathogens in the mouth.

Conservative and surgical treatment of phlegmon of the oral cavity is carried out by experienced specialists of our dental clinic in the Central Administrative District.We will help you cope with an illness of any complexity. To make an appointment for a preliminary consultation and get additional information, please call.

Bags under the eyes | Symptoms, complications, diagnosis and treatment

Bags under the eyes – mild swelling or puffiness under the eyes – common as we age. As we age, the tissues around the eyes, including some of the muscles that support the eyelids, weaken. The fat that helps support the eye can then transfer to the lower eyelids, causing the eyelids to become puffy.Fluid can also build up in the space under your eyes, making the puffiness worse.

Bags under the eyes, as a rule, cause aesthetic discomfort and are rarely a sign of a serious underlying medical condition. Home remedies like cold compresses can help improve the appearance of eye bags. For persistent or bothersome puffiness under the eyes, beauty treatments are available.

When to see a doctor

You may not like the way they look, but bags under your eyes are generally harmless and do not require medical attention.See your doctor if swelling:

  • Serious and persistent
  • Accompanied by redness, itching or pain
  • Affects other parts of the body such as legs
  • Your doctor will want to rule out other possible causes that could contribute to the swelling, such as thyroid disease, infection, or allergies

Reasons

As we age, the tissues and muscles that support the eyelids weaken.The skin may begin to sag and oil, which is usually confined to the area around the eyes, may move to the under-eye area. In addition, the space under the eyes can build up fluid, making the area under the eyes puffy. This can lead to several factors, including:

  • Fluid retention due to weather changes (e.g. hot, humid days), hormone levels, or eating salty foods
  • Lack of sleep
  • Allergies or dermatitis, especially if the swelling is accompanied by redness and itching
  • Heredity – bags under the eyes may be the norm for a particular family

Treatment methods

Various methods are used to improve the appearance of puffiness under the eyes.These include laser treatments, chemical peels, and fillers, which can improve skin tone, tighten skin, and rejuvenate the appearance of bags under the eyes.

Surgical intervention

Eyelid surgery (blepharoplasty) is the ability to remove bags under the eyes. During blepharoplasty, the surgeon makes a subtle incision just below the eyelashes in the natural fold of the eye or inside the lower part. The surgeon removes or redistributes excess fatty, muscle and sagging skin.It is then reattached to the skin with tiny dissolving stitches along the natural crease of the eyelid or inside the lower eyelid. The procedure is usually performed as an outpatient procedure.

In addition to correcting bags under the eyes, blepharoplasty can also restore:

  • Baggy or swollen upper eyelids
  • Excessive upper eyelid skin that interferes with vision
  • Sagging lower eyelids, which can lead to white under the iris – colored part of the eye
  • Excess skin on the lower eyelids

Talk to your doctor about the risks of blepharoplasty, which include infection, dry eyes, and problems with vision, tear ducts, and eyelid alignment.

90,000 Tongue cancer – DZM

It is not the most frequent form among oncological diseases, but nevertheless, it occurs quite regularly, occupying the majority of cases among oral cavity cancers.

Cancer of the tongue is a tumor of a malignant type, the basis of the formation of which is the epithelial cells of the mucous membrane of the tongue. The disease is characterized by a diffuse or local type of compaction of organ tissues, papillomatous outgrowths formed on the surface of the tongue, as well as ulcers.

The likelihood of developing tongue cancer with different localization increases with age. Most people who are treated for this disease are men between 40 and 60 years old. After 80 years – this disease rarely begins to develop initially. There is data on the detection of tongue cancer in young children, although this pathology is not typical for this age.

Causes and risk factors.

Among the reasons for the development of cancer of the tongue, leading importance is given to external unfavorable factors:

  • Long-term smoking and consumption of alcoholic beverages. The combination of these two factors increases the likelihood of a malignant neoplasm in the oral cavity several times: alcohol significantly enhances the carcinogenic properties of tobacco mixtures.
  • Chronic mechanical trauma to the tongue: wearing poorly installed prostheses, trauma to the mucous layer by the edge of a broken tooth, regular biting of the organ.
  • Occupational hazards – work with salts of heavy metals, oil products.
  • Constant use of dishes that are too hot, burning the mucous membrane of the tongue, constant use of hot spices.
  • Chronic inflammation of the oral cavity – stomatitis, gingivitis, hyperkeratic forms of systemic lupus erythematosus, lichen planus.

! The simultaneous influence of two or three adverse factors on the human body at once increases the likelihood of cancers in the oral cavity.

Some precancerous diseases are also distinguished, with the development of which the risk of the formation of a malignant tumor of the tongue increases several times. These diseases include:

  • Bowen’s disease – the formation of a single spot on the tongue, its surface is smooth. The outbreak may sink or erosion forms in its place (photo).
  • Leukoplakia – an area of ​​constant inflammation, may look like a whitish spot or a wart that grows gradually.Such changes have a tendency to keratinization.

Classification of tongue cancer.

Cancer of the tongue is divided according to its localization in the organ, shape, nature of growth and histological structure.

By localization (location):

  • Cancer of the body of the tongue. This localization is detected in about 70% of patients, usually with this location, the tumor affects the lateral surfaces of the organ or its middle part.
  • Cancer of the tongue root is detected in 20% of cases. This site is also referred to as oropharyngeal cancer. The emergence of malignant tumors in the posterior half of the oral cavity is always characterized by a more aggressive course.
  • Cancer localized below the tongue. Found in 10% of cases.

( cancer of the root of the tongue)

According to the form, cancer of the tongue is divided into:

  • Ulcerative form. An ulcer is formed on the tongue, which has uneven and often bleeding edges. Ulcerations affect the lower part of the tongue and its middle.
  • Infiltrative form. In a patient, a lumpy, dense lump – infiltration can be palpated in the thickness of the tongue. The mucous layer above the seal is thinned, with this form of cancer pain is expressed. Infiltration in most cases is formed at the tip of the tongue and in its back.
  • Papillary form is exposed when a tumor on a thin or thick pedicle grows over the tongue in different parts of the mucous layer.This type of malignant neoplasm is characterized by slow growth and usually affects the lateral parts of the tongue.

(initial stage of papillary cancer of the tongue)

By the nature of growth, cancer of the tongue can be:

  • An exophytic tumor. In this case, the malignant neoplasm grows into the oral cavity.
  • Endophytic tumor. The location of the formation is limited by the thickness of the organ.

Clinical manifestations.

In the development of tongue cancer, three stages of its formation are distinguished:

  • initial stage,
  • developed
  • neglected.

Initial stage. It has a low-symptom course, which may be invisible to the patient. The first stage is manifested by the formation of special papillary outgrowths or whitish spots on the tongue, which are often confused with the usual plaque. In addition, local seals, redness, which appear immediately on the lateral part of the tongue, may form.There may also be an increase in the submandibular lymph nodes.

As a rule, pain does not occur at the initial stage, but in rare cases it can be observed. If pain is still characteristic of the initial stage, then usually it does not have a clear localization, therefore it is often perceived as caries, periodontitis, glossitis, pulpitis, traumatic glossalgia, or a chronic type of tonsillitis.

Developed stage – expressed by various symptoms. It is often accompanied by characteristic pains of varying intensity.The pain can be of different localization and have a so-called diffuse nature. It happens that the pain syndrome can spread to other areas of the oral cavity or even to the ear.

In case of irritation of the oral mucosa with necrosis products, salivation may increase, and due to the disintegration of the tumor, patients develop an unpleasant odor from the mouth. At this stage, it becomes difficult to swallow, the patient feels numbness of the tongue. In addition to painful sensations when swallowing, there may be difficulties in speech or pronunciation of certain sounds.

Clinical manifestations in accordance with the form of cancer:

  • Papillary – presented in the form of a dense outgrowth located above the surface of the mucosa, covered with plaque-like or papillary growths.
  • Ulcerative – occurs among patients not so often, almost 2 times less often papillary. It is characterized by an ulcerative surface surrounded by a roller, which from time to time increases in size. In the first stages of development, this form will not be characterized by pain.Only after a time, when the tumor reaches a certain size, pain and characteristic bleeding will be expressed. If the ulcer is infected or additional inflammation has joined it, then the cancer can be masked, making it difficult to diagnose.
  • Infiltrative – will be characterized by rapid tumor growth directed into the thickness of the tongue, which is manifested by its compaction. This form is characterized by a diffuse nature. It can spread to the entire tongue, leading to poor tongue mobility.The deepest slit ulcers will be characteristic of the infiltrative ulcerative form of tongue cancer.

Started stage. Characterized by an aggressive course and very rapid tumor growth, which is also accompanied by the destruction of nearby tissues, as well as metastasis to the region of regional lymph nodes (chin, cervical, submandibular). Metastases at this stage of tongue cancer can be in the lungs, liver or brain.

General symptoms of the presence of an oncological process:

  • feeling of weakness,
  • feeling of chronic fatigue,
  • loss of appetite,
  • weight loss,
  • the appearance of a malfunction of internal organs.

Diagnostics.

The asymptomatic course of tongue cancer at an early stage does not allow timely detection of the disease.

As a rule, a change in the mucous membrane at the initial stage, detected during a routine examination or during the treatment of caries, may not be perceived significantly, but is mistaken for a common injury, but not for cancer. For the same reason, many cases of tongue cancer can only be diagnosed in the second or third stage.

Primary diagnosis, namely examination and palpation of the neoplasm, is carried out by an oncologist. An accurate diagnosis will be made only after the received and studied data of a cytological examination of a smear taken from the surface of such an ulcer , as well as after a histological examination of the tumor by means of a biopsy.

In order to find out how much the tumor has grown into the organ and / or other structures of the oral cavity (determination of the prevalence of the oncological process), instrumental visualization methods are used: ultrasound of soft tissues, X-ray, CT of the facial skull and orthopantomography (X-ray examination, which allows obtaining an expanded image all teeth with jaws adjacent to the facial skeleton).

To diagnose the presence of metastases of cancer of the tongue use: biopsy of the lymph nodes, MRI and CT of the brain, chest x-ray, ultrasound of the liver or skeletal scintigraphy.

! Differential diagnosis of tongue cancer should be carried out with a benign tumor of the tongue, one of the forms of primary syphilis, tuberculous ulcer and leukoplaxis.

Treatment.

Combined – radiation therapy, surgical and chemotherapy.

Radiation therapy.

As a rule, it is carried out both before and after the operation. Radiation therapy is carried out in two ways: remotely or by the method of interstitial irradiation. As for the latter, the primary focus and the area of ​​metastasis are irradiated first. If the tumor is large, then this, like infiltrative growth, is considered an indication for a combined type of chemoradiation therapy.

Palliative radiation therapy is combined with chemotherapy in patients with distant metastases.

Surgical treatment.

Conducted to eliminate the tumor. Surgical treatment will include resection of the tongue or performing a glossectomy. If the cancer has already grown into the soft tissue up to the bottom of the oral cavity, capturing bone structures, then the operation will be accompanied by resection of the affected tissues or jaw bone.

Plastic surgery

In further periods of postoperative recovery, methods of plastic surgery can be applied in order to return the lost structures of the maxillofacial region.If the cancer of the tongue has metastasized to the lymph nodes, then they should also be removed.

Prevention.

  • Preventive measures to prevent tongue cancer are in
  • Conducting self-examinations of the oral cavity and tongue
  • Undergoing preventive examinations by specialists
  • refusal of bad habits (refusal to take alcohol and smoking)
  • eliminate the causes that provoked injury mucous membrane of the tongue – good processing of fillings after their installation, correct selection and installation of dentures, as well as treatment of dental chips
  • Carrying out oral hygiene is also an important preventive measure.

Animal allergies. Myths and Reality

Many families have pets. But in addition to the joy of communicating with them, the owners may also face such a problem as an allergy to animals. Statistics show that 30-60% of the world’s inhabitants suffer from one or another type of allergy. Every third person has allergic rhinitis, every tenth has bronchial asthma.

The term “allergy” dates back to 1906.It was introduced by a pediatrician from Vienna, Clemens von Pirke. Now this term is understood as a specific immune response of the body to a certain substance – an allergen.

Causes of Allergy

Our body is designed in such a way that it must constantly withstand a certain level of threats. If there are no threats, the immune system begins to react to completely harmless agents (allergens), and often to cells of its own body (autoimmune diseases).

Our immune system makes antibodies to specific allergens as if they are dangerous, even if they are not.For example, inhaling an allergen, the immune system reacts to the ingested agent and causes a local inflammatory reaction in the nasal passages and lungs, and regular and prolonged exposure to the allergen can lead to bronchial asthma.

Anaphylactic shock

This is the most dangerous form of allergy. There is a sudden itching, shortness of breath, a decrease in blood pressure, swelling of the face and larynx, up to asphyxiation. All this can be fatal if urgent help is not provided on time.

Animal allergy

Pet allergy is one of the most common allergic conditions caused by intolerance to antigens from saliva, fur, feathers, skin particles or pet waste products. Symptoms depend on the way the allergen enters the body – most often it is recorded:

  • pruritus,
  • lacrimation,
  • edema and itching of the eyelids,
  • nasal congestion,
  • sneeze,
  • cough,
  • sore throat,
  • sometimes bronchial asthma.

Animal allergy risk factors

Pet allergies are common. However, the risk of developing it increases if blood relatives have allergic diseases and asthma.

Contact with pets at an early age can influence the risk of developing allergies. Some studies have shown that children who have been in contact with domestic dogs in the first year of life have a higher resistance to upper respiratory tract infections in childhood than children who grew up in families without dogs.

It’s important to remember about cross-allergy. If you are allergic to one type of animal, for example, cats, there is a possibility of cross-allergy to other types of animals.

Animal allergens

Particles of wool, skin flakes or feathers most often contain substances that cause allergic manifestations. With their small size and light weight, they are able to stay in the air for a long time, to penetrate into the respiratory tract.Fluff and wool can also be fixed in fabrics and pile of carpets – this explains the persistence of allergies even after eliminating contact with the animal.

When allergic to cats, the most common allergen is saliva protein (not wool, as is commonly believed). Cats love to lick themselves, and this is how allergenic proteins from saliva get onto the coat. Accordingly, the more wool, the faster and more easily allergens spread throughout the house.

Sometimes allergens are found in organisms parasitizing on the integuments of animals (fleas, microscopic mites, fungi).Often, this type of allergy occurs suddenly and disappears after treating the animal.

The feces or urine of some animal species may contain provocative substances. Most often, allergies appear after cleaning trays, cages or terrariums and are limited to skin symptoms. Sometimes the appearance of allergens in the discharge is associated with pet diseases.

Allergy to feed

Cases of allergy to food for animals and for fish are described.Fish and reptiles themselves rarely cause allergies.

Relationship of allergy to animal sex

The sex of the animal does not have any effect on the presence or absence of allergies. But a castrated animal is safer in terms of allergies than an uncastrated animal, since the release of the “aggressive” protein Fel D1 by castrated animals is less.

Are there hypoallergenic animals?

An allergy can occur to absolutely any animal and a hypoallergenic animal is a myth.But there are pets that can provoke allergies less often than others.

A turtle can be a good pet for an allergic person. She has no fur, the amount of saliva and sweat is negligible, she is very easy to care for. But its waste products (feces) can also cause unwanted allergic reactions, so it will be ideal if a person who is not susceptible to allergies is cleaning it.

Pretty hypoallergenic and such cute animals as chinchillas, because they have neither sebaceous nor sweat glands.Therefore, a chinchilla is almost ideal for an allergy sufferer. “Practically” because it is very rare, but the reaction to chinchillas is manifested.

A good option and bald guinea pigs.

Bichon Frize can also be suitable for people with allergies. Despite the fact that their wool is thick and dense, it falls out very little. But the Yorkshire Terrier, contrary to popular belief, can cause allergies with the same probability as dogs of other breeds.

I am allergic, but I want a pet!

If you really want to have a pet, use the recommendations:

  • Consult an allergist, take tests (allergy panels), skin tests. Get recommendations for basic therapy and emergency care.
  • When choosing an animal, stay in close contact with it longer to assess the body’s response. Because an allergic reaction manifests itself only after the second contact with the allergen, make an appointment to meet again.It is better to clarify the situation before purchasing a pet than to return it later or look for a new home.
  • It is advisable that the cleaning of the animal is carried out not by the allergic person himself, but by one of the family members.
  • Pet bedding and beds should be cleaned and washed at least once a week.
  • Daily wet cleaning will reduce the amount of allergens in the air.
  • Use air purifiers with a HEPA filter. It is an excellent trap for allergens.
  • There is no place for a cat or a dog in the bedroom, and even more so in the bed of an allergic person! Use special covers for all bedding and wash them regularly.
  • Replace curtains with less heavy curtains or blinds that are easy to clean and that will not collect animal hair and epidermal particles.
  • Bathe the animal weekly using special anti-allergenic shampoos, which are available among the products for allergy sufferers.
  • If you are allergic to food, someone from the family should be involved in feeding the pet, and not the allergic person himself. If it comes to ready-to-eat foods for cats or dogs, try switching your pet to natural food (the diet is developed by a veterinarian dietitian).

Good news for allergy sufferers!

In July 2019, scientists from Purina’s research division, along with allergists from the J. Washington University School of Medicine, talked about a new cat food supplement that, with prolonged use, prevents an animal from causing allergies in humans. The effectiveness of the supplement has been confirmed in laboratory tests and in experiments with cats and people with allergies. Perhaps soon the new food will become a truly effective solution for those who love cats, but cannot yet be with them.

In any case, when starting a pet, you must remember that this is for many years and carefully weigh your capabilities!

Health to you and your pets!
Department of Dermatology IEC “PiK”

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