Oral medicine: 12. lumps and swellings: salivary

Specialist referral may be indicated if the Practitioner feels:

Salivary glands usually swell because of inflammation (sialadenitis) (Figure 1), which is often viral but may have other causes (Table 1). Obstruction of salivary flow is another common cause (obstructive sialadenitis) (Figures 2, 3). Rare causes include salivary gland or other neoplasms (Figures 4–7).

In children, most salivary gland swellings are caused by mucoceles or mumps. In adults, most swellings of the salivary glands are caused by mucoceles (Figure 8), salivary duct obstruction (typically by a stone); but sialadenitis, Sjögren's syndrome and neoplasms are important causes to be excluded.

It can be difficult to establish whether a major salivary gland is genuinely swollen, especially in obese patients. A useful guide to whether the patient is simply obese or has parotid enlargement is to observe the outward deflection of the ear lobe, which is seen in true parotid swelling.