Salivary Stones May Be Causing Your Mouth Pain — Here’s How to Get Rid of Them

Salivary gland stones — or sialolithiasis — occur when hardened bits of material like saliva block the tube that connects the salivary glands to the inside of the mouth. These yellow or brown stones are a major source of mouth pain and swelling. They can even lead to serious infections. 

Here’s what you should know about how to recognize and treat salivary stones. 

How do you know if you have a salivary stone?

Salivary stones usually cause two hard-to-ignore symptoms: mouth pain and salivary gland swelling. 

Swelling is the most common symptom of a salivary stone. Both the duct and the gland can get swollen. And you might be able to see the swelling in the mirror. You will be able to feel the swelling when you touch your face (see below for where these glands are). You might notice that both the gland and the duct feel tender too. 

Most people also experience pain. Some people feel it all the time. And others only notice when they open and close their mouths. The pain usually gets worse whenever you need to produce more saliva, like when it’s time to eat. 

Another way you can tell if you have a salivary stone is by looking inside your mouth at the opening of the salivary ducts. If the stone is near the opening, you’ll be able to see a yellow or yellow-brown stone. If the stone isn’t near the opening, you may be able to feel the stone if you feel along the duct. 

For reference the three sets of salivary glands are:

• The parotid glands: These are located on the cheek near the angle of the jaw. The duct passes across the cheek and opens above the second upper molar. 

• The submandibular gland: This is located under the jaw. The duct passes under the jaw and chin and opens under the tongue. You can see the openings on either side of the lingual frenulum — the band that connects the underside of the tongue to the bottom of the mouth. 

• The sublingual glands: The glands and duct openings are on the floor of the mouth, under the tongue.

Up to 90% of salivary stones form in the submandibular gland. About 10% of stones form in the parotid gland. And stones are least likely to form in the sublingual gland. 

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What causes salivary stones? 

Scientists don’t know what causes salivary stones. Some research suggests that salivary stones start as tiny particles inside the salivary gland and grow bigger when they get into the salivary gland duct. This is the tube that connects the gland to the mouth. 

Research shows that some risk factors can increase your chances of developing salivary stones. You’re more likely to develop stones in your salivary gland duct if you have: 

• High levels of protein in your saliva

• High levels of calcium in your saliva

• Low levels of magnesium in your saliva

• Thick saliva secretions 

• Dry mouth or conditions that cause dry mouth, like Sjörgen’s disease

• Gout 

You’re also more likely to develop salivary stones if:

• You’re older

• You’re taking medications that cause dry mouth

• You’re dehydrated

Are salivary stones serious?

Salivary gland stones can be painful. Though they don’t usually pose harm to your health. 

But you can develop more serious problems, like infections, from a salivary stone. If a salivary stone gets stuck for a long time, bacteria can build up in the blocked duct. This will likely lead to infection and abscesses. 

Infection can lead to long-term damage inside the salivary gland. If infected, the gland can scar and stop working. 

How do you treat salivary stones?

If you think you have a salivary stone, you should see your healthcare provider or dentist before trying at-home treatment. They can make sure your mouth swelling is from a salivary stone and not something more serious like mouth cancer or a serious dental infection.

But the good news is that most salivary stones can be treated with simple tools you can use at home.  

At-home treatments

There are several home remedies that can help break down salivary stones, especially if they’re small and you can see them near the duct opening, including:

• Drink plenty of fluids. Staying hydrated helps break down salivary stones and prevent them from reforming. 

• Eat citrus fruits. Sour citrus fruits make your salivary glands work overtime. The extra saliva can push the stone out of the duct and into your mouth. You can try eating lemons, limes, and grapefruits. Or you can add their juices to water.

• Suck on lemon candies. If eating lemons doesn’t sound appealing, you can also try sucking on hard, lemon-flavored candies throughout the day. Opt for sugar-free candies which are better for your teeth. 

• Massage your salivary gland and duct. Gently massage your gland and the duct several times a day. You want to gently push the stone along the duct toward the opening in your mouth. 

• Take an over-the-counter pain reliever. Acetaminophen (Tylenol) and ibuprofen (Motrin) can help ease the pain, discomfort, and swelling from your salivary stone. They won’t help get rid of the stone, but they will keep you comfortable while the other treatments do their work. 

If you can see the stone, don't try to remove it. It can be tempting to reach for it with a pair of tweezers. But this can lead to serious injury and infection. Instead, keep using the above methods. And if it still hasn’t popped out on its own in a few days, see your healthcare provider. 

Prescription treatments 

Your healthcare provider may also recommend prescription treatments to help you pass your salivary stone. 

Sialogogues are prescription medications that tell the salivary glands to make more saliva. This helps push the stone out of the duct. The most commonly used sialogogue is pilocarpine. 

You will need to take antibiotics if you have a salivary gland infection because of your salivary stone. Most people need to take antibiotics between 3 and 4 times a day for 7 to 10 days. The most commonly prescribed antibiotics for salivary gland infection include:

• Dicloxacillin

• Cephalexin

• Amoxicillin/clavulanate

• Clindamycin

Salivary stone removal

If at-home and prescription treatments aren’t enough, your healthcare professional may ask you to see an ENT (ear, nose, and throat) specialist to have your salivary stone removed. 

There are different ways to remove a salivary stone, including:

• Irrigation: This method uses sterile water to flush out the stone.

• Lithotripsy: This medical procedure breaks up stones into smaller pieces. Smaller pieces can pass through the duct more easily than one large stone. There are different methods specialists can use, including laser lithotripsy and shock wave lithotripsy. 

• Sialoendoscopy: A specialist passes a thin tube attached to a camera into the salivary duct. The tube contains either small forceps or a tiny basket which can pull the stone out. 

• Surgery: If lithotripsy and endoscopy don’t work, you may need surgery to remove your stone. The specialist will make a small cut inside your mouth and remove the stone. You will receive local anesthesia to make sure you’re not in pain during the procedure.

Here’s some more good news: Once your stone is gone, you’re unlikely to get another one. Research shows that less than 10% of people develop more than one salivary stone during their lifetime. 

But these same studies also show that people wait a long time before seeing a healthcare provider about their symptoms. Less than a third of people see a provider within 6 months of developing pain and swelling from a salivary stone. Others wait for years. 

So if you have mouth pain and swelling, see a provider as soon as possible. You can get rid of that stone safely and likely never have to worry about salivary stone pain again.

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Written by:

Ronald W. Dworkin, MD, PhD

Ronald W. Dworkin, MD, is a board-certified anesthesiologist who has been practicing anesthesiology in a community hospital for 30 years. He has taught in the honors program at George Washington University for over 10 years and works as a senior fellow at the Hudson Institute.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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