Definition and Classification
- Sialolithiasis refers to the formation of calculi within a salivary gland.
- Calculi are hard, stone-like concretions made from mineral salts.
- Tonsiloliths and renal calculi are other types of calculi.
- Sialolithiasis can cause painful swelling and inflammation of the gland.
- Obstructive salivary gland disease can also lead to the mealtime syndrome.

Signs and Symptoms
- Intermittent pain that worsens before mealtimes.
- Swelling of the gland, often appearing or increasing before mealtimes.
- Tenderness of the involved gland.
- Palpable hard lump near the end of the duct.
- Lack of saliva coming from the duct.

Causes
- Abnormalities in calcium metabolism, dehydration, and reduced salivary flow rate can contribute to lithogenesis.
- The formation of a calcified mass involves the layering of organic and inorganic material.
- Food debris, bacteria, or foreign bodies can enter the ducts and be trapped by abnormalities in the sphincter mechanism.
- Stone formation is more common in the submandibular gland due to higher calcium concentration and slower saliva flow.
- Salivary calculi are associated with chronic sialadenitis and can be composed of uric acid crystals in cases of gout.

Diagnosis
- Diagnosis is usually based on the patient's history and physical examination.
- X-ray can confirm the presence of salivary gland calculi in 80% of cases.
- Ultrasound imaging can be used to visualize sialolithiasis.
- Inflammation and dilation of the duct can be observed in imaging.
- Other diagnostic techniques include sialography and CT scans.

Management and Epidemiology
- The stone is usually removed to manage sialolithiasis.
- Different techniques are available for stone removal.
- In rare cases of recurrent stone formation, removal of the submandibular gland may be necessary.
- Non-invasive options for small stones include hydration, moist heat therapy, NSAIDs, and consuming bitter or sour foods.
- Citrus fruits like lemon or orange may increase salivation and promote stone expulsion.
- Shock wave therapy (Extracorporeal shock wave lithotripsy) is another treatment option.
- Minimally invasive treatment includes sialendoscopy.
- Surgical options include cannulating the duct to remove the stone (sialectomy) or making a small incision near the stone for removal.
- In cases of recurring stones, the salivary duct may be removed.
- Antibiotics may be used to prevent infection while the stone is lodged in the duct.
- The prevalence of salivary stones in the general population is about 1.2%.
- Salivary stones causing symptoms occur in about 0.45% of the general population.
- Sialolithiasis accounts for 50% of all diseases in major salivary glands.
- It also represents 66% of all obstructive salivary gland diseases.
- Salivary gland stones are twice as common in males compared to females.
- The most common age range for salivary stones is between 30 and 60.
- Salivary stones are uncommon in children.