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.

Sialolithiasis (Wikipedia)

Sialolithiasis (also termed salivary calculi, or salivary stones) is a crystallopathy where a calcified mass or sialolith forms within a salivary gland, usually in the duct of the submandibular gland (also termed "Wharton's duct"). Less commonly the parotid gland or rarely the sublingual gland or a minor salivary gland may develop salivary stones.

Sialolithiasis
Calculi (salivary gland stones) removed from the sublingual gland
Specialty	Dental surgery

The usual symptoms are pain and swelling of the affected salivary gland, both of which get worse when salivary flow is stimulated, e.g. with the sight, thought, smell or taste of food, or with hunger or chewing. This is often termed "mealtime syndrome." Inflammation or infection of the gland may develop as a result. Sialolithiasis may also develop because of the presence of existing chronic infection of the glands, dehydration (e.g. use of phenothiazines), Sjögren's syndrome and/or increased local levels of calcium, but in many instances the cause is idiopathic (unknown).

The condition is usually managed by removing the stone, and several different techniques are available. Rarely, removal of the submandibular gland may become necessary in cases of recurrent stone formation. Sialolithiasis is common, accounting for about 50% of all disease occurring in the major salivary glands and causing symptoms in about 0.45% of the general population. Persons aged 30–60 and males are more likely to develop sialolithiasis.