Parotitis

Alternative names
Salivary gland infections; Saladenitis

Definition
This is a disorder caused by viral or bacterial infection of the salivary glands.

Causes, incidence, and risk factors

The salivary glands are around the mouth. They produce saliva, which moistens food to aid in chewing and swallowing. Saliva contains enzymes that begin the digestion process.

Saliva also aids in mechanical cleansing of the mouth by washing away bacteria and food particles. Saliva keeps the mouth moist and helps to keep dentures or orthodontic appliances (such as retainers) in place.

There are 3 pairs of salivary glands. The 2 largest are the parotid glands, 1 in each cheek over the angle of the jaw in front of the ears. Two submandibular glands are at the back of the mouth on both sides of the jaw. Two sublingual glands are under the floor of the mouth.

All of the salivary glands empty saliva into the mouth through ducts that open at various locations in the mouth. Parotitis (parotiditis) is an inflammation of one or both of the parotid salivary glands.

An infection of the salivary glands is somewhat common. Viral infections such as Mumps often affect the salivary glands (Mumps most often affects the parotid glands). This form of parotitis is now much more rare in children because of the MMR immunization vaccine.

Bacterial infections usually result from obstruction (such as salivary duct stones) or poor oral hygiene.

Symptoms

     
  • Swelling of the face (particularly in front of the ears, below the jaw, or on the floor of the mouth)  
  • Dry mouth  
  • Abnormal tastes, foul tastes  
  • Mouth or facial pain, especially when eating  
  • Decreased ability to open the mouth  
  • Fever

Signs and tests
An examination by the health care provider or dentist shows enlarged salivary glands. Pus may drain in the mouth in some cases. The gland may be painful, particularly with bacterial infections. Viral infections such as Mumps may cause painless swelling of the glands.

Treatment

In some cases, no treatment is necessary.

If there is pus or a fever, or if the infection is known or presumed to be bacterial, antibiotics may be prescribed. Antibiotics are not effective against viral infections.

Good oral hygiene, with thorough tooth brushing and flossing at least twice per day, may aid healing and help prevent an infection from spreading. If you are a smoker, stop Smoking as it helps in recovery.

Warm salt water rinses (1/2 teaspoon of salt in one cup of water) may be soothing and keep the mouth moist.

Drink lots of water and use sugar-free lemon drops to increase the flow of saliva and reduce swelling.

Expectations (prognosis)
Most salivary gland infections resolve spontaneously or are cured with treatment. Complications are not common, but they may occur.

Complications

     
  • Abscess of salivary gland  
  • Localized spread of bacterial infection (cellulitis, Ludwig’s angina)  
  • Recurrence of infection

Calling your health care provider
Call your health care provider if symptoms of salivary gland infections are present.

Call your health care provider if a salivary gland infection has been diagnosed and symptoms worsen, particularly if fever increases, or there is breathing or swallowing difficulty (these may be emergency symptoms).

Prevention
In many cases, salivary gland infections cannot be prevented. Good oral hygiene may prevent some cases of bacterial infection.

Johns Hopkins patient information

Last revised: December 3, 2012
by Martin A. Harms, M.D.

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