It’s funny, isn’t it? We go about our days, eating, talking, barely giving a thought to some of the amazing little structures working away inside us. I had a patient come in once, Mr. Henderson, a lovely chap, who said, “Doc, my mouth just feels… wrong. So dry, all the time.” It turned out his salivary glands weren’t quite doing their job as they should. And that got me thinking – most of us probably don’t ponder our salivary glands much until something feels off. So, let’s talk about these unsung heroes of your mouth.
Getting to Know Your Salivary Glands
So, what exactly are these salivary glands? Well, they’re the tiny powerhouses in your mouth and throat responsible for making saliva – you know, spit. They release this saliva through little openings, almost like tiny sprinkler systems. And saliva? It’s more important than you might think. It keeps your mouth and throat comfortable, helps you swallow your food, gets the digestion process started, and even protects your teeth from those pesky bacteria that cause cavities.
You’ve got three main pairs of these glands:
- Parotid glands: These are the biggest ones, sitting just in front of your ears. Think of them on either side of your face. They have little ducts that open up near your upper back teeth.
- Submandibular glands: You’ll find these tucked under your jawbone. They release saliva from under your tongue.
- Sublingual glands: These are smaller, located right under your tongue, on the floor of your mouth.
Beyond these major players, you also have hundreds, even up to a thousand, tiny minor salivary glands. They’re scattered all over the lining of your mouth and throat. While small, they contribute a good deal to your daily saliva production!
What Do Salivary Glands Actually Do?
Their main job, plain and simple, is making saliva. And saliva is a bit of a superstar:
- It keeps everything lubricated, so your mouth and throat don’t feel like a desert.
- It moistens food, making it easier to swallow. Imagine trying to get a dry cracker down without it!
- It contains an enzyme called amylase, which is like a head-start for your stomach, beginning to break down starchy foods.
- It helps wash away food particles, keeping your mouth cleaner.
- This cleaning action also helps lower your risk of cavities and gum disease.
- It even helps keep the acid balance (the pH) in your mouth just right.
And it doesn’t stop there. That saliva is crucial for digestion. When you eat, saliva mixes with the food, starting the breakdown and making it slippery enough to travel down your throat, through your esophagus, and into your stomach.
Ever wonder how much saliva you make? An adult can produce about one to two liters a day! That’s a lot. In fact, over a year, you could probably fill a bathtub. Most of it – 99% – is water, but the other 1% is packed with important stuff like proteins, enzymes, and mucus. And here’s a cool fact: just one drop of your saliva contains your entire genetic makeup. Plus, without saliva, you wouldn’t even be able to taste your food properly, as food molecules need to dissolve in it for your taste buds to register them. Oh, and ever notice you produce more saliva right before you’re sick to your stomach? That’s your body’s clever way of trying to protect your teeth and throat from harsh stomach acids.
A Little More About Their Structure
We mentioned the main glands. The parotid glands are the largest, each a bit smaller than your ear. The sublingual glands are about the size of an almond, and your two submandibular glands together are roughly walnut-sized. The minor ones? Teeny tiny, around 2 millimeters. Each gland is wrapped in tissue and made up of fat and special cells called acini that secrete the fluids.
When Salivary Glands Cause Trouble
Most of the time, your salivary glands work without a hitch. But sometimes, things can go a bit sideways. Here are some common issues we see:
- Salivary gland stones (Sialolithiasis): These are tiny “stones” made from salts in your saliva. They’re more likely if you’re dehydrated or take certain medications that cause dry mouth (xerostomia). If a stone blocks a duct, it can be quite painful and lead to swelling or even an infection. Ouch.
- Salivary gland swelling: Swelling can happen for a few reasons. You might remember mumps from childhood (though it’s much rarer now thanks to vaccines!) – that causes swollen parotid glands. Swelling can also be a sign of a blocked duct, an infection, or sometimes, a tumor.
- Salivary gland infection (Sialadenitis): This usually happens if a gland is blocked or if you have chronic dry mouth. Bacteria can take hold. Sometimes, a staph infection can be the culprit. People with conditions like anorexia can be more prone to this.
- Salivary gland dysfunction: This basically means your glands aren’t working right, most often meaning they’re not making enough saliva. This can be caused by:
- Certain infections, like HIV.
- Autoimmune diseases, such as Sjögren’s syndrome, lupus, or rheumatoid arthritis.
- Some medications – certain antihistamines, antidepressants, and drugs for Parkinson’s, for example.
- Cancer treatments like chemotherapy or radiation therapy to the head and neck.
It’s worth noting that not all dry mouth is due to gland dysfunction; dehydration, breathing through your mouth, stress, and anxiety can also play a role.
- Salivary gland tumors: Thankfully, most tumors in the salivary glands are benign (not cancerous). Examples include adenomas (like pleomorphic adenomas) and Warthin’s tumor. However, some can be malignant (cancerous), such as mucoepidermoid carcinomas or adenoid cystic carcinomas.
If you notice persistent dry mouth, new swelling around your jaw or ear, pain, or difficulty opening your mouth wide, it’s definitely worth a chat with your doctor.
How We Figure Out What’s Going On
If you come to us with symptoms that point to a salivary gland issue, we have a few ways to investigate:
- A good ol’ chat and physical exam: We’ll talk about your symptoms and I’ll gently feel the glands in your neck and mouth.
- Imaging tests: Sometimes, an ultrasound, CT scan, or MRI can give us a better look at the glands and any stones or masses.
- Salivary gland scan: For this test, a tiny, safe amount of a radioactive tracer is injected into your arm. It travels to your salivary glands, and a special camera takes pictures. This helps us see how well your glands are working, especially if we suspect Sjögren’s syndrome or issues with saliva production.
- Biopsy: If there’s a lump or a persistent concern, we might need to take a small sample of tissue from the gland. This is often done with a fine needle (fine-needle aspiration) or, for minor glands, a tiny incision inside your lip. A pathologist (a doctor who specializes in looking at cells and tissues under a microscope) then examines the sample to check for infection, inflammation, or cancer cells.
Treatment, of course, depends entirely on what we find. It could be as simple as drinking more water, sucking on sugar-free sour candies to stimulate saliva, or warm compresses. For infections, antibiotics might be needed. Stones might pass on their own, or sometimes need a little help from us or an ENT (Ear, Nose, and Throat) specialist. For tumors, treatment often involves surgical removal. If it’s cancerous, further treatments like radiation therapy or chemotherapy might be part of the plan. We’ll discuss all options for you, every step of the way.
Take-Home Message: Caring for Your Salivary Glands
Your salivary glands are small but mighty, playing a key role in your oral health and digestion. Here’s what to keep in mind:
- They produce saliva, which is vital for lubrication, digestion, and protecting your teeth.
- Common issues include stones, infections, swelling, and dry mouth.
- Persistent dry mouth, pain, or swelling around your jaw or ears warrants a doctor’s visit.
- Many conditions are treatable, especially with early detection.
- Staying hydrated and practicing good oral hygiene can help keep them healthy.
A Final Thought
It’s easy to overlook the little things our bodies do for us every single day. But when something like your saliva production goes awry, you really notice it. If you’re experiencing any concerns, please don’t hesitate to reach out. You’re not alone in this, and we’re here to help figure things out.