Submandibular Gland Infection
Infection of the salivary glands beneath the jaw
Quick Facts
- Type: Salivary gland condition
- Affected gland: Submandibular (under the jaw)
- Common causes: Blocked duct, stone, bacteria
- Main symptom: Painful swelling under the jaw
Overview
A submandibular gland infection is inflammation and infection of the submandibular salivary glands, which lie beneath each side of the jaw. These glands produce a large share of the mouth's saliva, and their ducts open under the tongue. The medical term for inflammation of these glands is sialadenitis.
Infection often develops when the flow of saliva is reduced or blocked, for example by a salivary stone or thickened saliva, allowing bacteria from the mouth to multiply in the gland. The result is painful swelling under the jaw, frequently worse at mealtimes. Many cases respond well to antibiotics and measures that restore saliva flow, but a blocked, infected gland can form an abscess and needs prompt care.
Symptoms
Symptoms come from inflammation and trapped saliva and may include:
- Painful swelling beneath the jaw, on one or both sides
- Pain that worsens during or before eating
- Redness or warmth over the swollen area
- A bad taste in the mouth or pus draining from the duct under the tongue
- Dry mouth
- Fever and feeling generally unwell
Warning signs of a serious infection include rapidly increasing swelling, high fever, and difficulty opening the mouth, breathing, or swallowing. A swelling in the floor of the mouth that pushes the tongue up is an emergency and needs immediate care.
Causes
Submandibular gland infection usually develops when saliva flow is reduced and bacteria invade the gland. Contributing factors include:
- Salivary stones: A stone blocking the duct is a common trigger, as the submandibular gland is especially prone to stones.
- Reduced saliva flow: Dehydration, certain medications, and recent illness or surgery slow saliva and allow bacteria to grow.
- Bacterial infection: Mouth bacteria can ascend the duct into the gland.
- Thickened saliva: Changes in saliva make blockage and infection more likely.
Risk Factors
- Dehydration
- Salivary stones or duct narrowing
- Older age and recent illness or surgery
- Medications that dry the mouth
- Poor oral hygiene
- Conditions that reduce saliva, such as dry mouth disorders
Diagnosis
Diagnosis is based on examination and the typical mealtime swelling, with imaging to find a cause:
- Physical examination: Feeling the swollen gland and checking for pus at the duct opening under the tongue.
- Ultrasound or CT scan: To look for stones, abscesses, or gland changes.
- Cultures: A sample of pus may be tested to guide antibiotic choice.
Treatment
Treatment combines fighting the infection with restoring saliva flow.
- Antibiotics: Used to treat bacterial infection.
- Hydration and saliva stimulation: Drinking fluids, warm compresses, gland massage, and sour or tart foods help flush the gland.
- Treating blockage: Removing a salivary stone, sometimes with sialendoscopy or a minor procedure, restores normal flow.
- Draining an abscess: A pocket of pus may need to be drained.
- Pain relief: Pain-relieving medication for comfort.
- Surgery: Rarely, a chronically infected or damaged gland is removed.
Prevention
- Stay well hydrated, especially when ill or after surgery
- Maintain good oral hygiene
- Stimulate saliva with sugar-free gum or tart foods if you are prone to gland problems
- Have salivary stones treated to prevent repeated infections
- Review drying medications with your doctor
When to See a Doctor
See a doctor for painful swelling under the jaw, especially with fever or pus draining into the mouth. Seek emergency care if swelling worsens rapidly, you have a high fever, the floor of your mouth swells and pushes your tongue up, or you have difficulty breathing or swallowing, as a deep spreading infection can be life-threatening.
Frequently Asked Questions
What causes a submandibular gland infection?
It usually develops when saliva flow is reduced or blocked, often by a salivary stone, allowing mouth bacteria to infect the gland. Dehydration and drying medications increase the risk.
Why does the swelling hurt more when I eat?
Eating triggers more saliva production. If the duct is blocked, the saliva cannot drain and backs up into the gland, so swelling and pain are typically worse around mealtimes.
How is a submandibular gland infection treated?
Treatment usually includes antibiotics, plenty of fluids, warm compresses, and saliva-stimulating foods. Any blocking stone is treated, and an abscess may need to be drained.
When is a salivary gland infection an emergency?
Seek emergency care if swelling worsens rapidly, you have a high fever, the floor of the mouth swells and lifts the tongue, or you have trouble breathing or swallowing. A deep neck infection can be life-threatening.
How can I prevent these infections?
Stay well hydrated, keep good oral hygiene, and stimulate saliva with sugar-free gum or tart foods if prone. Treating salivary stones and reviewing drying medications helps prevent recurrence.
References
- MedlinePlus, U.S. National Library of Medicine. Salivary gland infections.
- American Academy of Otolaryngology-Head and Neck Surgery. Salivary gland disorders.
- Mayo Clinic. Salivary gland infections.
- National Institute of Dental and Craniofacial Research (NIDCR). Salivary gland conditions.