Diagnosis of salivary stones (Salivary calculi)

Amin Abusallamah

key features to diagnose

• Adult males mainly affected

• Usually (80%) in submandibular gland

• Unilateral

• Usually form by accretion of calcium salts round organic nidus.

Cont…

• Usually form by accretion of calcium salts round organic nidus.

• Occasionally asymptomatic until palpable in the mouth or seen in routine radiograph

• Do not cause dry mouth

• Should be removed by manipulation or incision of duct

Diagnosis

• History • Clinical examination• X-ray examination.

History

• Careful history and examination are important in the diagnosis of Salivary calculi (in fact, in all aspects of medicine & dentistry).

• Pain and swelling of the concerned gland at meal-times and in response to other salivary stimuli are especially important.

Clinical examination

• Examination of the head and neck by the health care provider or dentist shows one or more enlarged, tender salivary glands.

Salivary calculus. This stone has impacted just behind the orifice of the submandibular duct forming a

hard nodule.

Cont…

• manual palpation of the floor of the mouth, in a posterior to anterior direction, reveals a salivary stone in a large number of cases of submandibular calculi formation.

• manual palpation of the gland itself can be useful, as a uniformly firm and hard gland suggests a hypo-functional or non-functional gland.

X-ray examination.

• Imaging studies are very useful for diagnosing salivary stone.

• Occlusal radiographs are useful in showing (radio-opaque) stones

Sialography

• Sialography is the radiographic examination of the salivary glands.

• It usually involves the injection of a small amount of contrast medium into the salivary ducts of a single gland, followed by routine X-ray projections.

• Sialography is useful in patients showing signs of salivary stone .

• CAWSON'S ESSENTIALS OFORAL PATHOLOGYAND ORAL MEDICINE

• Chapter … 18 … pages … 255,256,257