Salivary gland disease
Pain linked to meals suggests obstruction; persistent swelling has a broader differential. Assess gland, duct, facial nerve and red flags.
Understand
Meal-related pain and intermittent swelling suggest obstruction; persistent painless swelling, facial weakness or a fixed mass raises other concerns. Major and minor glands have different patterns.
Assess
Examine ducts, express saliva, palpate glands and neck and assess dry mouth, medication and systemic disease. Choose ultrasound or other imaging to answer a defined question.
Apply
Treat infection or obstruction according to severity and refer a suspicious mass promptly. Recurrent symptoms may need a salivary specialist rather than repeated antibiotics.
Key distinctions
Salivary obstruction often fluctuates with salivary stimulation; infection may add fever, tenderness and pus. Dry mouth has broad causes and changes caries and candidosis risk. A persistent mass, especially with facial nerve weakness or fixation in the parotid region, is a different diagnostic pathway. Ultrasound, MRI or other studies should be chosen for the question rather than ordered reflexively.
Think through a case
A submandibular swelling flares during meals and settles afterward. Duct obstruction is plausible, but persistent firm enlargement requires a broader investigation.
The distinction to remember
Do not repeatedly prescribe antibiotics for meal-related swelling without assessing for stone or stricture.
Test your recall
What history supports salivary obstruction?
Show answer
Recurrent swelling or pain around meals.