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Sialadenitis

Learn the symptoms of sialadenitis and how to treat it.
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Written by
Laura Henry, MD.
Resident in the Department of Otolaryngology-Head & Neck Surgery at the University of Pennsylvania
Medically reviewed by
Clinical Fellow, Pediatric Otolaryngology, Children's Hospital of Philadelphia
Last updated January 6, 2021

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What is sialadenitis?

Sialadenitis is an infection of the salivary glands, which make saliva.

Saliva is essential because it helps with killing germs in your mouth, digesting food, preventing bad breath, and protecting against tooth decay.

There are three main salivary glands: near the ears (parotid), under the tongue (sublingual), and under the bottom jaw (submandibular). All produce saliva that flows through salivary ducts (tiny tubes), directly into your mouth.

Sialadenitis is painful, but it’s not an emergency unless there is so much mouth swelling that you’re having difficulty breathing. If that happens, go straight to the ER.

Otherwise, contact your doctor for advice on relieving symptoms.

Most common symptoms

Pro Tip

It’s very important that you complete the entire course of antibiotics if prescribed, as sometimes bacterial sialadenitis can develop into cellulitis, or rarely, an abscess. If your symptoms get worse or don’t improve within 3 to 4 days, go back to your physician. —Dr. David R. Lee

Sialadenitis can affect any or all of the salivary glands. The infected glands become painful and swollen.

Discomfort may be felt in front of the ear on either side, under the jaw on either side, or inside your mouth. You may have decreased saliva.

Other symptoms include fever and chills, which are general signs of infection.

Main symptoms

  • Pain and swelling near the ears, in the mouth, or under the jaw (depending on which glands are involved).
  • Decreased saliva production.
  • Dry mouth.
  • Pain with eating.
  • Fever and chills.

How do you treat sialadenitis?

Dr. Rx

Ask your doctor the best way to manually massage the affected gland. For the parotid gland, start just in front of your ear and massage toward your nose and mouth. It may hurt a bit as you force any thick saliva in the duct out. For the submandibular glands, start with your thumb just below the corner of your mandible and pull towards your chin, following just under your jaw bone. —Dr. Lee

A doctor needs to know whether the infection is bacterial or viral. Usually, if it’s in glands on both sides of your mouth, it’s likely viral. If it’s only on one side of your mouth, it’s bacterial.

If it’s a bacterial infection, you can take an antibiotic. Viruses need time to get better on their own.

Whether bacterial or viral, these treatments of sialadenitis may relieve some symptoms.

  • Drink lots of water and fluids, ideally 6 to 8 8-oz glasses of water per day.
  • Try natural ways of boosting saliva (called sialogogues). Sucking hard candies and chewing sugarless gum are two good options.
  • Apply warm compresses on the affected glands and painful areas.
  • Gently massage painful areas on your cheek or under your jaw with fingertips (this can help manually express any infection that is in the gland or ducts).
  • Brush and floss at least twice daily.

What antibiotics treat sialadenitis?

Treating a bacterial infection requires antibiotics. Typically, doctors will prescribe dicloxacillin (Dycill) or cephalexin (Keflex) for sialadenitis. Always finish the medications as instructed, even if your symptoms improve while you are taking the medicine.

If you get sialadenitis again, see your doctor or an ENT (Ear, Nose, and Throat) specialist to check why the infection keeps coming back.

What causes sialadenitis?

Pro Tip

Many patients are surprised by the foul taste in their mouth after the manual massage of the affected gland. This is due to the drainage of the infected spit. While having an unpleasant taste and being painful, releasing this fluid is one of the best ways to treat the infection. —Dr. Lee

Any decrease in saliva production increases the risk of bacterial infection. Saliva controls the amount of bacteria in the mouth.

Possible causes of decreased saliva include dehydration. This is especially common in hospital patients, people recovering from surgery, and the elderly.

Taking certain medications that can cause dehydration, such as diuretics, antihistamines, beta blockers, or barbiturates, can also decrease saliva production.

Anyone with decreased saliva is also more susceptible to developing salivary gland stones, small calcium deposits in the salivary ducts that block the flow of saliva. This can cause a backup of saliva in the gland and a buildup of bacteria that can lead to inflammation and infection.

Some viruses (most commonly mumps), a complex autoimmune condition called Sjogren’s syndrome, and the eating disorder anorexia nervosa can also trigger sialadenitis, but overall these causes are less common causes than dehydration.

Preventative tips

  • Staying well-hydrated is key.
  • Good oral hygiene includes brushing and flossing teeth twice a day.
  • Viral sialadenitis caused by mumps can be prevented with the measles, mumps, and rubella vaccine. These vaccines are usually given in childhood.
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Resident in the Department of Otolaryngology-Head & Neck Surgery at the University of Pennsylvania

Dr. Henry is a first-year resident in the Department of Otolaryngology-Head & Neck Surgery at the University of Pennsylvania. She received her medical degree from the University of Pennsylvania and her BA in political economy from Williams College. As a medical student, she was the editorial manager of an otolaryngology publication and has extensive experience with medical writing. She is currently working on research projects for publication in the sub-specialty fields of otology, head and neck cancer, and facial plastics. Outside the hospital she enjoys fly fishing, squash, hiking, and watching pro tennis.

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