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Diseases originating in the salivary glands are uncommon in children. When they do occur, they are usually infections or salivary gland masses. In addition, several disease processes that affect the entire body, may also involve the salivary glands.
Saliva is produced by major and minor salivary glands in the head and neck. We have six “major” salivary glands, including the parotid glands (in front of the ears), the submandibular glands (behind our jaw) and the sublingual glands (under the tongue). We also have hundreds of tiny “minor” salivary glands, located in the mouth and throat.
Salivary glands play an important role in digesting food, protecting our teeth from cavities, and lubricating our mouth during swallowing and speaking.
Infection is the most common disease process to affect the salivary glands. Infections are usually bacterial or viral.
Bacterial infections usually cause rapid enlargement of the infected gland. This is accompanied by pain, fever, reduced ability to eat by mouth, and generalized fatigue and discomfort. The parotid glands are the most common glands affected, and the infection is called parotitis. Bacterial infection of the salivary glands requires an accurate diagnosis by your doctor, and is usually treated with antibiotics, hydration, and oral care. Occasionally, your doctor may ask you to use a hot compress and massage the infected gland, or use things like sour candy to increase salivary production. Young patients, and patients with severe infection, may require hospital admission for intravenous antibiotics and fluids.
Viral infections also include symptoms of pain, difficulty eating, and generalized discomfort. However, unlike bacterial infections, viral salivary gland infections are often less tender and fevers are not seen as often.
Juvenile Recurrent Sialadenitis (JRS) or parotitis is a form of chronic salivary gland inflammation that is not associated with infection. JRS is usually a recurrent, painful inflammation located in the parotid salivary gland, and occurs (and resolves) spontaneously at least two times each year. This frequently stops after a few years.
The majority of salivary gland masses in children are benign (not cancer). The most common benign salivary mass in children is the hemangioma, usually occurring in the parotid gland. Less commonly, the submandibular gland and minor salivary glands may be involved. Treatment for salivary hemangiomas is often conservative (meaning no treatment is required), and does not usually require surgery.
There are several other kinds of masses that may occur in the salivary glands. These are much less common than the hemangioma in young children. When they do occur, your doctor will probably order an imaging examination like a CT scan, or and MRI scan, to evaluate the mass. Treatment depends on the location of the mass, and the possible diagnosis.
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