Salivary gland stone treatment — swelling under the jaw at mealtimes

Key facts

• Stones most often block the submandibular duct under the jaw
• Swelling and pain typically appear or worsen at mealtimes
• Hydration, massage and sour sweets can help small stones pass
• Stones near the duct opening can often be removed under local anaesthesia
• Swelling affecting swallowing or breathing needs emergency care

Why swelling appears at mealtimes

The major salivary glands, the parotid in front of the ear, the submandibular under the jaw and the sublingual under the tongue, release saliva through ducts into the mouth. When you see, smell or start eating food, saliva production increases sharply. If a stone partly blocks the duct, saliva backs up behind it, so the gland swells and aches, sometimes within minutes of starting a meal. The swelling often eases gradually over an hour or two as saliva trickles past the stone. Most stones form in the submandibular gland, because its saliva is thicker and its duct runs uphill.

Symptoms and complications

Typical symptoms include a tender swelling under the jaw or in front of the ear related to meals, a feeling of fullness, and sometimes a small hard lump felt under the tongue along the duct. Some people notice a gritty or salty taste. If saliva stays trapped, bacteria can cause a gland infection (sialadenitis), with constant swelling, redness, increasing pain, fever and pus coming from the duct opening into the mouth. Repeated infections can damage the gland over time. Dehydration, certain medicines that reduce saliva, and a history of gland inflammation can make stones more likely.

How stones are diagnosed

Diagnosis starts with the history and an examination of the glands from outside and inside the mouth. The surgeon may gently press the gland to see whether saliva flows freely from the duct, and can sometimes feel a stone in the floor of the mouth. Many submandibular stones are calcified enough to show on dental X-rays or CBCT, which help locate them. Ultrasound is commonly used to find stones and assess the gland, and in some cases specialised imaging is arranged. It is also important to rule out other causes of swelling under the jaw, such as dental infections, swollen lymph nodes or gland tumours.

Treatment options

Small stones may pass on their own with conservative measures: drinking plenty of water, massaging the gland towards the duct, applying warmth, and sucking sour sweets or lemon to stimulate saliva flow. Anti-inflammatory pain relief helps, and antibiotics are used if infection is present. Stones close to the duct opening in the floor of the mouth can often be removed through a small incision under local anaesthesia. Stones deeper in the duct or within the gland may need specialised techniques such as sialendoscopy, or occasionally gland removal, which are carried out by specialist hospital teams; Dr. Al-Khan arranges referral when this is the right option.

When to seek care

Book an assessment if you have repeated swelling under the jaw or in front of the ear around mealtimes, or a lump you can feel under the tongue. Seek same-day care for constant swelling with redness, pus in the mouth, fever or severe pain, as these suggest infection. Go to an emergency department for swelling under the tongue or jaw that affects swallowing, breathing or speaking, or rapidly spreading facial swelling. A gradually enlarging lump that does not hurt, in a salivary gland that is not related to meals should always be examined, because it may need imaging and a biopsy.

Oral and maxillofacial surgery treats conditions of the mouth and jaws that go beyond routine dentistry: impacted teeth, cysts and benign lesions, jaw injuries, and preparation of bone for implants.

Prepared by the Manhal Medical Center editorial team · Updated: 2026-10-18 · Treating specialist: Dr. Moataz Al-Khan

This page is general information and does not replace a consultation. Suitability, risks and results vary between patients.