Overview of the Parotid Gland

The parotid glands are one of the three major types of salivary glands in the body, and they're probably most recognized by those who remember the "chipmunk cheeks of the mumps from back before the vaccine was available. The glands sit low on each side of your face and secrete saliva.

The parotid gland performs important functions and is involved in certain diseases, as well.

Dry mouth can significantly impact your quality of life. It can affect swallowing, create a burning feeling in the mouth, and predispose you to cavities.

Anatomy

You have two parotid glands, each one located in front of each ear. You also have two other major salivary glands, which are called the sublingual (under the tongue) and submandibular (under the jaw) glands.

All three salivary glands attach to a tube, called a duct, that transports saliva from the gland to the mouth. The duct attached to the parotid gland is called Wharton's duct.

Function

The function of the parotid gland and other two major salivary glands is to produce and secrete saliva, a substance that helps break food down so you can digest it properly.

Saliva also helps to defend against bacteria and prevent cavities.

Diseases of the Parotid Gland

Several types of medical conditions can affect your salivary glands, including dry mouth, infection, stones, and tumors.

Xerostomia (Dry Mouth)

When your salivary glands don't function properly and either stop or produce too little saliva, you can develop a dry mouth. Medically, this is called xerostomia. This condition has a number of potential causes, including:

• Radiation therapy
• Sjogren's syndrome (an autoimmune disease)
• HIV/AIDS
• Diabetes
• High blood pressure
• Hepatitis C
• Lymphoma
• Medications, including antihistamines and chemotherapy drugs

Sialadenitis (Infection)

Sialadenitis is a bacterial or viral infection that can affect the parotid gland as well as the submandibular gland. It most often arises after slowed drainage from the gland from a partial obstruction results in a secondary infection.

Symptoms may include:

• Tenderness of the cheek
• Fever
• Swelling
• Pain with eating
• Sometimes, the presence of pus where the duct opens into the mouth

Sialadenitis is most common in people with a chronic illness or who become dehydrated.

• Depending on the cause, treatment may include:
• Antibiotics or antivirals
• Warm compresses
• Massage of the gland, which can be painful
• Sucking on lozenges or cough drops to stimulate the flow of saliva and help your saliva wash out the infection

If the infection isn't promptly treated, an abscess may form, which may require drainage.

A chronic form of sialadenitis, which is usually related to an obstruction rather than an infection, can occur. In these cases, surgery to perform all or part of the gland is a treatment option.

Sialolithiasis (Obstruction)

Sialolithiasis is an obstruction that's usually due to a stone (calculus) blocking the Wharton's duct, which carries saliva to your mouth.

The obstruction causes pain and swelling on the side of the face of the affected gland. The formation of a stone can be triggered by not drinking enough fluids or taking a medication that reduces your saliva production.

If the obstruction is due to a stone, initial treatment may include:

• Drinking lots of fluids
• Massaging the gland
• Sucking on a lemon drop or vitamin C lozenge to trigger saliva production

If this doesn't work, your healthcare provider can use an instrument to remove the stone.

Stones close to the duct opening on the floor of the mouth can sometimes be removed through your mouth. Stones that lie deeper in the duct are more challenging to treat, as using instruments in this region could damage a nerve. In those cases, treatments similar to those for kidney stones, such as corporeal shock-wave lithotripsy, or fluoroscopic basket retrieval may be effective.

If stones are chronic and severe, the parotid gland itself may need to be removed, but this is not done if at all possible.

Other less common causes of obstruction in the parotid gland include:

• Dentures compressing the duct opening
• Tooth eruption as a result of trauma
• Mucous plugs or foreign bodies that get into the duct
• A neoplasm (tumor) or a swollen lymph node that blocks the duct

Inflammatory/Infiltrative Disorders of the Parotid Gland

Several medical disorders may result in enlargement of the parotid gland, either by infiltrating the gland or by causing inflammation in it. These include:

• Sjogren syndrome
• Diabetes
• Sarcoidosis
• Alcoholism 
• HIV/AIDS
• Drug-induced (some medications can make saliva thicker, such as iodine)

Mumps (Viral) Infection and the Parotid Gland

The most common viral infection salivary gland is mumps, which causes enlargement of both parotid glands. Prior to the introduction of the vaccine in 1967, mumps was a very common childhood infection, characterized by "chipmunk cheeks."

Outbreaks still occur occasionally, but it is a rarity now. If you have symptoms of mumps, it is important to see a healthcare provider for accurate diagnosis and treatment.

Tumors

The parotid gland can also develop growths or masses, called tumors. These tumors are often benign rather than malignant (cancerous). In contrast, tumors of the other major salivary glands, as well as the minor salivary glands, are often malignant. Malignant parotid tumors are usually either mucoepidermoid and adenocystic carcinomas, or adenocarcinomas.

What to Do If You're Concerned

If you notice swelling or tenderness over your parotid gland, talk to your healthcare provider. Not only could your discomfort signal an infection or stone which should be treated, but a swollen parotid gland might also indicate an underlying disease process.

Your primary care healthcare provider may refer you to an ear, nose, and throat doctor (ENT) for further evaluation.

A Word From Verywell

The parotid glands on each side of your face perform an important function in creating saliva, which in turn aids in digestion, lubricates your mouth, and inhibits dental decay. Infections and stones in the parotid glands may require treatment, and swelling of the parotid glands may provide important clues as to the presence of other medical concerns as well.