A revolution in the management of obstructive salivary gland disease

Salivary gland obstruction is the commonest cause of salivary gland disease presenting to the general dental practitioner. To date, with the exception of the most surgically accessible stones found within the anterior ducts, there has been little treatment to offer patients except surgical removal of the gland, with the associated risks to the facial and trigeminal nerves. In the last 10 years, more conservative treatment modalities have been developed, opening up a range of treatment options which combine to provide an alternative management of these cases. This paper presents data from one unit in which lithotripsy, which is the destruction of stones (calculi) using shock waves, basket retrieval, a modified minor surgical technique, and balloon dilatation have been used to treat salivary gland obstruction successfully. Over 70% of stones can now be retrieved leaving a functioning gland.

Salivary gland obstruction is a clinical problem presenting to the general dental practitioner, and requires an understanding of the range of treatment options available.