Bacterial infection can lead to the inflammation of the salivary glands. Bacterial sialedenitis commonly affects the parotid gland,submandibular glands are rarely affected.
ACUTE BACTERIAL SIALEDENITIS
Clinical Features
This is characterized by sudden onset of unilateral pain at the angle of the mandible. The affected gland is enlarged, tender, and very useful. There is a purulent discharge from the Stensen’s duct. Patients may be febrile with other signs of inflammation. The condition is common in debilitated and dehydrated patients predisposed to xerostomia.
Management
- Give amoxicillin 500mg 8 hourly orally.
- Initiate analgesics treatment: Ibuprofen 400mg orally 8 hourly.
- Improve oral hygiene of the patient by debridement and irrigation.
- Carry out surgically drainage if indicated using needle aspiration.
CHRONIC BACTERIAL SIALEDENITIS
This is chronic or recurrent and may be idiopathic or associated with factors that cause ductal obstruction. The disease starts as an unilateral swelling at the angle of the mandible. The recurrent type shows periods of remission.
Management
- Give amoxicillin 500mg 8 hourly orally.
- Initiate analgesics treatment: Ibuprofen 400mg orally 8 hourly.
- Excise the sialolith.
- In intractable cases, excise the salivary gland.