Salivary Glands & Oral Lesions
Assess meal-related swelling, gland infection and persistent oral abnormalities.
Quick revision ↓ Medical Dictionary
01Salivary obstruction
Painful gland swelling that worsens around meals suggests impaired salivary drainage, often from a stone or duct narrowing. Examine the gland and duct opening where appropriate and assess hydration. Ultrasound or other imaging may help locate the cause. Recurrent symptoms need a plan rather than repeated treatment without addressing obstruction.
02Acute gland infection
Tender swelling, fever and purulent duct discharge can indicate sialadenitis. Assess systemic illness, hydration, immune status and possible obstruction. Treatment may include supportive measures and antimicrobials chosen through local guidance. Abscess, rapidly progressive swelling or airway symptoms requires urgent specialist review and consideration of source control rather than outpatient therapy alone.
03Persistent masses
A persistent focal salivary mass needs evaluation even if painless. Rapid growth, fixation, skin involvement, neck nodes or facial weakness increases concern. Specialist imaging and appropriately planned tissue sampling distinguish inflammatory and neoplastic causes. Avoid assuming every parotid lump is benign based on its location or a short symptom history.
04Dry mouth
Xerostomia can relate to medicines, dehydration, autoimmune disease or previous treatment. Ask about dry eyes, swallowing, dental decay and oral discomfort. Review causes with the relevant treating clinicians and support oral hygiene and dental care. Do not stop essential medicines without a risk-benefit discussion or assume all dryness is simply age related.
05Oral lesions
Examine ulcers, white or red patches and lumps in their clinical context. A traumatic ulcer should improve after the cause is removed; persistence beyond the expected healing period needs review. An unexplained oral ulcer lasting more than three weeks meets an important suspected-cancer referral trigger in NICE guidance. Record the lesion and ensure responsibility for follow-up.
High-Yield Revision
- Meal-related swelling suggests obstructed salivary flow.
- Facial weakness with a parotid mass is concerning.
- Persistent oral lesions need a defined review or referral plan.
Common Pitfalls
- Calling every painless salivary lump benign.
- Repeating infection treatment without evaluating obstruction.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.