My Doctor Online The Permanente Medical Group

Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Overview

Sialadenitis is an infection or inflammation of the salivary glands. There are major salivary glands in front of your ears and on the floor of your mouth. Many minor salivary glands are in your cheeks, lips and tongue. The main purpose of these glands is to secrete saliva to help you digest your food. These glands can become infected with bacteria or a virus. Occasionally there can be a severe infection in which an abscess or pocket of pus can form. Treatment includes drinking plenty of fluids, taking antibiotics if necessary, and in more rare cases, surgical drainage.

Symptoms, Screening and Diagnosis

Symptoms of sialadenitis include pain and a tender swelling in your mouth or throat. Eating, or even the thought of eating, stimulates saliva production in your mouth and if there is inflammation or blockage of the saliva gland, the gland may swell and become painful.

You can have swelling of the gland without infection or inflammation. This is due to a partial blockage in the saliva channels. Occasionally there can be a severe infection where a pus-filled pocket or abscess forms. If this happens, it will need to be drained.

Depending on which salivary gland or duct is infected, people with sialadenitis often have these symptoms: 

  • Pain during meals
  • Swelling
  • Pus
  • Fever
  • In severe cases, fever and perhaps chills
  • Dry mouth

We can diagnose salivary gland infection by examining your mouth and throat. If we find an infection (abscess) or blockage (stones), we may have to take tests for further evaluation.

Causes

The cause of an infected salivary gland (sialadenitis) is an infection or blockage of the gland or duct. It is seen more frequently in elderly people or people who have chronic illnesses. A salivary gland may become blocked due to dehydration, a stone, or a tumor (although this is rare). Any of these conditions can lead to an infected salivary gland.

Poor oral hygiene can also cause an infection of the salivary gland.

Treatments

Most often, an infected salivary gland or duct can be managed by following these steps:

  • Take oral antibiotics.
  • Drink plenty of fluids. We recommend you drink at least 8 to 10 glasses of water daily. You can mix some lemon in the water and this will help stimulate saliva, helping to keep the channels flowing by removing any possible sludge or stones that may be in the way.
  • Massage the glands.
  • Apply warm compresses to the glands.
  • Suck on sour lemons to stimulate saliva production.

In most situations, we are able to manage your condition without surgery. Sometimes however, we may consider a surgical option in order to treat abscesses or stones.

Your Care with Me

If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.

If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.

During your office visit, we will discuss your medical and family history, and I will perform a physical exam. I will also perform a thorough head and neck exam. Sometimes, this may include the use of a fiberoptic flexible scope inserted through the nose to examine the back of the throat and voice box. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options, and together we will create a treatment plan that is right for you.

The vast majority of salivary gland infections are effectively treated with antibiotics and do not require surgery. Sometimes no treatment is required at all.

If a stone is blocking one of the salivary gland ducts, we can usually remove it through the mouth. Often, this can be done in my office. It will depend on the exact location of the stone, your condition, the degree of swelling, and whether any further tests are needed. If the stone is not readily accessible, I may schedule the procedure in the operating room. This may include removal of the stone through the floor of mouth by making a small incision over the stone, or it may include Sialoendoscopy (a procedure where the duct opening is dilated and a very small optical scope is inserted into the duct and the stone extracted). Another option may require removing the gland.

If I find an abscess, I may recommend surgical drainage or aspiration and prescribe an antibiotic for you.

If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.

If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.

If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.

Coordinating Your Care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology and health education, makes getting your care easier for you.

Another major benefit is our comprehensive electronic medical record system which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.

When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

If you come to an office visit
  • At the beginning of your visit, you will receive information about when you are due for your next test, screening or immunization. We can discuss and schedule any preventive tests that you need. 
  • At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
  • To help you prepare for your visit, please see additional details under Office Visit. 
If I prescribe medications

We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.

If refills are needed in the future, you can:
  • Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
  • Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed

For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures we will schedule an appointment with the Radiology department. When the results are ready I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.

If I refer you to another specialty colleague

If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.

If surgery or a procedure is a treatment option

I will recommend you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.

If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.

Convenient Resources for You

As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available at any time that is most convenient for you. From my home page you can:

Manage your care securely
  • View and compose secure e-mail messages.
  • Manage your prescriptions.
  • View your past visits and test results.
  • View your preventive services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
  • Read about causes, symptoms, treatments and procedures.
  • Find interactive health tools, videos, and podcasts to help you manage your condition.
  • View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
  • Locate health education classes and support groups offered at every medical center.
  • Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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