From the Guidelines
Swelling of the submandibular glands can be caused by several conditions, with sialadenitis (inflammation of the salivary gland) being the most common, as noted in a study published in the British Journal of Anaesthesia 1. This inflammation often results from bacterial infections, particularly when there's obstruction from salivary stones (sialolithiasis) [ 1 ]. Some key causes of submandibular gland swelling include:
- Bacterial infections
- Mumps virus, producing bilateral painful swelling
- Other infectious agents including cytomegalovirus, HIV, and bacterial pathogens like Staphylococcus aureus
- Autoimmune conditions such as Sjögren's syndrome, sarcoidosis, and IgG4-related disease
- Ductal obstruction from stones, strictures, or mucous plugs leading to saliva backup and subsequent swelling
- Malignancies including squamous cell carcinoma and lymphoma, especially with persistent unilateral enlargement
- Reactive lymphadenopathy of the submandibular lymph nodes, which can mimic glandular swelling
- Dehydration and certain medications like anticholinergics, antihypertensives, and antipsychotics reducing saliva production, potentially contributing to inflammation
- Trauma to the floor of the mouth or poor oral hygiene introducing bacteria, leading to sialadenitis Prompt evaluation is essential as treatment depends on the underlying cause [ 1 ]. According to the most recent evidence from 2025, the management of Sjögren's syndrome, a common autoimmune cause of submandibular gland swelling, involves a multidisciplinary approach with topical and systemic therapies [ 1 ]. The European League Against Rheumatism (EULAR) recommends a stepwise approach to managing Sjögren's syndrome, starting with symptomatic relief using topical therapies and considering systemic therapies for active systemic disease [ 1 ]. In cases of suspected or diagnosed cancer of the major salivary glands, including the submandibular gland, initial staging and post-therapy assessment are crucial for determining the best course of treatment [ 1(#ref-7 #ref-9) ]. Overall, the causes of submandibular gland swelling are diverse, and a thorough evaluation is necessary to determine the underlying cause and guide appropriate treatment.
From the Research
Causes of Swelling of Submandibular Glands
- Nonmalignant swelling may be caused by:
- Mumps
- Sialadenitis
- Sjögren syndrome
- Cysts
- Infections 2
- Submandibular lymphadenopathy may result from:
- Infections of teeth
- Upper respiratory tract
- Sinuses
- Tonsils
- Infections mononucleosis
- Cut scratch disease 2
- Neoplastic growths in the submandibular area may include:
- Tumors of the submandibular gland
- The tail of the parotid gland
- Hodgkin's disease
- Non-Hodgkin's lymphomas 2
- Sialadenitis can be acute or chronic and caused by:
- Bacterial etiologies (most common bacteria is Staphylococcus aureus)
- Viral etiologies (most common in children are mumps and juvenile recurrent parotitis)
- Obstructive etiologies 3
- Sialolithiasis (salivary stones) can cause up to 50% of salivary gland disorders and is associated with:
- Salivary stasis
- Inflammation
- Dehydration
- Malnutrition
- Medications
- Chronic illness 3
- Staphylococcus aureus is a major human pathogen that can cause a wide range of clinical infections, including: