Discharge Instructions for Sialolithiasis
Patients with sialolithiasis should be instructed to increase fluid intake to at least 2L per day, maintain good oral hygiene, apply warm compresses to the affected area, massage the gland toward the duct opening, and return immediately if they experience worsening pain, fever, or increased swelling.
Post-Treatment Care Instructions
Hydration and Diet
- Increase fluid intake to at least 2-3 liters of water daily to promote salivary flow 1
- Maintain a balanced diet with adequate calcium intake (1,000-1,200 mg/day) 1
- Limit sodium intake to less than 2,300 mg per day 1
- Avoid foods that stimulate excessive salivary production during the healing phase (citrus, spicy foods)
Pain Management
- Take prescribed pain medications as directed
- Apply warm compresses to the affected area for 15-20 minutes, 3-4 times daily to reduce inflammation and promote drainage
- Massage the affected gland gently toward the duct opening to encourage saliva flow and potential passage of small residual fragments
Oral Hygiene
- Maintain meticulous oral hygiene with regular brushing and flossing
- Use warm salt water rinses (1/2 teaspoon salt in 8 oz warm water) 4-6 times daily
- Avoid alcohol-based mouthwashes which may cause irritation
Follow-up Care
Monitoring
- Monitor for stone recurrence by checking for swelling before or during meals
- Follow up with your healthcare provider in 1-2 weeks for evaluation
- Regular imaging may be required to assess for residual or recurrent stones
Warning Signs (When to Seek Immediate Medical Attention)
- Fever over 101°F (38.3°C)
- Increasing pain not controlled by prescribed medications
- Progressive or sudden swelling of the affected gland
- Purulent discharge from the duct opening
- Difficulty swallowing or breathing
- Spreading redness or warmth in the neck or floor of mouth
Prevention of Recurrence
Daily Practices
- Continue increased fluid intake (2-3 liters daily) permanently 1
- Stimulate salivary flow regularly by:
- Sucking on sugar-free candies
- Chewing sugar-free gum
- Performing gentle gland massage
Medication Considerations
- For patients with recurrent stones, discuss with your doctor about:
- Sialagogues (medications that increase salivary flow)
- Antilithogenic agents that may help prevent stone formation
Special Considerations
Post-Surgical Care (if applicable)
- If surgical removal was performed:
- Keep the surgical site clean according to specific instructions
- Complete the full course of prescribed antibiotics
- Avoid strenuous physical activity for 1 week
- Soft diet for 2-3 days following the procedure
Stent Care (if placed)
- If a salivary duct stent was placed:
- Avoid manipulating or removing the stent
- Follow specific care instructions for the stent
- Return for stent removal as scheduled by your provider
Long-term Management
- Regular dental check-ups every 6 months
- Consider 24-hour urine collection to assess for metabolic abnormalities if stones recur 1
- Maintain healthy weight through appropriate diet and exercise, as obesity may be a risk factor for stone formation 1
The management of sialolithiasis focuses on stone removal and prevention of recurrence through increased hydration, proper oral hygiene, and regular follow-up care. With appropriate management, most patients can expect good outcomes and reduced risk of recurrence.