From the Research
Sublingual sialolithiasis can be effectively treated with a combined endoscopic and transoral approach, as evidenced by the most recent and highest quality study 1. This approach allows for the identification of the location of the sialolith to guide removal and helps identify stone fragments and additional stones remaining after sialolithotomy. The treatment options for sublingual sialolithiasis include:
- Conservative measures such as hydration, warm compresses, gentle massage of the affected gland, and sialagogues like lemon drops or sour candy to help flush out smaller stones naturally
- Pain management with NSAIDs like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) to control discomfort
- Minimally invasive procedures like sialendoscopy or intraoral surgical removal under local anesthesia for accessible stones
- More extensive surgery such as sublingual gland excision for larger or deeply embedded stones
- Antibiotics like amoxicillin-clavulanate (875/125mg twice daily for 7-10 days) if infection is present
- Recurrence prevention includes maintaining good hydration, regular dental check-ups, and avoiding tobacco and excessive alcohol which can thicken saliva.
It is essential to note that sublingual gland sialolithiasis has a distinct presentation that is not associated with obstructive symptoms, and the treatment approach should be tailored to the individual patient's needs 1. The use of computed tomography (CT) can be helpful in distinguishing between sublingual gland and submandibular gland sialolithiasis, allowing for a more accurate diagnosis and treatment plan 2. Overall, the goal of treatment is to relieve symptoms, prevent further complications, and improve the patient's quality of life.
In terms of specific treatment recommendations, the combined endoscopic and transoral approach is the most effective treatment option for sublingual sialolithiasis, as it allows for the removal of the stone and the prevention of further complications 1. This approach should be considered for patients with persistent or large stones, and should be performed by an experienced surgeon to minimize the risk of complications. Additionally, patients should be educated on recurrence prevention strategies, including good hydration, regular dental check-ups, and avoidance of tobacco and excessive alcohol.
It is also important to consider the potential complications of sublingual sialolithiasis, such as chronic sialadenitis and glandular atrophy, and to take steps to prevent these complications through prompt and effective treatment 3. Overall, the treatment of sublingual sialolithiasis requires a comprehensive approach that takes into account the individual patient's needs and the potential complications of the condition.