Most blocked salivary glands can be treated at home with a combination of warm compresses, gentle massage, hydration, and sour foods that stimulate saliva flow. About 80% of salivary stones form in the submandibular gland (under the jaw), with another 10 to 20% in the parotid gland (in front of the ear). The blockage is usually caused by a small calcium stone, and the size and location of that stone determines whether you can resolve it yourself or need medical help.
What a Blocked Salivary Gland Feels Like
The classic sign is swelling and pain in the affected gland that gets worse during meals. Eating triggers saliva production, but the stone blocks it from draining, so pressure builds. You may notice a firm lump under your jaw or near your ear, and the swelling often goes down between meals before flaring again the next time you eat. Some people can feel or even see a small hard bump inside their mouth near the duct opening.
If the blockage leads to infection, symptoms escalate. The gland becomes tender and hard, you may develop a fever, and pus can sometimes drain from the duct opening inside your mouth. An infected blocked gland needs antibiotic treatment targeting common mouth bacteria, not just home care.
Home Treatments That Work
Conservative treatment is always the first step, and it works well for smaller stones. The goal is simple: get saliva flowing forcefully enough to push the stone out of the duct.
Warm compresses: Apply a warm, moist cloth to the swollen area for 10 to 15 minutes several times a day. The heat increases blood flow and helps relax the duct, making it easier for the stone to move.
Gland massage: While applying heat (or right after), use your fingers to gently massage the gland toward the duct opening inside your mouth. For a submandibular stone, that means pressing from underneath the jaw and sweeping forward toward the floor of your mouth. The motion should be firm but not painful, like you’re trying to coax the stone along the duct.
Sour foods and drinks: Anything that makes your mouth pucker generates a strong burst of saliva. Lemon drops have been the traditional recommendation from clinicians for decades. A study comparing various options found that sour lollipops and lemon sherbet candies were the most effective at stimulating saliva flow among common sweets. Straight lemon juice or a splash of malt vinegar also work. Sucking on these several times a day, especially before and during meals, keeps the pressure behind the stone high.
Hydration: Drink plenty of water throughout the day. Dehydration thickens saliva and makes stones more likely to form or get stuck. There’s no magic number, but staying consistently well-hydrated keeps saliva thin and flowing.
Many small stones pass on their own within a few days to a couple of weeks with this routine. You’ll know it worked when you feel a sudden gush of salty or odd-tasting saliva in your mouth, and the swelling quickly resolves.
When Home Treatment Isn’t Enough
If the stone is too large to pass on its own, or if symptoms keep coming back, there are several medical procedures that can help without removing the gland entirely.
Sialendoscopy
This is the most common minimally invasive option. A doctor threads a tiny, flexible camera into the salivary duct through the opening inside your mouth. Once they can see the stone, they use small instruments passed through the scope to grab and remove it, or break it into pieces small enough to flush out. There are no external incisions, which means no visible scars.
Success rates are high. Studies following patients for over three years show that 80 to 90% experience complete relief of symptoms, with stone-related blockages responding even better than other duct problems. In one long-term study, 11 of 12 patients with stones had complete symptom recovery. The one patient who didn’t was found to have a new stone five years later, which was successfully treated with a second procedure.
Shock Wave Lithotripsy
For the 10 to 20% of stones that can’t be reached with a scope (because they’re too deep in the gland or embedded in tissue), shock wave lithotripsy is an option. This technique uses focused sound waves from outside the body to shatter the stone into fragments small enough to wash out naturally.
It works best on parotid gland stones, where complete clearance rates reach 67 to 71%. Submandibular stones are harder to clear fully, with success rates around 28 to 49% depending on the stone’s exact position. The stone must be larger than about 2.4 mm in diameter for the device to target it, and submandibular stones should generally be under 7 mm for this approach. People with pacemakers cannot undergo this treatment, and it’s postponed if there’s an active infection.
Gland Removal as a Last Resort
When stones keep coming back despite repeated procedures, or when the gland has been damaged by chronic infection, surgical removal of the gland itself is sometimes the best option. This is most common with the submandibular gland, since that’s where the vast majority of stones form and where recurrence tends to be highest.
Removal eliminates the problem permanently, since there’s no gland left to produce stones. You have multiple salivary glands, so losing one doesn’t cause dry mouth for most people. The trade-off is that it’s a more invasive surgery with a small external incision under the jaw and a longer recovery compared to scope-based procedures. It’s typically reserved for people whose quality of life is significantly affected by repeated episodes of blockage and infection that less invasive treatments haven’t been able to control.
How Doctors Diagnose the Blockage
If you visit a doctor for a suspected blockage, they’ll likely start with an ultrasound. It’s painless, quick, and doesn’t involve radiation. However, ultrasound picks up salivary stones only about 65% of the time, and it’s particularly likely to miss stones located toward the front of the duct under the tongue.
A CT scan is much more accurate, detecting stones about 98% of the time. Your doctor may go straight to CT if the ultrasound is inconclusive but symptoms strongly suggest a stone. During a sialendoscopy, the camera itself serves as both a diagnostic and treatment tool, since the doctor can see the stone directly and remove it in the same session.
Preventing Future Blockages
Once you’ve had one salivary stone, you’re at higher risk for another. The prevention strategy mirrors the home treatment approach: stay well hydrated every day, not just when symptoms appear. Periodically sucking on sour candy or lemon drops keeps the glands active and the ducts flushed. Gentle massage of the glands, especially if you notice any early tightness or swelling around mealtimes, can help keep things flowing before a full blockage develops. Good oral hygiene also matters, since bacteria from the mouth can travel up the ducts and contribute to inflammation that sets the stage for stone formation.