When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Sialadenite

Last reviewed: 16 Aug 2025
Last updated: 19 Jul 2022

Summary

Definition

History and exam

Key diagnostic factors

  • febre
  • dor e disfagia
  • edema facial
  • edemas doloridos recorrentes
  • exsudatos de pus pela abertura da glândula salivar
  • uso de medicamentos xerostômicos
  • trismos mandibulares
  • dificuldade respiratória (estridor, uso de músculos acessórios, batimento da asa do nariz, sibilo)
  • paralisia do nervo craniano
  • doença do tecido conjuntivo ou síndrome de Sjögren
Full details

Other diagnostic factors

  • edema episódico durante a alimentação
  • recentes intervenções cirúrgicas sob anestesia geral
  • ressecamento dos olhos e da boca
  • candidíase oral
  • exposição ao contraste iodado
  • edemas indolores recorrentes
  • deslocamento do lobo auricular
  • pródromo de parestesia na glândula afetada
  • edema no palato duro
Full details

Risk factors

  • depleção de volume e desnutrição
  • imunossupressão
  • Síndrome de Sjögren
  • doenças do tecido conjuntivo
  • mulheres entre 50 e 60 anos de idade
  • anestesia geral
  • medicamentos xerostômicos
  • sialolitíase
  • obstrução mecânica crônica e/ou múltiplos episódios de inflamação aguda
  • trauma (morder a bochecha)
  • procedimentos ortodônticos/dentários
  • sialectase, diverticulite e estenoses
Full details

Diagnostic tests

1st tests to order

  • cultura e sensibilidades do exsudato do ducto
  • Hemograma completo
  • radiografias faciais (filmes oclusais e/ou dos tecidos moles)
Full details

Tests to consider

  • ultrassonografia da glândula afetada
  • Tomografia computadorizada (TC)
  • sialografia digital por subtração
  • Sialografia por ressonância magnética (RM)
  • cintilografia usando radioisótopo pertecnetato Tc 99m de sódio
  • anticorpos anti-SSA/Ro, anti-SSB/La
  • fator antinuclear
  • fator reumatoide
  • citologia por aspiração com agulha fina (FNAC) da glândula afetada
  • RNM
  • biópsia das glândulas salivares menores
  • IgG4 e IgE
  • biópsia das glândulas salivares maiores
  • sialoendoscopia
Full details

Treatment algorithm

INITIAL

sinais de comprometimento das vias aéreas

ACUTE

sialadenite bacteriana aguda (não obstrutiva)

sialadenite obstrutiva

sialadenite autoimune

sialadenite necrosante subaguda

ONGOING

sialadenite crônica: recorrente ou esclerosante (<3 vezes/ano ou não grave)

sialadenite recorrente: qualquer causa (>3 vezes/ano ou ataques graves)

Contributors

Authors

Chris Avery, MD, MChir, FDSRCS, FRCS, FRCS (OMFS)

Consultant Oral and Maxillofacial Surgeon

Honorary Associate Professor Senior Lecturer

University Hospitals of Leicester NHS Trust

Leicester

UK

Disclosures

CA declares that he has no competing interests.

Acknowledgements

Dr Chris Avery would like to gratefully acknowledge Dr Alfredo Aguirre, Dr Michael N. Hatton, and Dr Ernesto de Nardin, previous contributors to this topic. AA, MNH, and EDN declare that they have no competing interests.

Peer reviewers

Issac van der Waal, DDS, PhD

Professor of Oral Pathology

Head of the Department of Oral and Maxillofacial Surgery and Oral Pathology

VU University Medical Centre and Academic Centre for Dentistry

Amsterdam

The Netherlands

Disclosures

IVDW declares that he has no competing interests.

Michael D. Turner, DDS, MD, FACS

Assistant Professor

New York University College of Dentistry

Department of Oral and Maxillofacial Surgery

Department of Periodontics and Implant Dentistry

New York University School of Medicine

New York

NY

Disclosures

MDT declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Fattahi TT, Lyu PE, Van Sickels JE. Management of acute suppurative parotitis. J Oral Maxillofac Surg. 2002;60:446-448. Abstract

Kraaij S, Karagozoglu KH, Forouzanfar T, et al. Salivary stones: symptoms, aetiology, biochemical composition and treatment. Br Dent J. 2014 Dec 5;217(11):E23.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Sialadenite images
  • Differentials

    • Caxumba
    • Sarcoidose
    • Tuberculose
    More Differentials
  • Guidelines

    • Updated S2K AWMF guideline for the diagnosis and follow-up of obstructive sialadenitis - relevance for radiologic imaging
    • Salivary gland disorders
    More Guidelines
  • Patient information

    Artrite reumatoide

    Sarampo, caxumba e rubéola: meu filho deve tomar a vacina tríplice viral?

    More Patient information
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer