Clinical Features of Sialolithiasis (Salivary Gland Stone) - Simplified Symptoms Pain during meals Moderate to severe pain occurs while eating, especially when saliva production increases. Pain is caused by increased pressure behind the obstructed duct. Swelling during and after meals Swelling of the affected salivary gland appears during eating. It may be diffuse and sometimes resemble cellulitis. Relief after meals Pain and swelling gradually decrease during rest when saliva production falls. Recurrent episodes Patients often give a history of repeated swelling and pain whenever salivary flow is stimulated. Symptoms continue until the obstruction is relieved. Spontaneous passage of stone Occasionally, small salivary stones may be expelled spontaneously through the duct opening. Clinical Examination Findings Point tenderness Most common finding. Tenderness is usually present near: Hilum of the gland, or Wharton's duct (submandibular gland duct). Reduced salivary flow Saliva secretion is decreased or completely absent due to duct obstruction. Signs of secondary infection Fever Increased tenderness Tense gland Trismus (difficulty opening the mouth) Mucopurulent discharge Thick, cloudy, gelatinous, or pus-like material may be seen mixed with saliva. Results from inflammation and stagnation of saliva behind the obstruction. Inflammation around the duct Redness, swelling, and tenderness along the course of Wharton's duct. Most noticeable in the floor of the mouth. Enlarged salivary gland Gland becomes enlarged, tense, and painful on palpation. Pain and pus on gland massage Palpation or milking of the gland may produce pain and discharge of pus through the duct opening. Complications (If Untreated) Acute suppurative sialadenitis Severe infection develops due to prolonged obstruction. Pus discharge from duct orifice Frank pus may exude from the duct opening. Systemic manifestations Fever Malaise Severe pain and swelling Exam Pearl (OMFS) Classic presentation of sialolithiasis: "Meal-time syndrome" → Painful swelling of the salivary gland during meals that subsides gradually after eating. This is highly suggestive of a salivary duct stone, especially in the submandibular gland. give it as image