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Dental and Oral Health (Adults)

Salavary gland infection after dental clean

01/23/2009

Question:

I`ve developed a situation that for the last year or so every time I go to my dentist for a semi annual routine cleaning, a few days after, I develop a salavary gland fluid build up under my chin due to an infection. I then go to my physician afterwards and she prescribes Clindamycin HCL 300MG capsules 3x a day for 10 days. This always resolves my problem but everyone is puzzled as to why this is occurring. This is only occuring from the dental cleaning and my dentist always takes out his instruments in front of me from a sealed package. My wife and two children also get cleanings with me during the visit and have never developed any problems. Could you please help.

Answer:

What may be occurring is that you are traumatizing the salivary gland duct system during the dental prophylaxis. I assume that when you describe "under your chin" you are referring to an area underneath the floor of the mouth or rather directly beneath the tongue. This in most cases is referred to as a mucocele or ranula. This is an extravasation of saliva into the tissue or a pseudocyst and is a result of trauma to the salivary duct system.

In this case the sublingual or submandibular gland is probably the gland involved. During the cleaning the dentist or hygienist causes minor manipulative trauma to the surrounding tissues and as a result, the ductal tissues become inflamed and swollen and a blockage results. Now the salivary gland continues to produce saliva and the swelling results (like a dam).

The ductal system of the submandibular glands in some patients is very tortuous and susceptible to stones and increased susceptibility to blockage. Thus, my take is as a result of having your mouth open and the dental professional compressing the overlying tissue that contains the salivary duct, this problem results. The use of Clindamycin is to treat an infection that develops as a consequence of the stagnant saliva and possible source for bacterial infection.

Now this is an assumption of what is going on based upon your description. Without examining you and also seeing what the periodontal status is in your mouth, other conditions may also be contributing to this problem. I would also like to see the extent of the trauma, such as high vac suction or how they instrument the teeth during the prophy.

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Response by:

Richard J Jurevic, DDS, PhD Richard J Jurevic, DDS, PhD
Formerly, Assistant Professor of Biological Sciences
School of Dental Medicine
Case Western Reserve University