Parotitis

Definition

Parotitis is inflammation in one or both of the parotid glands. These are 2 large salivary glands that are inside each cheek over the jaw in front of each ear.

Parotitis can be:

• Acute—inflammation that resolves in a short period of time with or without treatment
• Chronic—includes persistent inflammation or alternating periods of flare-ups and remission

Parotid Gland

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Causes

An inflamed parotid gland has several causes. These vary depending on whether the condition is acute or chronic. The most common causes include:

• Bacterial infection
• Mumps
• Other viral infections
• Blockage of saliva flow
• Autoimmune diseases

Risk Factors

This condition is more common in older adults. Other factors that may increase your chance of parotitis include:

• Dehydration and/or malnutrition
• Recent surgery
• Radiation therapy for head and neck cancer
• Medical conditions, such as:
  • HIV infection
  • Diabetes
  • Alcohol use disorder
  • Sarcoidosis
  • Sjogren’s syndrome
• Blocked saliva flow, resulting from:
  • Salivary stone in the parotid gland
  • Mucus plug in a salivary duct
  • Tumor—usually benign
• Psychiatric conditions, such as depression or eating disorders
• Use of certain medications
• Poor oral hygiene

Symptoms

Acute parotitis may cause:

• Sudden facial pain and swelling that worsens with salivation or after eating
• Redness and tenderness
• Pus that may drain into the mouth

Chronic parotitis may cause:

• Swelling around the parotid gland
• Dry mouth
• Milky secretions
• Strange or foul taste in your mouth
• Fever, chills, and other signs of infection

Chronic parotitis can destroy the salivary glands.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. This may be enough to make a diagnosis. Tests may include a blood test and a fluid sample from the parotid gland.

Imaging tests evaluate the parotid gland and surrounding structures. These may include:

• Ultrasound
• CT scan
• MRI scan
• Sialography to evaluate the ducts in and around the parotid gland

Treatment

Treatment depends on what is causing the parotitis. Options may include:

Good Oral Hygiene

Flossing once a day and thorough tooth brushing at least twice a day may help with healing. Warm salt-water rinses can help keep the mouth moist. If you smoke, talk to your doctor about ways you can quit.

Medications

Medications may include:

• Antibiotics for bacterial infections (antibiotics are not effective for viral infections)
• Anti-inflammatory drugs to manage inflammation and pain

Blockage Removal

Your doctor may need to remove a stone, tumor, or other blockage. Increasing saliva flow may be all that is needed to remove a mucus plug.

Prevention

To help reduce your chances of parotitis:

• Get prompt treatment for any infections.
• See your dentist for proper oral care as recommended.
• Drink plenty of fluids throughout the day to avoid dehydration.
• Receive the measles, mumps, and rubella (MMR) vaccination if you have not yet been vaccinated