Submandibular gland swelling and stones
Download leaflet (PDF)What is the submandibular gland?
There is a submandibular gland beneath each side of the lower jaw. Saliva drains through a duct that opens under the tongue. Stones can obstruct this duct and cause swelling; infection and tumours are other possible causes. Not every lump under the jaw comes from the salivary gland.
Features that may be more reassuring
Pain and swelling that increase with meals and settle between them often suggest a stone or narrowed duct. This is usually a treatable blockage. However, recurrent episodes or a lump that remains between meals still need checking. Lack of pain does not exclude a significant problem.
Red flags: arrange prompt assessment
Contact your GP or specialist promptly for a persistent or enlarging lump, rapid growth, a lump that feels fixed, increasing unexplained pain, numbness or another lump in the neck. These features do not necessarily mean cancer, but need investigation.
When to seek urgent help
Seek same-day GP or NHS 111 advice for painful swelling with fever, redness or pus, or if you cannot drink enough. New facial weakness also needs urgent assessment. Call 999 for sudden facial droop, especially with arm weakness or speech difficulty.
Call 999 for breathing difficulty, rapidly increasing swelling under the tongue or in the neck, or inability to swallow your saliva. Do not wait for a routine appointment.
How is it assessed?
Assessment includes your symptoms, examination of the mouth and neck, and often ultrasound. A persistent lump may need an ultrasound-guided needle sample; MRI or CT is sometimes helpful. Tests are considered together rather than relying on how a lump feels.
Treatment and self-care
A small stone may pass, while others need removal through the mouth or with sialendoscopy (a miniature camera passed into the duct). Gland removal is sometimes needed if less invasive treatment is unsuitable or unsuccessful. A tumour requires a separate specialist treatment plan.
While awaiting assessment for suspected blockage, drink water regularly, massage gently and try sugar-free gum if comfortable. Do not cut or probe under the tongue. Seek review if symptoms recur, persist or worsen.