Submandibular gland swelling is usually caused by a blocked duct, a salivary stone or an infection and often settles with hydration, warm compresses or antibiotics. A lump that is hard, painless or persistent should be assessed by a specialist to rule out a tumour.
Submandibular Gland Swelling: Sialadenitis, Stones and Tumours
Dr Thomas Ho
Senior Consultant General and Head & Neck Surgeon, Accredited Surgical Oncologist
MBBS(Sydney), MMed(Surg), AFRCS(Ireland), FRCS(Edinburgh), FAMS(General Surgery)
What Is the Submandibular Gland?
Finding a swelling or lump under your jaw can be unsettling, especially if it appears suddenly or worsens when you eat. In most cases this points to the submandibular gland, one of the major salivary glands and the cause is treatable.
You have two submandibular glands, one on each side, just below the jawbone. Each gland produces saliva and releases it into the mouth through a narrow channel called Wharton’s duct, near the base of the tongue.
Together with the parotid glands (in front of the ears) and the smaller sublingual glands (under the tongue), they make up your major salivary glands and produce a large share of your daily saliva, especially during meals.
Because saliva flow through Wharton’s duct increases when you eat, problems with this gland often show up or worsen at mealtimes, a clue that helps distinguish it from other types of neck swelling.
What Causes Submandibular Gland Swelling?
Several distinct conditions can cause the submandibular gland to swell and they are managed quite differently, so an accurate diagnosis matters.
| Cause | What it is | Typical pattern |
|---|---|---|
| Sialadenitis | Inflammation or infection of the gland, often bacterial or viral | Sudden swelling, tenderness, sometimes fever |
| Sialolithiasis (salivary stone) | A small mineral deposit blocking Wharton’s duct | Swelling and pain that flare up while eating, then ease |
| Sjögren’s syndrome or other autoimmune conditions | The immune system affects the salivary glands | Gradual swelling, often with dry mouth and dry eyes |
| Benign tumour (e.g. pleomorphic adenoma) | A non-cancerous growth within the gland | Slow-growing, usually painless, firm lump |
| Malignant tumour | A cancerous growth within the gland | Firm, sometimes fixed lump, may grow steadily and can be associated with nerve symptoms |
Salivary stones are one of the more common causes of submandibular gland swelling, partly because the gland’s saliva is thicker and its duct runs uphill, making it more prone to stones than the parotid gland.
Symptoms to Watch For
The symptoms below are commonly linked to submandibular gland conditions. Having one or two does not automatically mean something serious is happening.
- Swelling under the jaw on one or both sides
- Pain that worsens noticeably during or just before meals
- Afirm or tender lump you can feel with your fingers
- Dry mouth or a change in the amount or taste of your saliva
- Redness or warmth over the swollen area
- Fever, in cases involving infection
When to See a Specialist Promptly
Most submandibular gland swelling settles with simple measures or resolves once a stone or infection is treated.
See a specialist sooner if the swelling is painless and persistent, feels hard or fixed in place, keeps growing over several weeks or comes with numbness, facial weakness or difficulty swallowing or breathing.
These features do not automatically mean cancer, but the gland does need a proper look.
How Is Submandibular Gland Swelling Diagnosed?
Diagnosis usually starts with a clinical examination, feeling the gland from outside the jaw and inside the mouth and checking the duct opening for stones or discharge. Your specialist at Thomas Ho Surgery may then recommend:
- Ultrasound, often the first imaging test, useful for detecting stones, cysts and many tumours
- CT or MRI scans, used for a clearer picture of deeper or more complex masses, particularly before surgery
- Fine needle aspiration cytology (FNAC), a simple sampling test used to check whether a lump is benign or requires further treatment
This staged approach means most people are not sent straight for scans or biopsies. Your specialist will explain which tests are necessary based on the examination.
Treatment Options for Submandibular Gland Conditions
Treatment depends entirely on the underlying cause and not every case requires surgery.
Infection (Sialadenitis)
Typically managed with hydration, warm compresses, gentle massage and antibiotics if bacterial. Surgery may be considered if the infection is recurrent or an abscess forms.
Salivary Stone
Often managed with hydration, sialogogues (agents that stimulate saliva flow) and massage, with small stones sometimes passing on their own. Surgery, either removing the stone via the duct opening or removing the gland itself, may be needed if stones are large, deep or recurrent.
Autoimmune-Related Swelling
Usually managed medically, often with a rheumatologist involved. Surgery is rarely needed for the gland itself.
Benign Tumour
Sometimes monitored, though most are removed to confirm the diagnosis and prevent further growth. When surgery is needed, this means submandibular gland excision.
Malignant Tumour
Treated with surgical removal, sometimes alongside additional treatment. This means submandibular gland excision, often with further planning around margins and lymph nodes.
Many infective and stone-related cases resolve with conservative treatment alone, without ever needing an operation.
Submandibular Gland Excision: What to Expect
When surgery is recommended, whether for a stone that cannot be cleared another way, a persistent tumour or recurrent infection, it is called submandibular gland excision.It is performed under general anaesthesia through a small incision below the jawline, positioned to keep scarring inconspicuous.
A key part of the operation is careful protection of the nerves nearby, particularly the marginal mandibular nerve (lower lip movement) and the lingual nerve (tongue sensation and taste), to reduce the risk of temporary or less commonly lasting side effects.
Most submandibular gland excisions are day surgery or a short overnight stay. The gland itself is not essential for normal saliva production, since your other salivary glands continue as usual.
Recovery After Parotid Gland Surgery
Recovery is generally straightforward. Expect some swelling and mild discomfort around the incision, manageable with prescribed pain relief. Light activities can usually resume within a few days, while strenuous activity is best avoided for one to two weeks, as advised by your surgeon.
Some patients notice temporary numbness or weakness near the lower lip or tongue at first. This is usually nerve irritation rather than permanent injury and tends to improve over the following weeks.
Getting Clarity on Your Symptoms
Most swelling under the jaw comes down to something manageable, whether that is an infection, a salivary stone or (less often) a growth that needs a closer look. The path from there is usually straightforward: a proper examination, imaging if needed and treatment matched to the cause, which for many people means hydration, warm compresses or a short course of antibiotics rather than surgery.
If your swelling, pain or lump has not settled or you would simply like to understand what is causing it, a specialist assessment can give you that clarity and outline what, if anything, comes next.
Concerned about a Submandibular Gland Swelling?
Book a consultation with Dr Thomas Ho to discuss your condition and treatment options.
The Specialist Leading Your Care
Dr Thomas Ho
Medical Director, Senior Consultant Head & Neck Surgeon
20+ Years of Clinical Experience
MBBS(Sydney), MMed(Surg), AFRCS(Ireland), FRCS(Edinburgh), FAMS(General Surgery), FSSO(USA)
Dr. Thomas Ho is a distinguished surgeon well known for his expertise in Cancer Surgery, especially in the field of Head and Neck cancers as well as Abdominal and Digestive cancers. In 2009 he was awarded a MOH scholarship and completed a Surgical Oncology Fellowship in Canada, becoming one of only a handful of surgeons in Singapore with this recognition.
Prior to private practice, Dr. Ho founded the Head and Neck Surgery and Surgical Oncology service at Tan Tock Seng Hospital. Dr. Ho is experienced in laparoscopic (keyhole) and robotic-assisted surgery, which he routinely employs in the treatment of thyroid cancer, colorectal cancer, hernias, gallbladder diseases, adrenal and spleen disorders.
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Frequently asked questions
What does the submandibular gland do?
It is one of your major salivary glands, producing a significant portion of your saliva and releasing it into the mouth through Wharton’s duct, particularly during eating.
Is submandibular gland swelling always serious?
No. Most cases are caused by infection or a salivary stone, both of which are treatable. Swelling that is painless, hard, persistent or growing should be checked promptly, but this does not automatically mean cancer.
What is a submandibular salivary stone and how is it removed?
It is a small mineral deposit that blocks saliva flow through Wharton’s duct. Smaller stones may pass with hydration and gentle massage, while others require a minor procedure to remove the stone directly or gland removal if the stone is large or recurrent.
Can submandibular gland swelling go away without surgery?
Often, yes. Infections typically respond to hydration, warm compresses and antibiotics where needed and smaller stones can pass on their own. Surgery is generally reserved for tumours, recurrent stones or infections that do not settle with conservative care.
What happens during submandibular gland excision?
It is a surgical procedure, usually done under general anaesthesia through a small incision below the jaw, to remove the gland while carefully protecting the nearby nerves.
Will removing my submandibular gland affect my saliva or digestion?
No noticeable effect for most people. Your remaining salivary glands, including the other submandibular gland and both parotid glands, continue to produce saliva as usual.
How do I know if a lump under my jaw could be cancer?
Features that warrant prompt specialist review include a lump that is painless, firm, fixed in place, growing over weeks or accompanied by numbness or facial weakness. A specialist can usually clarify the cause quickly through examination and imaging or FNAC.
How long does recovery take after submandibular gland surgery?
Most patients resume light activities within a few days and avoid strenuous activity for one to two weeks. Your surgeon will confirm a timeline specific to your procedure and health.
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References
- Adhikari, R., & Soni, A. (2022). Submandibular sialadenitis and sialadenosis. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK562211/
- Hammett, J. T., & Walker, C. (2024). Sialolithiasis. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK549845/
- Koch, M., Mantsopoulos, K., Müller, S., Sievert, M., & Iro, H. (2022). Treatment of sialolithiasis: What has changed? An update of the treatment algorithms and a review of the literature. Journal of Clinical Medicine, 11(1), 231. https://doi.org/10.3390/jcm11010231
- Rassekh, C. (2022). Contemporary review of submandibular gland sialolithiasis and surgical management options. Cureus, 14(8), e28147. https://doi.org/10.7759/cureus.28147
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