What is a sialogram?
A sialogram is a test your doctor can use to diagnose a blocked salivary
gland or duct in your mouth. The procedure uses X-rays. It’s also called a
Your salivary glands are located on each side of your face. You have three
pairs of major salivary glands. The parotid glands, which are the largest, are located
inside each cheek. They’re above your jaw in front of your ears. Your
submandibular glands are below your jawbone on both sides of your jaw. Your
sublingual glands are on the bottom of your mouth under your tongue.
Salivary glands release saliva into your mouth through salivary ducts. A
free flow of saliva to the mouth is important for digestion and general oral
Functions of saliva
Saliva adds moisture to food when it enters your mouth. The moisture helps
with chewing and swallowing. It also helps prevent choking. Enzymes in saliva
initiate the digestion process before you swallow food.
Saliva also works to keep your mouth clean. It helps wash bacteria and food
particles away. Moisture from saliva also helps keep oral appliances, such as
dentures and retainers, secure in your mouth.
Why is a sialogram performed?
Your doctor can use a sialogram to evaluate blockages in a salivary duct or
gland. Your doctor may recommend a sialogram if you have one or more of the
- a constant abnormal or foul taste in your mouth
- an inability to fully open your mouth
- discomfort or pain when opening your mouth
- dry mouth
- mouth pain
- face pain
- swelling over your jaw in front of your ears
- swelling of your face or neck
While these symptoms occur in the salivary glands, they can be a result of:
- infections in the mouth or elsewhere in the body
- salivary duct stones
- salivary duct infections
- oral cancer or other types of cancer
- sarcoidosis, which is a condition in which patches of
inflammation occur throughout the body
- Sjogren’s syndrome, which is an autoimmune disorder
that causes dry mouth and eyes
Salivary gland tumors are rare. They occur most often in the parotid gland.
The growths slowly increase in size, expanding the gland.
Preparation for a sialogram
You should tell your doctor the following before you have a sialogram:
- Tell them if you have a contrast or iodine allergy. You
may need medication to prevent an allergic reaction during or after the
- Tell them if you’re taking any prescription or
over-the-counter medications. In most cases, the test will not interfere
with your medication schedule.
- Tell them if you’re pregnant or think you’re pregnant.
If your doctor gives you a sedative to take at home, you won’t be able to drive
yourself to the procedure. If that’s the case, you’ll need to arrange for
No other preparation is typically necessary for a sialogram.
How is a sialogram performed?
A sialogram is normally an outpatient procedure. It typically takes place in
the radiology department of a hospital or clinic. The procedure typically takes
about 30 minutes. It may take longer if the duct opening is difficult to locate.
Your doctor or an X-ray technician will perform the sialogram. They’ll give you a
germ-killing mouthwash. They may give you a sedative to help you remain calm. Stronger
sedation may be necessary if you’re unable to remain still.
You’ll lie on your back on an
X-ray table. You’ll have to open your mouth very wide. No numbing agent is
used. The procedure causes only minimal discomfort.
They’ll take an X-ray. This
will show if there are any stones that might prevent the contrast material, or
dye, from entering the ducts and reaching the gland.
They’ll place a small,
flexible tube called a catheter in the opening of the salivary duct. They may
ask you to hold the tube in place. The technician will inject contrast material
into the duct. You may experience pressure and some discomfort. After the dye
fills the salivary gland, it will be visible by X-ray.
Your doctor may need to
examine your salivary gland from different angles. You may have to turn your
head in different directions. You may also need to hold your breath
periodically. This helps you stay still for the X-ray images.
They may give you lemon juice
to increase the amount of saliva in your mouth. They’ll take additional images
to observe how your saliva drains into your mouth.
What to expect after a sialogram
After the sialogram is over, the contrast material will drain into your
mouth. They may instruct you to massage your salivary glands. This will aid in
draining the dye. The dye may taste bitter. It’s safe to swallow the dye.
After your sialogram, you can return to your normal diet and activities.
What are the risks of a sialogram?
A sialogram will expose you to minimal amounts of radiation. However, the
test can help your doctor learn important information about your health. The
risk of radiation exposure is considered acceptable for this reason. Special
considerations may be necessary for pregnant women, women who are
breast-feeding, and children. These groups have an increased risk of harm from
A sialogram is a minimally invasive technique. However, it carries a small
risk of damage or puncture to the salivary duct, swelling, and tenderness. Infection
is a rare complication. Contact your doctor if you experience:
- soreness or pain that continues after 24 hours
- swelling or bleeding of the salivary duct
- a fever
Understanding the results
A radiologist will interpret the images from your test. They’ll send a
report to your doctor. Abnormal results may indicate:
- narrowing of the salivary ducts
- infection or inflammation of the salivary gland
- stones in the salivary ducts
- a tumor in the salivary gland
Blockages or tumors may require further investigation. Follow-up tests on
your affected glands and ducts might include:
- an ultrasound
- an MRI scan
- a CT scan
- sialoendoscopy, which involves using a tiny camera to
see inside the salivary gland
- a biopsy