Submandibular Swelling: Causes, Assessment, and Treatment
A Hampshire ENT Clinics patient guide
A swelling under the jaw or in the upper neck is often related to the submandibular gland, one of the major salivary glands. While many causes are benign, persistent or recurrent submandibular swelling should always be assessed by an ENT specialist.
At Hampshire ENT Clinics, we provide prompt, consultant-led assessment of submandibular gland problems, with access to modern imaging and specialist salivary gland care.
What Is the Submandibular Gland?
The submandibular glands sit beneath the jawline, one on each side. They produce saliva that drains into the mouth via a small duct opening under the tongue.
Because of this anatomy, problems with the gland or duct can cause visible swelling, pain, or discomfort, particularly around mealtimes.
Common Causes of Submandibular Swelling
1. Salivary Stones (Sialolithiasis)
The most common cause of submandibular swelling.
Stones block saliva flow
Swelling often worsens during or after eating
May be painful or associated with infection
2. Infection (Sialadenitis)
Blockage or dehydration can lead to bacterial infection, causing:
Painful swelling
Redness or tenderness
Occasionally fever or discharge into the mouth
3. Chronic Inflammation
Recurrent swelling without infection may occur due to:
Partial duct blockage
Autoimmune or inflammatory conditions
Reduced saliva flow
4. Tumours of the Submandibular Gland
Less common, but important to exclude. These may be:
Benign
Malignant (a higher proportion than parotid tumours)
Persistent, firm, or painless swelling requires careful assessment.
Symptoms That Should Prompt ENT Review
Recurrent swelling under the jaw
Swelling that worsens with eating
Pain, redness, or tenderness
Dry mouth or altered taste
Firm or progressively enlarging lump
Associated neck lumps
How Is Submandibular Swelling Investigated?
Assessment at Hampshire ENT Clinics may include:
Clinical examination of the neck and mouth
Ultrasound scan to detect stones or masses
CT scanning for deeper or complex disease
Fine needle aspiration (FNA) if a tumour is suspected
This approach helps distinguish obstructive, inflammatory, and neoplastic causes.
Treatment Options
1. Conservative Management
For mild or early disease:
Hydration
Gland massage
Saliva stimulants (e.g. sugar-free sweets)
Antibiotics if infection is present
2. Stone Management
Depending on size and location:
Endoscopic stone removal (sialendoscopy)
Surgical removal of the stone
Gland removal in selected cases
3. Surgery
Surgery may be required for:
Recurrent infection
Persistent obstruction
Tumours of the submandibular gland
Operations are performed with care to protect nearby nerves.
Frequently Asked Questions (FAQs)
Is submandibular swelling usually serious?
Most cases are due to salivary stones or infection, which are benign and treatable. However, persistent swelling should always be assessed.
Why does the swelling get worse when I eat?
Eating stimulates saliva production. If the duct is blocked, saliva cannot drain, causing painful gland swelling.
Are submandibular stones common?
Yes. The submandibular gland is the most common site for salivary stones due to thicker saliva and the uphill course of the duct.
Do I need a scan?
Ultrasound is often the first investigation. CT scans are used if stones are not clearly seen or if surgery is being considered.
Will antibiotics cure the problem?
Antibiotics treat infection but do not remove stones. Definitive treatment may be needed if blockage persists.
Is surgery always necessary?
No. Many patients improve with conservative or minimally invasive treatment. Surgery is reserved for recurrent or complicated cases.
Can submandibular swelling be cancer?
Cancer is uncommon but possible. Any firm, painless, or progressive lump requires specialist assessment.
Where can I be assessed?
Assessment and treatment are available at Hampshire ENT Clinics, with consultant-led care across Portsmouth, Winchester, Salisbury, and the wider Hampshire region.
Expert Salivary Gland Care
Submandibular swelling is common and often treatable, but accurate diagnosis is essential. Early ENT assessment helps prevent recurrent infection and ensures serious causes are not missed.
📞 If you have persistent or recurrent swelling under your jaw, contact Hampshire ENT Clinics to arrange an expert assessment.