They sound bizarre

They sound bizarre: saliva stones that grow in the mouth, ruining appetite and making chewing agony - yet they're far. The aroma from the roast beef and Yorkshire pudding was delicious. But as Seanne Brearley settled in her seat at her friend's house to enjoy the meal with her friends, a tell-tale pain throbbed under her chin.

Struggling to eat the mouthwatering Sunday lunch, she found every bite a huge ordeal.

This was not an isolated incident, but a bizarre ritual whenever Seanne was presented with an appetising meal.


Relief: Seanne Brearley can now eat without pain

Relief: Seanne Brearley can now eat without pain


'I was OK with bland food such as a bowl of Corn Flakes or a sandwich. But eating anything hot and cooked - in other words, with the kind of smell that would get my mouth watering - was like tackling an assault course,' says Seanne.

'Along with having a pain under my chin, I'd also get a golf-ball-sized swelling in the same place, which would last for about half an hour. Not only was it uncomfortable - but it was also quite frightening because I couldn't open my mouth properly.

'Once, I went to a Chinese restaurant with some friends and couldn't even get past the starter. Although I convinced myself it couldn't be anything sinister, like cancer, because it came and went, it still bothered me terribly.'

Seanne's problem, which started around 18 months ago, seemed to baffle her GP and dentist.

'The longer it went undiagnosed, the more painful it became. Worse still, as the glands under my tongue became more and more swollen I felt increasingly unable to open my mouth.'

Eventually Seanne was referred to an ear, nose and throat specialist who X-rayed her mouth and throat before diagnosing salivary stones, a condition that affects as many as 300,000 people, yet which is often missed because it is poorly understood.

The condition occurs when debris reacts with chemicals in the saliva; this crystallises into a stone that can block the salivary ducts, obstructing the normal flow of saliva.

The problem becomes acute at mealtimes as this is when extra saliva is produced, particularly in response to hunger and aroma. This in turn causes pain and swelling around the glands.

'Eating anything hot and cooked with the kind of smell that would get my mouth watering was like tackling an assault course'

If the problem is left untreated for long periods, the backed up saliva can also cause infection.

'Salivary stones are probably far more widespread than we realise because they won't be picked up routinely, say by dental X-rays, unless they are big enough,' explains Dr Jackie Brown, a consultant radiologist based at Guy's Dental Hospital in London.

This leaves many patients in severe pain. 'People like Seanne can suffer for months without a doctor or dentist knowing what the problem is,' says Dr Brown.

'No one knows why some people are prone to them and it seems to have nothing to do with genetics, previous illness or even living in a hard-water area.'

Once a stone has formed, it starts to grow at a rate of about 1mm a year until it blocks the gland, causing pain and swelling whenever excess saliva is produced, such as at meal times.

There are three major salivary glands around the mouth - under the tongue, in the cheek and close to the jawline. There are also many small salivary glands scattered throughout the mouth and which you can feel as little bumps in your cheeks and lips.

Both the major and minor glands have ducts - channels down which the saliva travels on its way to the mouth - and all of these can be affected by stones.

If the stone is small enough, it may be flushed out by increasing the flow of saliva with a sour sweet or citrus fruit (which stimulates the flow of saliva) combined with increased fluids and massage.

However, if this doesn't help, the traditional treatment involves an operation under general anaesthetic, during which a surgeon cuts through the cheek to remove the whole gland. A

s well as being uncomfortable for the patient, and causing scarring, it also carries a significant risk of damaging important nerves that give the face its movement and expression.

But Guy's Dental Hospital, where Seanne was referred, has pioneered a range of new techniques to tackle the problem, tailored according to the size of the stone. For larger stones - which tend to be about 1cm in size - surgery carried out under general anaesthetic involves cutting under the tongue to remove the stone with miniature forceps.

'No one knows why some people are prone to them and it seems to have nothing to do with genetics, previous illness or living in a hard-water area'

Medium stones - around 5mm - are zapped with pulses of energy known as acoustic shockwaves. The procedure involves waves of energy - a bit like intense ultrasound - being pulsed through to the stone by a special machine pressed against the cheek.

The stone itself then absorbs the energy, cracks into small pieces, and is then washed away by the patient's saliva.

However, Seanne's stone was small - around 4mm. For this size of stone, Guy's Hospital carries out a procedure under local anaesthetic.

First, a tiny endoscope tube with a camera and light at the tip is passed into the blocked duct to locate the stone accurately.

Then a 'basket', which is attached to the tube, is passed via a catheter down the salivary duct to grab the stone and pull it out.

'When my specialist explained I had these little stones, I was astonished. I'd never heard of anything like it,' says Seanne.

She adds: 'Of course, being told I'd have to have an operation was a bit daunting - but it was only under local anaesthetic, so I wasn't too worried.

'I was also pleased - at long last they'd found the root of the problem and would be able to cure me,' says the 30-year-old social worker from North London.

Guy's Dental Hospital is the only centre in the UK offering such treatment and specialists see approximately 600 patients a year. But so new is Seanne's operation that six other consultants were in the room watching Dr Brown carry out the procedure.

During the 45-minute operation, Seanne felt nothing, just some tugging as it was carried out. Her mouth was sore for several hours and she was prescribed antibiotics to guard against infection. She was also advised to eat as much tasty food as possible to simulate saliva in the once-blocked duct - so that night she responded to the advice by tucking into a tikka masala curry, her favourite dish.

Seanne says: 'When I had that first mouthful, it was an incredible moment. There was no swelling or throbbing pain. Just a slight ache from the operation.

'I couldn't believe that I was finally able to eat such tasty food again. There are also no stitches that have to be removed.

'Afterwards, I was given the stone Dr Brown removed and couldn't believe it; it was roughly half the size of a Tic Tac and really hard, harder than I imagined.

'It only took two days for my mouth to feel back to normal and since then I've not had a problem. Now, I enjoy food even more knowing what a burden having an appetising meal used to be.' ( dailymail.co.uk )

For more information, call Guy's Dental Hospital on 020 7188 7188.

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