In today's episode of "strange medical case studies from around the world," doctors in India recently came across a man with tooth pain who was suspected of having an impacted tooth. However, on closer inspection, they realized the unusual structure in his mouth wasn’t actually a trapped tooth, but a colossal salivary gland stone. Writing in the BMJ Case Reports, the clinicians report that the 37-year-old man arrived at a private dental practice with complaints of acute pain and swelling in his lower jaw. An X-ray revealed the presence of a hard growth below his premolar teeth, which the clinicians initially suspected could be an impacted tooth, a trapped tooth has been blocked from breaking through the gum. But when they carried out an ultrasound scan of his jaw, doctors saw a very different picture. The ultrasonography revealed the growth was actually a mass of crystallized minerals that was lodged in his salivary gland, known as a sialolith. Salivary gland stones are typically just 2 to 10 millimeters in size, rarely larger than a lentil, but this specimen was at least 2 centimeters (0.8 inches) in length. As the study notes, salivary glands stones that measure over 1.5 centimeters are extremely rare and are defined as “giant sialoliths”. Ultrasonography of the salivary glands revealed the presence of a giant sialolith. BMJ Case Reports 2020. Salivary gland stones are a calcified mass that can gather in the salivary gland of the mouth under the tongue. They can occur for a number of reasons, but they’re typically associated with dehydration, smoking tobacco, or a mouth infection. There’s also some evidence that suggests it can be caused by food debris, bacteria, or foreign bodies becoming stuck in the salivary gland, causing it to produce a calcium abnormally. They’re typically no great threat to your health, but they can cause a fair amount of pain, swelling, and occasional infection. To remove the sialolith, people are advised to suck on a lemon to stimulate the salivary gland, drink a lot of water, or gently message around the stone. However, if the stone is large, doctors might remove it using a blunt instrument or even surgery. In this case, the man’s salivary gland stone was removed using a blunt instrument. All's well that ends well. Source