Asymmetrical Sublingual Glands: Causes and Concerns

The shape of the sublingual gland varies?

Hello, doctor.
I noticed that the shapes of my submandibular glands on both sides were different one day (I'm not sure how long this difference has been present, maybe a long time or maybe not).
I then discovered several small white spots on the right submandibular area, and after scraping them with my finger, that area became inflamed and red, but it healed quickly within a few days.
Since then, the shape of the submandibular gland on the right side has definitely changed, but I haven't experienced any more white spots or inflammation.

On the left side, it feels similar to typical images, being elongated and noticeably protruding when I feel it with my tongue.
On the right side, it feels more rounded (the middle part is wider compared to the left, and the elongated shape at the front and back is not very pronounced) and flat, almost not protruding at all.
However, when I lift my tongue and look at it, the visual difference seems minimal; I can only feel a significant difference when using my tongue or fingers.

Additionally, since March, I have noticed small lymph nodes appearing in three areas: the mid-right neck, behind the ear, and at the junction of the neck and collarbone (approximately directly below the submandibular gland).
These lymph nodes are painless and movable, measuring about 0.4 to 1 cm.
They started appearing in March, and I have no symptoms such as nasal congestion, night sweats, ear pain, insomnia, or weight loss.
However, I have not sought medical attention yet due to work commitments.

1.
I would like to ask if the shapes of the submandibular glands are generally similar to the images, or is it normal for them to be different on both sides?
2.
If it is abnormal, which specialist should I consult, and what could be the potential causes?
3.
I am currently experiencing the eruption of a wisdom tooth on the right side, but it feels like it has only partially emerged and is not coming out completely.
Could this be related?
4.
On the same side, I have a slight abrasion on my cheek due to wearing a retainer at night.

Niming, 20~29 year old female. Ask Date: 2018/05/17

Dr. Li Jiaxuan reply Otolaryngology

1.
Sorry, I didn't see the image; both sides should be almost symmetrical.

2.
Asymmetry, swelling, or suspected masses should be evaluated by a physician.

3.
Inflammation of the alveolar bone and gums can lead to enlarged cervical lymph nodes; it is recommended to visit an otolaryngology clinic.
Thank you!

Reply Date: 2018/05/17

More Info

Understanding asymmetrical sublingual glands can be a source of concern for many individuals, especially when changes in shape or texture are observed. Your description of the differences between your left and right sublingual glands, along with the presence of small white spots and subsequent inflammation, raises several important points to consider.

1. Normal Anatomy vs. Variability: The sublingual glands, located beneath the tongue, can exhibit some natural variability in size and shape among individuals. However, significant asymmetry, especially if it is accompanied by other symptoms, may warrant further investigation. Typically, both glands should be symmetrical and have a similar texture. If one side appears flatter or less pronounced, it could indicate an underlying issue, particularly if this change is new or has progressed over time.

2. Potential Causes of Asymmetry: The asymmetry you are experiencing could be due to several factors. Inflammation, infection, or blockage of the salivary ducts can lead to changes in gland shape. The small white spots you mentioned could have been mucoceles or minor infections that resolved quickly, but they may have left residual changes in the gland's structure. The presence of lymph nodes in the neck area that are mobile and non-tender may suggest a reactive process, possibly due to local inflammation or infection.
3. When to Seek Medical Attention: Given your symptoms, it would be prudent to consult with a healthcare provider, preferably an ear, nose, and throat (ENT) specialist or a dentist who specializes in oral health. They can perform a thorough examination, possibly including imaging studies, to assess the glands and surrounding tissues. If there is a concern about infection, a biopsy may be warranted to rule out any serious conditions.

4. Connection to Wisdom Teeth: The fact that you are experiencing issues with your right lower wisdom tooth could indeed be related. Impacted wisdom teeth can cause localized swelling and inflammation, which may affect the nearby sublingual gland. If the tooth is partially erupted, it can create a breeding ground for bacteria, leading to infections that could impact the salivary glands.

5. Oral Hygiene and Care: Maintaining good oral hygiene is essential, especially when dealing with wisdom teeth and potential irritation from orthodontic devices. Ensure that you are cleaning the area around your wisdom teeth thoroughly to prevent infection. If you notice any signs of infection, such as increased swelling, pain, or fever, seek medical attention promptly.

In summary, while some asymmetry in the sublingual glands can be normal, significant changes, especially those accompanied by other symptoms like lymph node enlargement, should be evaluated by a healthcare professional. The connection between your wisdom teeth and the changes in your sublingual glands is plausible, and addressing any dental issues may help alleviate your concerns. Regular check-ups with your dentist or an ENT specialist will provide you with the best course of action for your symptoms and overall oral health.

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