Tuesday, September 29, 2009

Who Shot the Sialolith?

"I shot the sheriff, but I did not shoot the deputy..." The song lyrics remind me somewhat of the photo I received recently from my brother Peter Jacobs, DDS. Pete practices near me in the small northern city of Manistique, Michigan.


You don't need to live in a large metropolitan area to see unique things in a dental office. This is one that I have never seen, so I thought it might be interesting to others. Pete sent me a photo of a sialolith, that is - a calcareous concretion or calculus of the salivary gland or duct. He had a patient come into his office with a swelling below his chin and under his tongue. On an xray examination, an artifact somewhat like a tooth was present. After some investigation, Dr. Pete made a small incision under the patient's tongue, and out popped what you see in the picture. The sialolith looks somewhat like a tooth that is tapered on each end. Over time, calcium deposits can build up in the salivary duct, and start to obscure it, causing a backup of saliva in the gland.


Note the size of the sialolith in comparison to the bullet laid alongside it in the photo. My brother is very passionate about hunting, and happened to have the bullet nearby to easily use as a size comparison. He says it's a 30.06 shell. I'm waiting for the deputy to confirm that!