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Oral Surgery/Submandibular duct stones and cyst - please help


QUESTION: Dear Mr Teig,

I have a ranula cyst under my tongue and a surgeon has diagnosed me with Submandibular duct tiny stones through ultrasound.  

I am sucking on lemon and drinking lots of water.  Will the cyst disappear automatically when the stones are removed? Or do I have to have a separate operation to remove the cyst?

I would really prefer not to have to remove my gland.  

Many thanks in advance for your help.

Kind regards

ANSWER: Fatima- it is a little difficult for me to tell you if normal saliva flow occurs after the lemon juice and drinking water.  I would also suggest warm salt water for 1-2 minutes, 4-5 times a day.  Often, if the stones are small, they will be released and the area resolve.  If, however, the stones remain, removal of them surgically might be the only way to restore normal saliva flow and relieve the blockage of the duct.

I hope the stones pass and saliva flows regularly.  

---------- FOLLOW-UP ----------

QUESTION: Dear Mr Teig,
Thank you for you reply.
Yesterday morning my ranula ruptured in my mouth.
My previous ultrasound  (3 weeks ago) confirmed stones but
today I just had an ultrasound scan and it seems the stones must have come out or dissolved.
They can't find any stones.

However, my ranula seems to be still growing again.  Does it mean the cyst will always be there even though the stones have gone?   Does it mean I still need to remove the gland?  

Pls could you advise if there is a possibility for the ranula to resolve itself ?
Thanks for your help.


ANSWER: Fatima -  There is always a possibility it might heal, but recurrences are very common unless all the components of the ranula are removed.  I suggest that you first try a regimen of warm salt and lemon juice rinses for about 1-2 minutes, 4-5 times a day.  Occasionally a pathway will develop, but the gland may also need removal.  Get back to the surgeon and have him help you follow the healing,  I wish you well and hope surgery can be avoided, but have the area followed closely.

---------- FOLLOW-UP ----------

QUESTION: Dear Mr Teig,

Thanks again for your kind response.  Pls could you give an idea how I should expect my surgeon to help follow my healing?  Would I need ultrasound again or xray?

Kind regards

Fatima - The surgeon just needs to continue to examine the floor of your mouth.  Seeing not every day like you might do, often disclosed more change.  So the surgeon is important for that visual exam  You might need ultrasound or additional xrays if swelling continues and blockage is evident.

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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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