Antibiotic treatment is necessary if the swelling of the salivary gland is associated with purulent discharge at the orifice of the gland duct or there are other signs of bacterial infection. Unilateral swelling of the submandibular gland is usually due to sialolithiasis. Bilateral swelling with few symptoms may be caused by sialadenosis, which is associated with systemic illnesses, or by SjOgren's syndrome. If unilateral swelling develops gradually, the possibility of a tumour should be considered, particularly in patients over 50 years of age. Do not take a biopsy but refer the patient to a specialist.
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