Sialography is a diagnostic imaging test that uses a contrast dye and X-rays to examine the salivary glands and their drainage ducts. It is not a treatment — it helps your doctor see whether a duct is blocked, narrowed, or damaged. The test is usually arranged through an ENT specialist or an oral surgeon, and it is often considered after simpler, non-invasive options like ultrasound have been tried. In Bangladesh, it is performed in radiology departments of hospitals and diagnostic centres.
What is sialography?
Sialography involves passing a very thin, flexible catheter into the opening of a salivary duct inside your mouth. A water-soluble contrast dye is then slowly injected, and a series of X-ray images are taken as the dye travels through the duct system. This outlines the anatomy of the duct and shows whether there are any blockages or abnormalities.
There are three major pairs of salivary glands: the parotid (near the ear), the submandibular (under the jaw), and the sublingual (under the tongue). Sialography is most commonly performed on the parotid and submandibular glands. The sublingual gland is rarely examined this way because its ducts are small and difficult to access.
When is sialography recommended?
Your doctor may suggest sialography if you have symptoms that point to a problem inside a salivary duct, such as:
- Suspected salivary duct stones (sialolithiasis) — small calcium deposits that can block the flow of saliva.
- Duct strictures — narrowing of the duct that causes saliva to back up.
- Recurrent swelling or pain in the cheek or jaw area, especially during meals.
- Chronic sialadenitis — long-standing inflammation of a salivary gland.
- Evaluation before a procedure like sialendoscopy or surgical removal of stones, to map the exact anatomy.
Sialography is sometimes used to assess gland damage in Sjögren’s syndrome, an autoimmune condition that causes dry mouth and eyes. However, MRI is now more commonly used for this purpose because it is non-invasive and does not involve radiation.
How is sialography performed?
The procedure is done in a radiology department and typically takes 15–30 minutes. Here is what you can expect:
- You will sit or lie down, and the area around the duct opening is numbed with a local anaesthetic spray or drops.
- The radiologist gently inserts a thin catheter into the duct opening in your mouth.
- A small amount of water-soluble contrast dye is slowly injected. You may feel a sensation of fullness or mild discomfort as the dye fills the duct.
- A series of X-ray images are taken from different angles to follow the dye through the duct system.
- After the images, the catheter is removed. You may be asked to drink water or gently massage the gland to help clear the dye.
No special preparation is needed, but you should tell your doctor about any allergies (especially to iodine or contrast media), if you are pregnant, or if you have a recent salivary gland infection. The test is usually avoided during an acute infection because it can worsen the inflammation.
What are the risks and side effects?
Sialography is generally safe when performed by an experienced radiologist, but like any procedure it carries some risks. These are uncommon but include:
- Contrast extravasation — dye leaking into the surrounding tissue, which can cause temporary swelling or pain.
- Duct perforation — a very small tear in the duct wall, usually minor and self-limiting.
- Infection — rare, but possible if the duct is already inflamed.
- Allergic reaction — to the contrast dye, which can range from mild itching to a severe reaction. Tell your doctor about any known allergies beforehand.
Because of the risk of worsening an infection, sialography is not performed during acute sialadenitis. Your doctor will weigh the benefits against these risks and discuss them with you before the test.
What do the results mean?
A normal sialogram shows smooth, branching ducts with free flow of contrast into the mouth. Abnormal findings may include:
- Filling defects — areas where the dye cannot pass, often indicating a stone.
- Narrowing (strictures) — a constricted segment of the duct.
- Ductal dilatation (sialectasis) — widening of the ducts, which can occur in chronic inflammation or Sjögren’s syndrome.
- Poor emptying — dye remaining in the gland after the procedure, suggesting a functional problem.
The radiologist will send a detailed report to your referring doctor, who will explain the findings and discuss the next steps — whether that means medical management, a minimally invasive procedure, or surgery.
How much does sialography cost in Bangladesh?
The cost of sialography in Bangladesh varies by city, the type of facility, and whether digital subtraction sialography (which gives clearer images) is used. The following ranges are approximate and based on typical private-sector pricing. Always confirm the exact price with the facility before booking.
| Item | Approx. BDT range | Notes |
|---|---|---|
| Public hospital (government) | BDT 1,000 – 3,000 | Subsidised, but waiting times may be longer and availability limited. |
| Private diagnostic centre | BDT 3,000 – 6,000 | Includes the procedure and radiologist’s report. |
| Corporate / private hospital | BDT 6,000 – 10,000 | Higher-end facilities with digital subtraction sialography may charge more. |
| Digital subtraction sialography (DSS) | Additional BDT 2,000 – 4,000 | Improves image clarity by removing bone and soft tissue background. |
Prices change over time and vary by city and equipment quality. Confirm the final cost with the radiology department before the test. Also note that sialography (সিয়ালোগ্রাফি) is a diagnostic test, not a treatment — you will still need to discuss the results with your ENT specialist or oral surgeon.
When to see a doctor
If you have persistent swelling of the cheek or jaw area, pain that worsens during meals, a dry mouth, or a foul taste that suggests a blocked salivary duct, consult an ENT specialist or an oral surgeon. They will examine you and may start with a simple ultrasound before deciding whether sialography is needed. Do not attempt to self-refer for this test — it is only performed after a clinical assessment and a clear medical indication.
Find dentists and dental clinics by division in Bangladesh
If you need a dental or oral health specialist for a salivary gland issue, you can search for qualified dentists and clinics in your division. The table below lists directory pages for each division.
| Division | Find listings |
|---|---|
| Dhaka | Find dentists in Dhaka |
| Chattogram | Find dentists in Chattogram |
| Khulna | Find dentists in Khulna |
| Rajshahi | Find dentists in Rajshahi |
| Rangpur | Find dentists in Rangpur |
| Sylhet | Find dentists in Sylhet |
| Barishal | Find dentists in Barishal |
| Mymensingh | Find dentists in Mymensingh |
Frequently Asked Questions
Do I need to prepare for sialography?
Preparation is usually minimal. Your doctor may ask you to avoid eating or drinking for a few hours before the test to reduce saliva production, which can make the ducts easier to see. Tell your doctor about any medications you take, especially blood thinners, and mention if you have a known allergy to contrast dye or iodine. You may also be asked to remove dentures or metal objects near your face. Always follow the specific instructions given by your radiologist or ENT specialist.
Is sialography painful?
You may feel some discomfort when the thin tube (catheter) is placed into the salivary duct opening, and a mild stretching sensation when the contrast dye is injected. Local anaesthetic is often applied to numb the area first, which helps reduce pain. After the test, some swelling or a salty taste in the mouth is common and usually settles within a few hours. If you experience severe pain, fever, or increasing swelling, contact your doctor promptly.
Can sialography be done during pregnancy or if I have a contrast allergy?
Sialography uses X-rays, so it is generally avoided during pregnancy unless the benefit clearly outweighs the risk. If you are pregnant or suspect you might be, inform your doctor before the test. If you have a known allergy to contrast dye, tell your doctor in advance — they may premedicate you with antihistamines or steroids, or consider an alternative imaging method such as ultrasound or MRI. Always discuss your full medical history with the radiologist before the procedure.
Sources
The following sources are from international journals, government health agencies, or recognized medical organizations:
- Salivary Gland Disorders – MedlinePlus (medlineplus.gov)
- Sialography – StatPearls (NCBI Bookshelf) (ncbi.nlm.nih.gov)
- Salivary gland stones – NHS (nhs.uk)
- World Health Organization — Sialography (who.int)
- MedlinePlus — Sialography (medlineplus.gov)
- CDC — Sialography (cdc.gov)
