The clinical signs associated with salivary stones (stones formed within the salivary gland) are reviewed and a case report is presented to illustrate diagnostic issues. The patient in the report had pain and swelling on the right side of his face, with particularly severe pain at mealtimes. Examination showed that one of the salivary glands on the right side was firm and enlarged, with little saliva production. A small, very hard mass was felt in the duct leading from the gland; attempts to manipulate the mass out of the duct were not successful. The mass could be seen with X-ray. It was surgically removed and the patient experienced no further pain or swelling. To diagnose sialolithiasis (salivary stones), dentists should observe the face for asymmetry, palpate the duct to find a rock-hard nodule, 'milk' it to assess the rate of salivary flow, take X-rays, and verify that the pain intensifies at mealtimes. This diagnosis should be kept separate from a diagnosis of inflammation of the salivary gland (sialoadenitis), mumps, or tumors of the gland. The symptoms associated with those conditions are reviewed. Salivary stones result from particular anatomical configurations of the duct, slow salivary rates, and certain compositions of the saliva. When diagnosed, they must always be removed, either by milking or by surgery. If an infection is present, antibiotics should be given before surgery. Patients rarely develop recurrences, but scarring occasionally promotes the formation of another stone. (Consumer Summary produced by Reliance Medical Information, Inc.)