Although most common in men of age 30 to 60 years, patients of any demographic may develop salivary duct stones. Most salivary stones occur in the Wharton duct from the submandibular gland. The patient typically presents after rapid swelling that suddenly appears beneath the jaw while eating. The swelling may be painful but is not inflamed and usually subsides within hours. This swelling may be intermittent and may not occur with every meal. Infection can occur, accompanied by increased pain, exquisite tenderness, erythema, and fever. Under these circumstances, pus can sometimes be expressed from the opening of the duct when the gland is pressed (Fig. 57.1).