What are tonsil stones or tonsilloliths?

February 27, 2017

What are tonsil stones or tonsilloliths?
Tonsil stones
Large tonsil stone in patient's mouth
Tonsillitis and tonsil stones
Your tonsils are located at the back of your throat, on either side. If you open our mouth wide enough you should be able to see them peeking up behind the tongue. Like lymphnodes, tonsils are part of your immune system and help fight infection. When they do their job, the tonsils will get inflamed and likely give you a sore throat. Your tonsils might respond in this way to any number of factors. Common, but often unknown contributors are tonsilloliths. 
What are Tonsilloliths (Tonsil Stones)?
Tonsilloliths are white or yellow bumps growing on the surface of your tonsils. They can range in size from rice to pea size. Some people have one tonsil stone, and others might have a small formation of stones. Tonsilloliths form as the result of fungal or bacterial activity on debris trapped in the tonsil pockets. Debris might include anything from dead cells and food particles to mucus and saliva. Typically tonsil stones are visible. However, sometimes they are burrowed down inside the tonsil where you can’t see them. 
What Causes Tonsilloliths?
As part of the immune system, the tonsils filter for viruses and bacteria while producing antibodies and white blood cells. Your tonsils also prevent foreign objects from passing into the lungs. Instead the particles lodge in the crevices and tunnels of the tonsils. Bacteria and fungi adhere and feed on the buildup, which often results in a foul odor. Over time, as with plaque and tartar, the debris calcifies and hardens. Other contributing factors might include poor dental hygiene, overlarge tonsils, or chronic sinus problems. While they rarely cause larger health complications, tonsil stones can still be an uncomfortable problem.  
Common Symptoms
In rare cases asymptomatic tonsil stones occur, and patients might not even know they have them. However, in addition to the white and yellow bumps, you will likely experience one or more of the following:
  1. Ear pain
  2. Difficulty swallowing
  3. Inflammation
  4. Redness
  5. Bad breath
  6. Sore throat
  7. Dry throat
Best Home Treatments for Tonsil Stones
The most common treatment for tonsil stones is gently removing them with a toothbrush. You can also:
  1. Cough enough to dislodge debris
  2. Gargle with salt water
  3. Express stones from the crevices with a cotton swab
  4. Use a water flossing device to remove stones
In-Office Treatments for Tonsil Stones
If you cannot remove them at home, you might consult with an ear, nose, and throat specialist, a dentist, or a physician to have tonsil stones removed. They might prescribe antibiotics, but this does not treat the underlying cause. Most physicians will use hand tools to remove stones manually. In more severe cases they will use laser tonsil cryptolysis or coblation cryptolysis (radio waves) to remove the deeper deposits. If tonsil stones become a recurring problem, you might consider a tonsillectomy as a last resort cure. 
Complications from Tonsil Stones
Tonsil stones affect a large part of the population, and though they often trigger several symptoms, the majority are benign. The most common complication is tonsil damage due to aggressive manual removal. 
Should I have my Tonsils Removed?
In the past having tonsils removed was seen as a childhood rite of passage, or something children needed, like vaccines. Before antibiotics, this was one way to prevent recurring strep throat and tonsillitis in children. Doctors would often pair the surgery with an adenoidectomy, also removing the adenoids during the procedure. In the medical world this surgery is called a T&A, and is still one of the most common surgical procedures performed on adolescents. While it is a low risk procedure, there is still a chance of complications with anesthesia and a risk of pain or bleeding after the procedure. Fortunately, you can try preventative care first. 
How to Prevent Tonsilloliths 
You should brush your teeth and tongue after every meal and right before bedtime. You should also floss your teeth daily to clear away unwanted bacteria. Gargling with salt water or antibacterial mouthwash (that does not contain alcohol) will also help prevent tonsil stones. You should also stop smoking and drink more water. 


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