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A few things to know about tonsil stones

Tonsils are tiny glandular structures that lie at the back of our throats, near the posterior borders of the tongue. While once, these structures had a primary role in preventing infections from throat and nose from entering the body, with the current standards of cleanliness and sterile environment, these parts of the systemic immunity have become vestigial. Tonsils might be essentially inconsequential in function, but these can be potential instigators for many diseases. Tonsillolith is one such condition that affects these parts.

What is a tonsil stone?

A picture of a young woman suffering from sore throat over white background

Located on or within the tonsils, tiny, white or yellow, irregularly shaped, pebble-like aggregates are called tonsil stones. Globules of mucous and bacteria that get caught in the crypts in the throat gradually develop into tonsil stones.

While in most cases these benign accumulations of debris and bacteria go unidentified as they rarely cause any major symptoms, when infected these can cause the tonsils to swell up and cause a range of difficulties. These tonsil stones are foul-smelling and are rarely seen as white tiny pebbles at the back of the throat.

Causes of Tonsil Stones

The natural anatomy of a tonsil includes a complex network of crevices, tunnels, and crypts. Debris like dead cells, food particles, mucus, saliva and bacterial cells can get trapped in these crypts. An excess of debris collects in conditions like poor oral hygiene, chronic sinusitis, chronic respiratory illness, and dry mouth.  When bacteria and fungi digest this debris further, a characteristic yellowish color and foul odor develops. Calcification of these agglomerates will gradually form the tonsil stones.

Symptoms of Tonsil stones

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Because the debris is gradually putrefied by the oral bacteria and fungi, patients with tonsil stones often complain of a severe bad breath. Unlike traditional causes of halitosis, foul oral odor due to tonsil stones will not subside even after regular oral hygiene measures. Tonsil stones are usually globular in shape, but some with sharp edges can dig into the sensitive tonsillar mucosa and cause a sore throat and pain.

Patients often feel a lump in the throat that cannot be swallowed or coughed. If a tonsil stone is large enough, it can cause bouts of coughing and gagging. Tonsil stones that recur frequently result in an exaggerated response from the body’s immune system. This causes an inflammation of the tissues and forms chronic tonsillitis. Stones that are large enough to impinge and irritate the glossopharyngeal or auriculotemporal nerve can result in a pain radiating to the ear.

Diagnosing tonsil stones

When you are suspecting tonsil stones, take a cotton swab or a toothbrush and gently probe the tissues. This spreading of the crevices will reveal any tonsil stone that may otherwise be hidden under the tissues. Tiny yellowish-white specks will be seen in the tonsillar area of patients. A thorough history of symptoms especially bad breath is often diagnostic of tonsilloliths.

Treatments of Tonsil Stones

sick woman with sore throat, inflammation

Gargling with salt water or opting for home remedies can sometimes exacerbate the condition. In severe cases most physician advice removal of the offending tonsil completely by a procedure called tonsillectomy.

  1. Tonsillectomy

This method is most suited for patients with recurring sore throat and tonsillitis episodes. While this surgical method is a definitive procedure that cures the condition, it is often not prescribed for adults. Excessive postoperative bleeding, longer recovery times, and severe post-operative pain are encountered in adults.

  1. Antibiotics

Antibiotics that target the anaerobic bacteria of the oral environment can provide initial relief. Unfortunately, this treatment is not based on eliminating the root cause of the occurrence and hence the condition can easily recur. Additionally, bacterial cells develop resistance to antibiotics rendering them ineffective.

  1. Curettage

A simpler counterpart of tonsillectomy, this procedure involves incising and curetting the tonsil stones of the area.

  1. Laser Resurfacing

This method produces minimal pain and scar tissue. It involves using carbon dioxide lasers to reshape the tonsillar fissures. This treatment requires multiple visits to completely eliminate sore throat and foul odor.

Tonsil stones are frequently undetected, tiny pebble-like formations of the throat. When symptomatic these are a cause of discomfort to the patient. Patients may suffer from symptoms like severe halitosis, sore throat, recurrent tonsillitis, gagging, and coughing.

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