What are Tonsilloliths?
The tonsils are areas of lymphoid tissue which are located on either side of the throat. The term tonsil is most used to describe what is known in the medical community as “palatine tonsils.” Tonsils, like other lymph organs function as part of the immune system and fight off infections of the pharyngeal and upper respiratory tract. Tonsils in humans occur on both the top and bottom of the throat and combine with another set of lymph tissues and compose the Waldeyer’s tonsillar ring.
Tonsil stones (Tonsilloliths) are white or yellow colored, foul smelling mucosal formations which appear in the crevasses of tonsils. Tonsil stones, while harmless, can feel like a foreign body lodged in the back of the throat and can be uncomfortable and may cause bad breath. Tonsilloliths are more common in adults than children and small stones on the tonsils do not cause any problematic symptoms which require treatment.
Symptoms, Causes and Diagnosis of Tonsil Stones
Symptoms of Tonsil Stones
There are a number of different signs which will indicate whether or not someone has tonsil stones which can include the following:
- Metallic taste in the mouth
- Recurrent halitosis, which is accompanied by a throat infection
- Coughing spells
- Closing or tightening in the throat
- Swallowing difficulty
- Sore throat
- White debris on the tonsils
- Tonsil swelling
- Otalgia (ear pain or earache)
Causes of Tonsil Stones
Tonsilloliths or tonsil stones can have a variety of different causes which can include:
- Dairy products
- Dead white blood cells
- Numerous oral bacteria
- Enzyme action of retained food
- Mucosal secretions
- Overly active salivary glands
Tonsil stones are not rare, though most people do not know what tonsil stones actually are or how to go about treating the condition.
How are Tonsil Stones Diagnosed?
A definitive diagnosis of tonsilloliths can usually be made upon a physical examination and visual inspection of the throat. Differential diagnosis by a physician can include malignancy (cancer), calcified granuloma (cancer) or an enlargement of the styloid process or pieces of bone originating from the brachial arches. The condition can be difficult to diagnose and may require radiological studies to confirm. Other ways of diagnosing tonsil stones can include:
- Computed tomography (CT)
Treatment for Tonsil Stones
A person can treat tonsil stones at home using a variety of different methods. Because of the gag reflex, a person may have a difficult time removing tonsil stones with a light scrubbing using a toothbrush; this method might remove surface tonsil stones. Another effective way to remove tonsil stones is by using a finger or a cotton swab pressed against the bottom of the tonsil and pushing in an upward motion. The pressure of the cotton swab can squeeze out the tonsil stones. There are also oral analgesics which can ease the gag reflex and help clean the tonsils and crypts of the throat.
A home remedy for removing tonsils stones without engaging the gag reflect is to tense up the throat, raise the tongue up to the roof of the mouth and swallow. The motion causes the tonsils to tense upward and sometimes the pressure can force a tonsil stone to pop out of the throat. Another remedy involves having a person consume a carbonated beverage such as club soda, seltzer water or tonic water which has also been effective at removing tonsil stones.
By using a salt water gargle can alleviate the pain caused by tonsillitis which often occurs with tonsil stones. Some people can benefit from antibiotic treatment for tonsil stones, the medications will not correct the problems that cause tonsilloliths and a person can experience side effects from the drugs. Another method of eradicating tonsil stones is to use a combination of oxygenating tablets and nasal sinus drops in order to neutralize the bacteria and loosen the stones from the throat. For older tonsil stones a person can try using a long stainless steel spoon to push the stone out from the underside.
Using pulsating irrigation a person can clear out the crypts of the throat and any type of accumulated debris which can contribute to the development of tonsil stones. To treat tonsil stones using pulsating irrigation a person would take a water pik or dental irrigator and using the gentle jet of water, aim the tip at the tonsil stone and work back and forth until the stone becomes dislodged. Once the stone has become loosened, it is recommended a person use a warm salt water gargle to remove any further debris from the back of the throat.
A person can also try to use a medicine dropper to suck out smaller tonsil stones to irrigate the area with hydrogen peroxide. The bubbling helps bring tonsil stones to the surface which can make it easier to remove using a suction device. Never use an object with a sharp tip and if a tonsil stone cannot be easily removed it may be necessary to visit a dentist for professional assistance.
The most aggressive form of treatment for tonsil stones is surgical removal by oral curette. Another long-term option is to treat the condition using a method called laser resurfacing. In a procedure called cryptolysis, which is performed under local anesthesia, a physician uses a scanned carbon laser to vaporize and remove the stones. With laser resurfacing, the edges of the crevices and crypts in the throat are flattened so that material and debris can no longer be trapped.
While tonsilloliths are not dangerous, the condition can be extremely uncomfortable and lead to secondary infections of the tracheal and respiratory tracts. With proper treatment and at-home care, tonsil stones can be prevented and treated successfully and the person can experience considerable relief. Before trying any of the above mentioned treatments it is recommended a person seeks a definitive diagnosis from a licensed medical professional and follows any instructions provided.