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Tonsil stones are smelly white or yellow lumps of variable size that form inside the tonsils. Tonsil stones are usually small in size. The smallest are only a millimeter in diameter, while the largest can be over a centimeter.
Tonsil stones can be quite hard and calcified, like a stone, or soft and compressible, like plasticine.
People who suffer from recurrent tonsillitis often develop tonsil stones as a complication.
The repeated swelling in the tonsils leads to the formation of cracks, gaps, or holes in the tonsillar crypts (folds in the tonsils) which accumulate food debris and calcium deposits over time resulting in the formation of tonsil stones.
Anyone, from children to the elderly, can develop this problem.
In most cases, tonsil stones are not large or harmful enough to warrant surgical intervention. (1)
Do tonsil stones cause bad breath?
Tonsil stones are strongly related to bad breath as they are made up of food, some of which could have been swallowed weeks previously.
This food sits in the tonsils and slowly rots, as it would if you left it out of the fridge, especially at body temperature. Rotting enables putrefying bacteria to multiply, and many of these emit foul smells.
The result is bad breath.
Although there is no proven link at this time, it has been observed that the successful treatment of chronic tonsil stones often leads to an improvement of other symptoms, particularly chronic bowel problems and other stomach issues.
Some patients with certain variants of chronic fatigue syndrome also reported an improvement in their condition after the resolution of tonsil stones, although this may be more related to the reduction of chronic inflammatory tonsillitis.
Why are children more prone to tonsil stones?
Children who suffer frequent episodes of tonsillitis often form tonsil stones.
However, the tonsils shrink back on their own by the time the child reaches the age of 10. Consequently, the tonsillar crypts (holes and folds) that caused the stones disappear, and no treatment is required.
Can an underlying medical condition cause tonsil stones?
Tonsil stones are not caused by any other medical condition other than having cracks or holes in your tonsils.
However, these cracks and holes usually develop in the wake of severe or recurrent tonsillitis. This condition is often associated with glandular fever, which generally affects teenagers.
In these cases, the prolonged or repeated swelling of the tonsils leads to the formation of tonsil stones.
Is it advisable to swallow tonsil stones?
Tonsil stones form when food is compressed into the side of the throat when chewing and swallowing.
In some people, cracks and holes appear in the tonsils, often after tonsillitis. Chewed food disappears down these cracks or holes and becomes compressed at the bottom.
Eventually, it becomes too big for the size of the crack/hole and fall out, sometimes while speaking. Tonsil stones are essentially safe to swallow as they are made up of food that you have swallowed.
Can a tonsil stone dissolve by itself?
Tonsil stones can disintegrate as they sit in the holes and cracks of the tonsils. They can then ooze out as a thick whitish fluid, which is usually swallowed.
This breakdown can sometimes occur in the midst of an operation to remove tonsil stones.
How can we avoid tonsil stones?
Tonsil stones cannot really be avoided if you have tonsillar crypts (holes and folds) where food can get lodged in. Realistically, the only options are to either put up with them or to have them surgically treated, such as through laser tonsil reduction.
Can a person suffer from tonsil stones multiple times?
Tonsil stones are often multiple and recurrent. Once you have cracks and holes in the tonsils, food is continually trapped and forms into tonsil stones.
Should tonsil stones be treated?
Tonsil stones that can be easily and effectively controlled by measures such as water jet irrigation can be treated in an entirely conservative manner as long as the treatment is not causing bleeding or recurrent tonsillitis.
However, most tonsil stone problems are difficult and time consuming to control. Eventually, the sufferer will need to see an ear, nose, and throat surgeon with an interest in this area, preferably with long-standing expertise in carbon dioxide laser surgery.
Surgical treatment should eradicate all associated symptoms, including recurrent tonsillitis, bad breath, and bad taste.
How to get relief from tonsil stones?
Current medical practice
Remember that tonsil stones are much more common than you think.
People shy away from discussing this problem as they are embarrassed by it. Because nobody talks about the problem, those suffering from it mistakenly assume that it is a rare condition, which further adds to the misplaced stigma.
The true incidence is not known but is thought to be over 10% of the adult population who have or have previously suffered from tonsil stones.
Unfortunately, tonsil stones are not widely recognized by general practitioners as a genuine health concern that requires formal treatment.
In most cases, the primary physician will ask the patient to gargle with salt water as a remedy.
It is only in very rare cases that patients are referred to the local ear, nose, and throat service. Even then, tonsillectomy for any indication other than cancer is usually not recommended as it is felt to be of limited clinical effectiveness. (2)
Thus, sufferers of tonsil stones are often not treated despite having marked and quite debilitating symptoms.
Short-term remedies for tonsil stones
The long-term answer for tonsil stones is to either wait for the tonsils to shrink back, if the sufferer is below 8 years old, or to have them surgically treated, either by complete removal of the tonsils or, better still, significant reduction of the tonsils so that the cracks and holes where food is trapped are gone.
However, there are short-term techniques to remove tonsil stones that sufferers often do in the morning after brushing their teeth. These include water jets and use of cotton buds or purpose-made small picks.
These techniques only remove the superficial stones but can certainly be very helpful. Some sufferers do this twice a day for years.
The downside of these techniques is that they can damage your tonsils and cause bleeding or, worse, set off tonsillitis.
What is the best remedy to cure tonsil stones permanently?
There is no doubt that the best way to cure tonsil stones is to remove the cracks and holes in the tonsils that cause the stones to form.
This means some form of tonsil removal, whether complete removal under general anesthesia (“traditional” tonsillectomy) or partial removal, often using carbon dioxide laser under local anesthesia. The latter procedure is widely recognized as being much less painful and dangerous than the other techniques.
Do tonsil stones cause tonsillitis?
Tonsil stones almost certainly do trigger tonsillitis (infection of the tonsils) all on their own. This is because the natural rotting process of the organic food that tonsil stones are made of causes local inflammation (soreness) in the cracks and holes where tonsil stones form.
This, in turn, leads to swelling of the lining of the tonsils deep in the crypts. Subsequently, the natural defensive wall of the tonsils weakens, allowing in viruses and bacteria that multiply to cause tonsillitis.
Can tonsil stones be a sign of throat cancer?
Tonsil stones themselves are not a sign of cancer.
However, white patches in the mouth can be the first sign of mouth or throat cancer. Hence, always get your throat and mouth checked if you think you have white patches.