What Are Tonsil Stones?
The tonsils are masses of lymph tissue situated in the back of the throat. Tonsil stones (also called tonsilloliths or tonsil calculi) are clusters of calcifications, or stones, that develop in the tonsil’s craters (crypts).
What Are Symptoms of Tonsil Stones?
Tonsil stones are hard and look like white or yellowish formations on the tonsils. Frequently, tonsil stones do not cause symptoms. When symptoms occur, they include:
- Persistent bad breath (halitosis)
- White or yellow formations on the tonsil
- Sore throat
- Tonsil swelling
- Difficulty swallowing
- Feeling of an object being stuck in the back of the throat/choking feeling
- Ear pain
- Chronic tonsil infection/inflammation
Small stones are common and are often swallowed without patients having symptoms or knowing they exist. Large stones are rare.
What Causes Tonsil Stones?
Tonsil stones are caused by several factors:
- Food particles, dead cells, mucus, and bacteria get lodged in the craters (crypts) of the tonsils
- The immune system perceives these as foreign invaders so it sends white blood cells to the area to fight the infection
- These white blood cells leave small calcifications behind
- Most of the time, the stones are small and are swallowed, but they can sometimes get stuck in the tonsillar crypts where they grow into tonsil stones
Several risk factors can predispose people to develop tonsil stones such as:
How Are Tonsil Stones Diagnosed?
Tonsil stones are often easily diagnosed because they can usually be seen in the back of the throat on physical examination. They usually appear as white or yellowish spots on or around the tonsils, and can range in size from a grain of rice to a pea.
Tests that can help diagnose tonsil stones include:
What Is the Treatment for Tonsil Stones?
Tonsil stones often dissolve on their own, are coughed up, or are swallowed and no treatment is needed.
If tonsil stones do not go away on their own, treatments include:
- Medications used to treat tonsil stones may include
- Laser treatment (laser tonsil cryptolysis): a noninvasive treatment used to minimize or remove tonsil crypts where tonsil stones can become lodged
- Coblation cryptolysis: a treatment that uses radio waves to change a salt solution into charged ions that can cut through tissue to reduce tonsillar crypts and get rid of tonsil stones
- Tonsillectomy: surgical removal of the tonsils, usually a last resort but the only cure for the condition
Removing tonsil stones at home is generally not recommended because tonsils are delicate tissues and bleeding and infection may occur if stones are not removed carefully. If tonsil stones are painful, large, or you are having difficulty breathing, see a doctor.
Home remedies that may help get rid of tonsil stones include:
- Coughing: Tonsil stones are often coughed up on their own. In some cases, a forceful cough may help dislodge them.
- Salt-water gargle: Gargling with salt water may help dislodge the stones.
- Non-alcohol mouthwash gargle: This may help dislodge stones and also improve bad breath.
- Apple cider vinegar gargle: This may help dislodge stones and also acts as an antibacterial agent.
- Honey gargle: Boil water, add 2 tablespoons of honey, allow to cool, and gargle to help kill bacteria.
- Oral irrigation: Oral irrigators may be used to gently shoot water into the back of the mouth to try to dislodge tonsil stones. Use this method carefully because if not done properly it may result in injury to the tonsils.
- Maintain good oral hygiene: Tonsil stones may be caused by food or bacteria that get stuck in the tonsillar crypts. Proper brushing and flossing may help prevent this from occurring.
- Use a tongue scraper: Use of a tongue scraper may help remove more bacteria from the mouth.
- Chew garlic: Crushing a clove of garlic releases allicin, which is responsible for its antimicrobial properties, and chewing crushed garlic may help kill bacteria that causes tonsil stones and bad breath.
- Oil pulling: This is an Ayurvedic remedy in which patients swish a tablespoon of oil (such as olive, coconut, or sesame) around the mouth for about 10 minutes to improve oral hygiene. Follow with toothbrushing.
- Remove with a cotton swab: Moisten the swab and GENTLY push nearby tissues to dislodge the stone. Be very careful not to injure the tonsils. Consult your doctor before attempting this method.
- Probiotics: Eating yogurt and other foods with probiotics can help kill the bacteria in tonsil stones.
- Carrots: Chewing raw carrots naturally increases production of saliva, which can help reduce stones.
- Apples: Apples are acidic, which may help fight bacteria in tonsil stones.
- Essential oils: certain essential oils such as lavender, lemongrass, and clove have antibacterial properties. Add a couple of drops to your toothbrush before brushing your teeth.
How Do You Prevent Tonsil Stones?
Tonsil stones may be prevented by:
- Proper oral hygiene: Regular brushing and flossing plus use of a tongue scraper to remove bacteria
- Gargling regularly with mouthwash or salt water solution
- Quitting smoking
- Drinking plenty of water
- Avoiding excess alcohol
- Limiting or avoiding carbonated beverages such as soda
- Treating sinus infections promptly
- Managing allergy symptoms
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