Understanding tonsilloliths or tonsil stones
While it is fairly normal to believe that kidneys are the only human organs to get stones, there is another body part which frequently develops stones – the tonsils. The tonsils are soft glandular structures made up of lymphocytes. These lymphocytes play an important role in building the immunity of our body and building resistance against disease-causing microbes. They are situated at the back of the throat so that they can prevent incoming bacteria from entering our systems via the throat.
Since tonsils are used to trap bacterial matter, over time the deposition of residual debris of food particles and bacteria may occur on the tonsils. The gradual calcification of these material leads to the formation of tonsil stones. This unhealthy deposition creates a breeding ground for bacteria and fungi causing a foul odor in the mouth. Such calcified depositions are whitish to yellow in color and may cause mild to severe pain in the throat, especially while swallowing.
It largely affects children within the age group of 5-15 years. Tonsils have a large number of nooks and crevices on its surface which makes it easy for food particles, bacteria, and post-nasal mucous drip to accumulate here. It is mostly occupied by sulfur-producing bacteria which are responsible for the trademark halitosis or bad-breath symptom.
What causes tonsil stones?
Tonsil stones are caused by calcification of debris in the tonsils which further develops a bio-film or a layer of microbes feasting on this deposition.
Mostly caused by food particles getting lodged in the pits and fissures of the tonsil’s surface, tonsil stones may also be caused by deposition of mucus.
The presence of following factors may further increase the risk of developing this condition:
- Poor dental hygiene which triggers bacterial deposition.
- Having large tonsils which provide a bigger area for debris to collect and calcify.
- Repeated bouts of sinus infections which lead to wrinkled tonsils and more mucous deposition.
- Inflammation of tonsils which renders the tonsils more susceptible to bacterial infestation.
- Using post nasal drips which may cause the liquid to settle in the throat region.
- Smoking causes the mouth’s self-cleaning capacity to reduce which further creates grounds for bacterial growth.
The tell-tale signs of tonsil stones
- Tonsil stones are usually white to yellow in color which can be seen at the back of the mouth. These usually form near the molars and wisdom teeth. In some cases, this whitish debris is visible whereas in many it can be only seen through CT scans or MRIs.
- Bad-breath or halitosis is one of the most common symptoms of tonsil stones. This is caused by the deposition of sulfur-producing bacteria within the crevices of the tonsils.
- A sore throat, discomfort in swallowing, frequent coughing and even sensation of throat closing up might be felt by the individual, in flared up conditions.
- Many individuals experience a strange metallic taste in their mouth owing to the stone formation.
- In case of enlarged tonsils and chronic tonsil growth, the person may also suffer from ear pain. This happens because the tonsils and ears share nerve pathways. Due to the enlargement of tonsils, there is increased pressure in the ears.
How does a doctor detect tonsil stones?
The presence of above-mentioned symptoms such as acute halitosis, swelling of tonsils, the appearance of stones at the back of the throat, and pain in swelling will enable the physician to detect tonsil stones.
In those cases where these symptoms are not clearly visible, routine radiological tests are employed to confirm the stones.
Various imaging techniques are used to detect calcified granuloma and/or malignancy of the tonsil growth.
Getting rid of tonsil stones
The treatment protocol applied depends upon the severity of the symptoms and the extent of stone formation. If the stones are smaller in size, they can be treated naturally. Natural treatment techniques include:
- Regular gargle with salt water or any other non-alcoholic mouthwash. This helps natural removal of bacterial and fungal growth. Warm water gargle will also relieve the pain caused by a sore throat.
- Sterilized picks or swabs can be used to remove the tonsil stones at home. Upon removal of the stones, the mouth should be immediately rinsed with salt water to remove any food particles lodged in the area.
- Consuming lemon juice, which is an excellent source of Vitamin C, is helpful in keeping infections at bay. Additionally, raw garlic and onions also help in fighting against the microbe growth.
- Maintaining a good oral hygiene by regularly removing bacteria and debris, especially with an electric toothbrush and tongue scrapping is helpful.
Treatment of tonsil stones can be done through medications and surgery too. Tonsillectomy or surgical removal of tonsils is conducted if no other measure works out in reducing them. Laser cryptolysis is another viable option where laser beams are used to smooth out the tonsil surfaces removing the collected debris. In milder cases, antibiotics may be prescribed to treat the condition. For more prominent tonsil stones, curettage method is used. In this method, the stones are scooped out of the tonsil surface and then cleaned by the use of oral irrigators.
Are there any preventive measures?
Tonsil stones usually affect people on a frequent basis, i.e, if an individual develops tonsil stones once; it is highly likely that he/she will face recurrent bouts of tonsilloliths.
For these people, it is important to maintain a good sense of oral hygiene and keep the tonsils free of debris collection.
Quitting smoking can also help one keep the mouth area germ free.
Regularly gargling with salt water and keeping oneself hydrated are important preventive measures.
One should avoid alcohol-containing mouthwash since these can eliminate the good bacteria from the mouth which keep your mouth naturally clean.
- It affects almost 6% to 10% every year, mostly in the age group of 20-40 years.
- 75% of people with high sulfur content in their oral cavities develop tonsil stones.
- It is observed to occur more in people suffering from tonsillitis.
- Oral thrush, a fungal infection, is also responsible for causing tonsil stones.
- Increased strain on the lymphatic system to fight against allergens may also cause tonsil stones.
Dos and Don'ts
- Clean your tongue and teeth twice daily and use oral irrigators frequently to prevent the deposition of debris and food.
- Keep your sinuses and nasal passage clean and mucus free.
- Mushrooms, cucumbers, celery, and onions are good for naturally getting rid of tonsil stones.
- Gargling with warm salt water is an effective treatment.
- Consume of red meat, processed items and beverages containing sugar, and caffeine since these promote bacterial growth in the mouth.
- Drink less water. Keep yourself completely hydrated.
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