Tonsil stones: Causes, symptoms and treatment
When talking about stones – The kidneys come to your mind right? But the kidney is not the only place where stones can develop; Stones also can develop in your tonsils. So let’s get information.
What are tonsils?
Tonsils are a gland like structure located on the back of your throat. There are 2 tonsils located on either side. They are made of tissue which consists of thousands of lymphocytes, cells that fight off infections in our body. Because of the increased lymphocytes, it is believed that tonsils take part in the immune system. It acts as a net and tries to trap the bacteria or any other foreign body that enters your throat. However, experts believe that tonsils do not contribute largely to the immune system and hence removing them is not a big issue and will not make one susceptible for infections.
What are tonsil stones?
Tonsil stones basically mean stones in your tonsils. It is also known as tonsilloliths. These are hard white or yellow substances that are located either on the surface of the tonsils or within the tonsils. They may vary in size from the size of a rice grain to a pea size.
What causes tonsil stones?
As mentioned above, tonsils are like nets. They are made up of crevices, tunnels and tonsil crypts in order to trap bacteria, viruses and other foreign matter that enters your throat. So, different types of debris such as dead cells, saliva, mucus and food get collected in these pockets within the tonsils.
With time, this debris undergoes calcification to form hard calcified stones. These are tonsil stones. The number and size of such a stone can vary. One may have several tiny stones in the tonsils while others may have just one large stone. However, large single tonsil stones are rare.
You are at a high risk of developing tonsil stones if you have:
- A bad dental hygiene
- Large tonsils
- Chronic sinus problems
- Chronic inflammation of tonsils
- Repeated episodes of tonsillitis.
Who is at risk of tonsil stones?
If you have any of the following factors, your risk of developing tonsil stones is greater:
- Chronic or recurrent tonsillitis
- Sinusitis and bacterial infections
- Post nasal drip
- Excessive alcohol consumption
- Certain dietary factors such as too much refined food
- Hyperactive salivary glands
- Dry mouth
What are the signs and symptoms of tonsil stones?
In most cases of tonsil stones, you wouldn’t even notice them. That is Most of the time they are asymptomatic. Even if they are large stones they can be asymptomatic and therefore are found incidentally o x-rays or CT scans.
In some, tonsilloliths may produce multiple symptoms.
Bad breath or halitosis
One of the main symptoms that indicate something is wrong with your tonsils. Several researches were carried out to see if there are volatile surface compounds. According to the studies, about 75% of people who had a high concentration of volatile sulfur compounds also had tonsil stones. These volatile sulfur compounds are produced by bacteria beneath the surface of the tongue.
Bad breath can occur due to many reasons but if your bad breath does not seem to improve with regular use of tooth pastes, mouth washes, and other products, you are probably having tonsil stones.
Difficulty in swallowing (Dysphagia)
Depending on the location and the size of the tonsil stones, you may develop difficulty in swallowing. This may be just for solids, liquids or both.
Again, depending on the site of tonsil stones you may develop pain or discomfort in your throat. However, if you develop tonsil stones together with tonsillitis, it may be difficult to determine whether this pain and discomfort is due to the infection or the tonsil stones.
Tonsils have a shared nerve supply by the glossopharyngeal nerve. Owing to this fact, tonsil stone may cause you to feel pain in the ears.
Swelling of your tonsils
When you develop tonsil stones, it irritates the tonsils and thus leads to inflammation which will cause your tonsils to swell. Sometimes the tonsil stone alone itself may cause your tonsils to enlarge or swell.
White debris at the back of your throat
Sometimes, white material may be visualized at the back of your throat but this is not always the case. Most of the time, they are hidden behind the folds of the tonsils. In such cases, they may be discovered on CT scans or MRI scans.
How are tonsil stones diagnosed?
Tonsil stones are often very difficult to be visualized by the naked eye. This is because of the site and the size of the tonsil stones; the tonsils have folds in them that make it a nice hiding place for the tonsil stones. Owing to the small size of the tonsil stones, it will be hard to visualize them. Therefore tonsil stones are mostly detected incidentally on imaging studies such as X-rays, CT (Computerized Tomography) scan and MRI (Magnetic Resonant Imaging) Scan.
What is the treatment for tonsil stones?
The treatment for tonsil stones will be planned according to two factors. They are:
- The size of the tonsillolith
- It’s risk of causing harm or discomfort
Since most cases of tonsil stones are asymptomatic, no treatment is required. However, if you are experiencing a bad breath or discomfort, you need treatment. The treatment options available for tonsil stones are many, ranging from home remedies to surgical removal of the entire tonsil.
The available treatment options for tonsil stones include:
Removal of tonsils at home
You can give a try at home to remove the tonsil stones with the help of picks, cotton wool swabs or tooth brush. Tonsils are delicate structures and therefore be gentle when you do this. This is risky and may lead to numerous complications therefore it is always better to consult your doctor before considering this option.
Gargle your throat with salt water
Gargling with salt water helps you to reduce the pain and discomfort caused by tonsillitis and thus tonsilloliths.
You can dissolve one quarter to half a tea spoon of salt and dissolve it in a cup of water and gargle.
Coughing may help you to loosen the tonsil stones and dislodge them. This will help you to get rid of them easily.
Antibiotics may not be the best way to treat the underlying cause but it will help you to destroy the bacterial organisms that play a major role in the development of tonsil stones. Antibiotics are not advisable to be used for a long time, which means that the tonsil stones are likely to return in the future.
Surgical removal of the tonsils
The surgical removal of tonsils is known as tonsillectomy. This is usually done when your tonsils are large and symptomatic and when all other means of treatment have failed to show results. This is a very simple procedure which can also be done after giving a local injection, meaning you do not need general anesthesia.
Surgical removal of the tonsils may be done using a scalpel, laser, or coblation device.
- Laser tonsil cryptolysis – This procedure uses a laser to remove crypts on the tonsils where tonsil stones usually lodge. This procedure is done under local anesthesia and its recovery time is minimal.
- Coblation cryptolysis – During this procedure, radio waves are used to convert a salt solution into charged ions which will cut through the tissues. Coblation cryptolysis also reduce tonsil cryptolysis in that it has no burning sensation.
What are the complications of tonsil stones?
Even though the complications that can arise from tonsil stones are rare, they are still possible. The biggest problem that can occur as a result of tonsil stones is damage to the tonsils. This is more likely to happen when you try to manually remove them at home using a cotton swab or a tooth brush; especially when they are used too aggressively or is pushed too far into the tonsil.
How can you prevent tonsil stones?
Tonsil stones may recur in many people. Luckily there are many precautions that you can take to avoid tonsil stones. These include:
- Maintain a good oral hygiene.
Use tooth pastes, mouth washes and other products to wash off the bacteria in your mouth especially those that may be present at the back of your tongue. Brush both your tongue and teeth at least2 times a day.
- Quit smoking
- Gargle your throat with salt water to get rid of the bad odor as well as to prevent stone formation in the tonsils.
- Drink at least 8 glasses of water and keep yourself hydrated.
- After a meal, gargle your mouth with water to wash down the food particles that may remain at the back of your throat after a meal.
- Avoid alcohol consumption in excessive amounts because it can cause your mouth to dry up as it is a diuretic.
- Cut down the intake of dairy products in your diet as these foods contain protein that anaerobic bacteria can grow well on.