If you ask people about stones in the body, most will immediately think of kidney stones, which are among the most common type of stones experienced. However, the tonsils are another place where potentially painful stones can develop. There are also stones called tonsilloliths, which develop in the tonsils and can often go unnoticed until they become quite painful and inflamed. Since many people are unfamiliar with tonsil stones, we will look at the signs, symptoms, and means of treatment to better inform you.
While tonsilloliths tend to be benign and often develop unnoticed, they are a common problem that, with a good understanding of the signs and symptoms, can be identified and properly treated, even at home.
There are a number of causes for tonsil stones and there are a range of ways to prevent their development in the first place.
Let’s look down the throat and discus tonsil stones. We will learn some basics about tonsils, tonsil stones, the basic makeup of the stones, the causes, a few treatments, as well as preventative measures you can practice to avoid this annoying condition from occurring or recurring.
The Basics of Tonsils
Tonsils are physical structures that are located at the back of the throat. There is one tonsil on each side of the throat. They are made of a special tissue that is designed to help the body prevent infection and fight infections that do form. There is much about the tonsils that is still not well understood, but it appears that they play a role in our immune functions.
The structure of the tonsil acts to trap biological invaders and keep them from getting past the throat. Another key function of the tonsils is to help keep foreign debris and biological pathogens from getting into the lungs as well.
Additionally, tonsils also serve as another pair of lymph nodes, which perform a very important function in the body. In addition to acting like a filter to keep potentially harmful things from getting past the throat or lungs, tonsils also produce white blood cells and other important antibodies. White blood cells have a very important function as they act to attack foreign pathogens that may attempt to enter the body.
The problem with tonsils is that these primitive structures often lead to more problems than they solve. Hence why so many people end up having to have their tonsils removed at some point in their life. The thinking is that tonsils evolved when humans were exposed to far fewer pathogens and potential biological invaders, so they did not evolve for the multiples of potential bacterial invaders that we face today.
People who have had their tonsils removed do not appear to be any more susceptible to infection than people who retain their tonsils. They seem to be predominately a relic left over from the evolutionary past. So those people that had their tonsils removed and ate buckets of ice cream in the hospital will not have tonsil stone issues.
What Are Tonsil Stones?
Tonsilloliths is the technical term for tonsil stones. In essence tonsil stones form from bacteria and other debris that can collect in the small crevices or sacks of the tonsils. This material can then harden into a stone, which can go unnoticed or cause a variety of related issues.
Tonsil stones are fairly common and many people have them and are never aware that they do. Those who have had many infections in the tonsils are more likely to develop tonsil stones than those who have not experienced such problems.
While tonsil stones are not often dangerous, they can be painful and cause some unpleasant issues if they get particularly large or are left untreated.
These collections of debris harden into yellow or white stones and can sometimes be visible when opening the mouth. These stones can range very widely in size, sometimes as small as a grain of rice to the size of a cherry tomato. Most often, they are small and do not cause any pain or complications of this sort. It is rather uncommon for someone to develop large stones, but not unheard of, and it is these larger of the stones that are likely to cause the most problem.
There are two types of tonsils: palatine tonsils and lingual tonsils. Stones most often occur in the palatine tonsil, but they can occur in the lingual ones too. These stones can affect people of all ages, from children to the elderly.
Tonsil stones aren’t, of course, actual stones, they are more akin to a living organism than a true stone. In fact, some tonsil stones that are comprised of mostly bacteria will even respriate. Interestingly, there is still much about the composition, formation, and mechanisms of tonsil stones and still a lot of debate as to how to classify and characterize them.
Symptoms of Tonsil Stones
Many people who deal with tonsil stones have no obvious symptoms. They can occur in people of all ages, but are most common in adults and teenagers with large tonsils.
Many people deal with these and they go unnoticed as they don’t always cause pain or any sort of discomfort. They are often visible as a small yellow or white object lodged in the back of the throat but they also often occur low enough that no part of the stone is actually visible. Sometimes stones, even large ones, are only discovered when an x-ray or other diagnostic procedure for the throat is undertaken for an unrelated issue.
One of the first and most common symptoms of tonsil stones is unexplained bad breath. Due to the composition of these stones, they often give off an unpleasant odor that doesn’t seem to go away with brushing and mouthwash. The smell is due to the process by which anaerobic bacteria reproduce and respirate.
Another common symptom of tonsil stones if the feeling that you have something stuck in the back of your throat that cannot be dislodged by swallowing. Sometimes, tonsil stones can be mild to moderately painful, causing pain and discomfort when swallowing.
Tonsil stones can cause bigger problems than just discomfort, however. Some people experience a weird metallic taste in the back of their throat from the stones. Others may experience coughing fits or even choking sensations.
With larger stones, tonsil infections can accompany tonsil stones, lead to difficulty swallowing, and lead to ear aches much like the type of pain associated with an ear infection. As the stone hardens and gets larger, many people experience an inflammation of the tonsils, which is often associated with an increasingly painful time swallowing.
Another symptom is visually being able to see the stone in the back of the throat. Many people notice tonsil stones when brushing their teeth as there appears to be some sort of white or yellow object stuck in the throat. More rarely, a chronic cough may also be a symptom of tonsil stones.
What Causes Tonsil Stones?
There appear to be a number of factors that contribute to the likelihood of the development of tonsil stones. Those who have had recurring issues with tonsil infections, inflammation, or other issues, are more likely to develop tonsil stones. Just like people come in different shapes and sizes, so too do tonsils.
Those who have larger tonsils will have more surface area and crevices that debris and bacteria can collect into, and thus, are more likely to suffer from tonsil stones.
There is evidence that dietary patterns can also contribute to the development and recurrence of tonsil stones. Some data points to high calcium diets increasing the likelihood of the development of tonsil stones. More research into the correlation or potential link between diet and the development of tonsil stones needs to be done before any generalizations can be made or definitive statements presented.
Poor dental hygiene is another common cause of tonsil stones, and is, in fact, the most common cause of tonsil stones. Without proper tongue and throat hygiene, even regular brushing and flossing doesn’t mean that you are safe from stones.
People who suffer from a variety of sinus issues, such as allergies or postnasal drip are also more likely to develop tonsil stones. The drip tends to provide material that can collect in the tonsils and promote the formation of stones. There also appear to be certain genetic factors that relate to the propensity to develop tonsil stones, but this is another area that needs additional study.
Prevention of Tonsil Stones
Since poor dental hygiene is one of the most common reasons that people develop tonsil stones, this is the most obvious and direct prevention and even solution. Brushing and flossing regularly will help to remove debris and bacteria from between and on your teeth, which reduce the material in your mouth that may become lodged in the crevices of your tonsils.
Additionally, cleaning your tongue and gargling and rinsing on a regular basis should be part of your oral hygiene routine. These steps will go a long way in the prevention of the development of tonsil stones. Using a mouthwash that has alcohol in it is another good preventative measure. When you gargle the wash in the back of your throat, it kills potentially harmful pathogens. Gargling can even work to loosen up any material that may have become lodged in the crevices of your tonsils.
Proper hydration is another good way to help prevent the development of tonsil stones. Some suggest a daily salt water gargle. Poor diet and lifestyle habits like smoking are also known to be associated with the development of tonsil stones, so addressing these issues will likely provide much in the way of prevention.
Treatment of Tonsil Stones
Even with the best oral hygiene and preventative care, tonsil stones may still occur. For many, no treatment is necessary as the stones go unnoticed or do not cause any pain or complications. For those that do cause pain or have the potential for complications, treatment is likely necessary to solve the problem. Some types of treatment do not even require a doctor.
For many tonsil stones, vigorous gargling and rinsing can work to dislodge the stone. If the stone is easy to see and accessible, it can also be removed, but it isn’t recommended that you try this yourself as these are sensitive organs that can be easily damaged if the removal isn’t done properly.
For some, a simple course of antibiotics is all that is necessary to take care of the tonsil stone. Antibioitics help reduce the number of bacteria in the mouth and throat which help to facilitate the development of tonsil stones. This is not a solution for the long term though, and there are a lot of potential drawbacks to the use of antibiotics. They often help with the issue in the short-term, but once the patient stops taking the antibiotics, the tonsil stones may often come back. That’s why prevention is key.
If the stone doesn’t come free with gargling or time, or it gets larger and starts to become painful, you will likely need to seek the help of a medical professional. In many cases, a process called laser tonsil cryptolysis is employed. This involves the use of lasers under general local anesthesia and removes the crevices through cauterization where the stones develop in the first place. This is a relatively simple procedure that has a short recovery time.
Another procedure used to eliminate tonsil stones is called coblation cryptolysis. This process is similar to the one involving lasers, but this does not use heat and laser beams to remove the crevices in the tonsils. Rather, a saltwater solution has radio waves sent through it, which ionizes the solution. It is via these ions that tissue is cut through for the removal of tonsil crevices.
In very severe cases or those where the problem continues to recur regardless of treatment attempts, a tonsillectomy, or removal of the tonsils themselves, may be necessary. The use of this as a treatment option is relatively controversial and is often seen as a last-ditch effort after all other treatment forms have been tried and failed.
Tonsil stones are a relatively common, though not well-known, medical condition. In many cases, they go unnoticed as they are not visible and do not cause any outward symptoms. They do not often cause a lot of complications and can even become dislodged through rigorous swishing and rinsing.
There are a number of causes of tonsil stones, from genetics to poor dental hygiene, and many things that can be done to help prevent the development or recurrence of these stones to begin with. However, even with good hygiene and taking preventative measures, tonsil stones can still occur. When they occur along with symptoms such as difficulty swallowing or ear and throat pain, a number of minimally invasive procedures are often a great way to treat and prevent the problem from recurring. In very severe cases, the entire tonsil may need to be removed.