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Thomas P. Connelly, D.D.S.

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Explained: What Are Tonsil Stones?

Posted: 09/08/11 09:12 AM ET

Let's talk about your tonsils today. Or, more specifically, a condition that can afflict them: tonsilloliths, otherwise known as "tonsil stones."

Tonsilloliths are a fairly common tonsil affliction, but they take a back seat to their more popular cousin, "tonsillitis," in people's minds. In fact, since they share several symptoms, they are often confused with each other.

Before we start, let's go over what the tonsils actually are. Your tonsils are two lymphatic glands in the back of your throat. They are generally thought of as guardians against respiratory infections, standing ever-diligent side by side. But, to be honest, they do not do their jobs very well and often cause more problems than they prevent. In fact, most medical professionals feel they are more a product of an earlier time, when we, as a species, faced fewer airborne germs (because we lived farther apart) (1). In my mind, they are akin to your appendix -- it probably had far more function several thousand years ago, but in this day and age is little more than a nuisance. Such is evolution.

I mentioned the tonsils cause more problems than they solve. That's because your tonsils are meant to trap bacteria that comes in through your mouth. But in doing so, they are at risk to infection themselves -- again, likely because there are so many more germs that we are exposed to today. In addition, your tonsils are more active / effective before puberty (2), which is why so many kids get tonsillitis (which is when the tonsils are infected.)

The other condition that affects the tonsils is tonsilloliths, or tonsil stones. These appear more in older children and adults and are caused when bacteria and other materials become caught in your tonsils. Your tonsils have all kinds of little nooks, crannies, crevices and pockets that catch bacteria (and other "stuff" -- even mucous and dead cells). Sometimes, this debris gets caught and becomes concentrated, attracting more and more. These can harden (calcify), and at that point, we call them tonsil stones.

Most tonsil stones are fairly small, perhaps even undetectable. But others can turn white, making them easy to see (in fact, this is the "classic" tonsil stone look). And some of them can grow large, making them very easy to see. Below is a link to some Google images for tonsil stones (3) so you can see what they look like. Trust me, finish your lunch first, okay? You're welcome.

Although they look really, really nasty, tonsil stones are not all that harmful, falling into the "annoying" category more than anything else. Their symptoms are as follows:

  • Bad Breath: Approximately 75 percent of people with tonsil stones suffer from halitosis (bad breath) that stems from the tonsil stones -- those little things stink!
  • Sore Throat: The area where the tonsil stone is located will hurt. In fact, if you have a tonsil stone and tonsillitis at the same time, you likely won't know which is causing the sore throat.
  • Difficulty Swallowing: First of all, a sore throat makes swallowing painful. Secondly, any obstruction will make swallowing difficult. (You looked at the pictures, right? Some of those are big!)
  • Tonsil Swelling: Because it's partly bacteria, etc., the tonsil stone can make your tonsils swell.
  • Ear Pain: Almost anything that affects your throat can cause ear pain. Tonsil stones are no exception.

As you can see, tonsil stones are no fun at all. So what can we do to prevent them? Well, sadly, the answer is "nothing." If you have tonsils, you may get tonsil stones, and there's little you can do about it. The only surefire prevention is complete removal of the tonsils (which is a very common -- and simple -- operation these days).

Say you have tonsil stones, and you want Dr. Connelly to tell you how to treat them, because you don't want to get your tonsils taken out. Well, as an NYC cosmetic dentist, I do see tonsil stones a lot and can offer a few tips on how to treat them.

The first thing I usually recommend is a good, old salt gargle. That helps many throat conditions and will likely lessen some of the discomfort you feel. Your dentist can also try to remove them with a swab -- I have done that before. (Patients have even reported to me that they did this themselves at home, although I don't recommend jabbing the back of your throat with anything.) Antibiotics could work, but I don't recommend them -- if we're at a point where we need antibiotic treatment, surgical removal of the tonsils is probably a better option.

You can also do nothing -- they very well could go away on their own. If you see a tonsil stone, but have no symptoms, and nobody is telling you your breath stinks, don't worry about it (for now, anyway).

I hope this post shed a little light on this common but largely ignored affliction. Until next time, keep smiling!

(1) http://www.webmd.com/oral-health/tonsil-stones-tonsilloliths-treatment-and-prevention

(2) http://www.mayoclinic.com/health/tonsillitis/DS00273/DSECTION=causes

(3) http://www.google.com/search?q=tonsil+stones

 

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Let's talk about your tonsils today. Or, more specifically, a condition that can afflict them: tonsilloliths, otherwise known as "tonsil stones." Tonsilloliths are a fairly common tonsil affliction, ...
Let's talk about your tonsils today. Or, more specifically, a condition that can afflict them: tonsilloliths, otherwise known as "tonsil stones." Tonsilloliths are a fairly common tonsil affliction, ...
 
 
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05:39 PM on 09/15/2011
@StrawHat I would leave the brochure after hours. It is probable that there is something medically wrong as just bad mouth hygiene wont cause an odor that horrible. Could be gingivitis and tonsil stones, or post nasal drip. Who knows but he should probably get it checked out. I had a boss that I never knew was in our work room until I smelled his breath from across the room. He suffered from severe post nasal drip. Someone finally told him because after about a month the odor became better and I noticed he was not as congested as he had been before and was going to the dr. more...
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GOODREASON
10:39 PM on 09/13/2011
My friend who had them would pick them out with a crochete hook.....
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tomteboda
01:37 AM on 09/10/2011
The description of tonsils as guardians is very close to how my grandfather's doctor explained it to him when he was a boy. The story goes that his mother took him to the doctor because he had many recurrent tonsil infections, and the doctor said to him:

"Your tonsils are like soldiers that fight nasty bacteria and germs in your mouth so they can't make you sick. Unfortunately, your tonsils have lost the war. Not only have they lost the war, they've joined the enemy."
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Freedom Rush
freedom is the oxygen of the soul
09:46 PM on 09/09/2011
i'm a bazillion years old and i've never had my tonsils taken out. in fact i have all my original factory parts (except for a couple of teeth, but i still have the wisdom teeth too) is that freaky or what?
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StrawHat
Eat veggies, don't vote for them
11:21 PM on 09/09/2011
Goodness, you're very lucky. :0)

They've taken my appendix, tonsils, all four wisdom teeth, gallbladder, and a hunk of foot tissue (melanoma) -- I'm running low on spare parts!
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Freedom Rush
freedom is the oxygen of the soul
10:41 AM on 09/10/2011
so very sorry to hear about the melanoma SH, but i believe that little messages like yours increase awareness. so maybe you helped someone today by telling that part of your story? i'd like to think so anyway. have a wonderful day, and keep taking good care of yourself, my friend. you're a keeper! :-)
09:33 PM on 09/09/2011
I haven't had a tonsil stone since childhood. I do remember them and they would always dislodge. Taste and smell was awful. Since I changed my diet to a mostly vegetarian and organic one I have not had one stone in over 40 years.
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Betsy Nelson Pavlica
10:31 AM on 09/09/2011
THANK YOU!!! I had no idea what those nasty white things in the back of my throat were until now. I'm looking forward to a nice saltwater gargle this evening!
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Widespread Panic
does anyone really care??
02:52 AM on 09/09/2011
Gah! I've been getting tonsil stones (I don't get tonsilitis) for about 15 years, but I didn't know what they were til a few years ago. I hate the darn things. I have to dig them out with my toothbrush or cough them up at least once a week. They are so darn annoying! And stink like crazy! I may consider getting my tonsils out they bother me so much.
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StrawHat
Eat veggies, don't vote for them
01:53 AM on 09/09/2011
Twice in my adult life I have had co-workers whose breath could almost kill. I work with a guy now who will fill an entire conference room with the most horrific odor imaginable as soon as he opens his mouth to speak. What's funny (in a morbid kind of way) is that he's also a germ phobe and super pin-neat in his grooming and attire. I have suspected that he has tonsil stones but I don't dare say anything to him for fear of causing an HR fire storm.

I've considered leaving a brochure on his keyboard at the end of the day Friday so no one will know it was me, but I hate to embarrass him or make him feel awful. Instead I just try to avoid him and hold my breath when he's near.

I welcome any suggestions.
09:37 PM on 09/09/2011
This guy probably has pyorrhea with or without tonsil stones. This is a tough call, but if it's really that offensive I'd leave the brochure. You would be doing him a huge favor.
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onwisconsin
Trust women; protect choice.
10:00 PM on 09/08/2011
I get these because I have cryptic tonsils. Cotton swab takes care of them if handled regularly. I'm not getting my tonsils taken out unless I have to. Your breath doesn't have to stink either.
10:53 AM on 09/08/2011
Great article... good work Dr. C