Article by Dr. Aayushi Dubey
Tonsil stones, or Tonsilloliths, are rigid white or yellow formations that are located on or inside the tonsils. It’s common for people with tonsil stones to not even feel they have them. Tonsil stones aren’t easy to see and they can range from rice-sized to the size of a large grape. Tonsil stones rarely cause larger health complications. However, sometimes they can grow into larger formations that can cause your tonsils to swell, and they often have a distinct smell.
Your tonsils are made up of tunnels, crevices, and pits called tonsil crypts. Different types of debris, such as mucus, saliva, dead cells, and food, can get stuck in these sacks and build up. Bacteria and fungi feed on this build-up and cause a distinct smell.
Over the period, the debris hardens into a tonsil stone. Some people might have only one tonsil stone, whereas others have many minor formations.
The most common symptom the patient’s experience is halitosis. If the tonsil stones are left untreated, bacteria continue to grow and increase the swelling of the tonsillar tissue. Symptoms of a severe throat and discomfort when swallowing is frequently experienced with tonsil stones that have gone undiagnosed and untreated. Moreover, patients can experience ear pain due to the inflammation of the tonsils.
When studying the bacteria causing inflammation of the tonsils, researchers have found both aerobic and anaerobic bacteria. One study reported that some of the anaerobic bacteria produce volatile sulphur compounds such as hydrogen sulphide and methyl mercaptan. The volatile sulphur has been implicated in halitosis. Therefore, patients who are prone to tonsil stones should avoid pastes, rinses, and drinks, such as wines, that contain sulphur.
Reducing the number of bacteria in the oral cavity will help prevent tonsil stones. Dentists can advise patients to have meticulous home care with electric toothbrushes, flossing, and rinsing with sulphate-free products. Avoiding consuming beverages with carbonation, sulphur, or dairy products will reduce the risk and growth of tonsil stones.
Removing tonsil stones chairside can be done with an air/water syringe or a tongue depressor. Lightly use the air/water syringe to spray the stones out of the tonsillar folds while using the suction to eliminate debris. The back of a tongue depressor can also be used to lightly push the tissue down around the stone to then lift the stone up and out.
Chronic tonsil stones can lead to the removal of the tonsils, which are a vital part of the immune system.