Explained: What Are 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.
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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, 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!

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