Tonsil Stones

What are Tonsil Stones?

Tonsil stones (Tonsilloliths) look like little white or yellow balls.  They can be so small that they are unnoticeable or fairly large (up to a few centimetres wide).

They are a result of bacteria, white blood cells, mucous (from post nasal drip), food particles and other debris that collect in holes and crypts of the tonsils.  This debris then becomes calcified and forms a stone.  Bacteria live in and on the tonsil stones, the worst bacteria associated with tonsil stones are anaerobes and they create awful smelling sulphurous odours.

What are the Risk Factors for Tonsil Stones?

• Dry mouth
• Post nasal drip
• Chronic tonsillitis
• Sinus infections
• Size, shape and depth of the tonsil crypts
• Diet and lifestyle ie too much dairy, refined foods, alcohol, stress

How do you know if you have Tonsil Stones?

Some tonsil stones are so small, you cannot see them, also they tend to hide in the tonsil crypts so often they are only detected during x-rays or scans.  

Other than that, you may notice some symptoms:

• Continuous bad breath not related to any other factors such as food
• Metallic taste in the mouth
• A sore throat
• Inflammed or swollen tonsils
• Visible white spots or stones emerging from holes or from behind the tonsils

How can you get rid of Tonsil Stones?

• Gargling with warm salt water helps to reduce the discomfort and pain associated with tonsil stones. Gargling is an effective technique which will help you to get rid of tonsil stones. Normal salt solution can be used after every meal to flush out the food particles from your mouth.
• Coughing and opening your mouth wide may help dislodge tonsil stones
• Using a cotton bud and gently pressing the tonsil from the bottom and gently prodding a little higher each time, this may help push the tonsil stones out.  Remember to press gently.
• You could use a medicine dropper.  The suction from the dropper can suck up the tonsil stones from the holes in your tonsils.
• An exercise to do is extend the head backward, place the tongue at the roof of the mouth and swallow.
• Laser resurfacing of the tonsils decreases the surface area (crypts, crevices, etc.). The procedure is called laser cryptolosis It can be performed using a local anesthetic. A scanned carbon dioxide laser selectively vaporizes and smooths the surface of the tonsils. This technique flattens the edges of the crypts and crevices that collect the debris, preventing trapped material from forming stones.

How can you Prevent Tonsil Stones?

If you don’t have tonsils, tonsil stones cannot form.  During childhood tonsils can be removed without much risk but this procedure is much more risky for adults. 

Ideally you want to prevent the tonsil stones from forming in the first place.  Here are some suggestions:

• Simple and obvious but make sure you brush your teeth in the morning and evening and ideally after every meal – brushing will dislodge the small food particles that get stuck in your teeth and helps keep your mouth bacteria free.
• Always use a tongue scraper as part of your oral care routine.  Once you have brushed your teeth – reach as far back on your tongue as you can without gagging.  This will remove bacteria that has built up on your tongue which your toothbrush may have missed.

• Gargle with alcohol free mouth wash or salt water – ideally every time you brush your teeth
• Don’t eat just before you go to bed- food particles remain in your mouth while you sleep and will accumulate in your tonsils.
• Eliminate or cut down on dairy products in your diet – dairy products encourage the build up of mucus and calcium, which are components that make up tonsil stones.
• If you are thirsty drink water – water keeps your mouth moist; fizzy drinks, juices and caffeine drinks can encourage tonsil stone growth.