Tonsil stones: causes, signs, removal
Tonsil stones: Description
Tonsil stones are called this way because they are formed in the furrows of the palatine tonsils and look like small white-yellow stones. They can vary in size, but their diameter is usually no more than five to six millimetres. Their consistency varies from rather soft and crumbly to hard as stone.
How are tonsil stones made?
This refers to the palatine tonsils (Tonsilla palatina). These are located on both sides of the posterior (soft) palate behind the palatal arch. They belong to the immune system and have the task of adapting the body’s defences to pathogens that enter the body with food.
The surface of the palatine tonsils has innumerable small depressions (crypts) that extend deep into the interior of the tonsil. In these crypts a mixture of food pulp, mucous membrane cells, white blood cells and bacteria collects, which is completely normal. When chewing, the palate muscles tense up, causing the crypts to regularly empty and refill.
However, certain lime salts are also found in food and saliva, which can be deposited in the pulp mixture of the crypts. When this happens, it hardens and the consistency appears stone-like. The tonsil stones are often located deep in the crypts, but can also reach the surface.
Tonsil stones: Symptoms
In most cases, tonsil stones do not cause any complaints. They are often only very small and – if they reach the surface of the almonds – are swallowed, coughed up or sneezed out unnoticed.
However, the components of a tonsil stone have an unpleasant smell that reminds one of rotten eggs. Therefore, especially larger tonsil stones can cause bad breath.
In rare cases, large tonsil stone can also cause a foreign body sensation on the posterior palate, which is particularly noticeable when swallowed. Swelling and pain in the affected tonsils are also possible.
Tonsil stones: Causes and risk factors
Tonsil stones are found in all people, but they are usually so small that they are not noticeable. Why they occur more frequently or even become larger is not known exactly.
However, doctors suspect that the size of the tonsils themselves plays a role. In people who basically have large tonsils, the crypts are also deeper. This makes tonsil stones lighter. The cause can also be a disturbed emptying of the crypts. They are often observed as a result of recurrent inflammation with scarring of the tonsils. This is why tonsil stones are particularly common in young adults who suffer from tonsillitis several times a year. However, this does not mean that people with tonsil stones automatically have more frequent tonsillitis.
Tonsil Stones: examinations and diagnosis
An tonsil stone is often a coincidental finding during a visit to the dentist or ENT doctor. Sometimes, however, a doctor will explicitly look for it, for example in the case of unexplained bad breath. Depending on its size and distance from the surface, an tonsil stone may shimmer whitish through the mucous membrane or appear as a white deposit on the tonsils. If it is deeper, it is normally not visible to the naked eye.
Ultimately, tonsil stones can be detected on X-rays and even better with computer tomography. Due to the costs and radiation exposure of these examinations, however, they are generally not used to detect tonsil stones. Only larger stones on the surface usually cause complaints.
Sometimes tonsil stones are confused with pus, which occurs with tonsillitis. In the case of an inflammation, however, the tonsils would also be severely reddened and swollen and the infection would usually be accompanied by fever.
Tonsil stones: Treatment
If you want to remove tonsil stones, there are several possibilities. Often no doctor is needed for this. Helpful methods to remove tonsil stones yourself are:
- With the head stretched backwards, open the mouth wide several times and close it again. This creates a tension in the palate muscles, which may massage out the tonsil stone.
- Press upwards against the underside of the tonsil, for example with a cotton swab or the back of the toothbrush. Some patients can also press tonsil stones with their tongue, which causes less gagging.
- Clean the tonsil with a mouth shower under low pressure. This often solves the tonsil stones.
- Household remedies such as mouthwashes based on sage or chamomile can also be helpful.
Anyone who wants to remove tonsil stones from themselves should never use pointed or sharp-edged objects for this purpose, as this could cause injuries.
If the attempt to remove the tonsil stones by yourself is unsuccessful, the ENT physician can usually help. He has special tools such as cuvettes or pipettes with which he can squeeze or aspirate the tonsil stones. The so-called roeder treatment is also a helpful method. The doctor places cupping glasses on the tonsils and sucks the stones out with the help of the vacuum.
Tonsil stones: Preventing
To prevent almond stones from forming in the first place, it can help to clean the tonsil regularly with a mouth shower. Even if you brush them gently when brushing your teeth, this cleans the crypts and thus makes the formation of tonsil stones more difficult.
Tonsil stones: course of disease and prognosis
Tonsil stones are usually harmless and are not even noticed by those affected. Larger stones can cause discomfort, but are usually easy to remove. However, tonsil stones often reappear after they have been removed