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Tonsil stones (tonsilloliths)

What are tonsil stones?

Tonsil stones, or tonsilloliths, are not actually stones, but the name given to food particles that get trapped in the pits of the tonsils. This food acts as a good breeding ground for bacteria, which encourage the food to decay. Tonsilloliths can therefore cause bad breath (also known as halitosis) and a chronic sore throat.


What causes them?

Everyone has pits in their tonsils, but in some people these pits become prominent and large enough to trap food in them during eating. People with a history of recurrent or chronic tonsillitis are more prone to developing this problem and they are most commonly seen in adults in their 20s to 40s.  


How is this condition diagnosed?

Tonsilloliths are diagnosed based on the symptoms and examination of the mouth by your GP or an ENT surgeon. Patients often give a history of being able to express a cheese-like substance from their tonsils with their fingertips. Most patients will be troubled by halitosis that does not get better despite using mouthwashes or practising good oral hygiene.


How is it managed?

It is first important to rule out that the halitosis is not being caused by something else such as gum disease (gingivitis), a chronically dry mouth (xerostomia), dental caries (rotten teeth), chronic sinus infections, medical problems such as liver failure or diabetes, or personal habits such as smoking. Many of these conditions can be treated with good results.


If tonsilloliths are seen to be the cause, then improving oral hygiene with regular tooth brushing, flossing and the use of mouthwashes can help.


Will removing the tonsils help?

If non-surgical measures do not help, then a tonsillectomy can be performed. With the tonsils removed, food can no longer get trapped and therefore tonsilloliths can no longer form and cause problems. Mr Trinidade can discuss further about whether tonsillectomy will help you.


More information.

Read about tonsillectomy here.  

A tonsillolith is seen here lodged within the left tonsil

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