Tonsil stones and their treatment

Tonsil stones and their treatment Photo: Ali Forghani

WASHINGTON, May 25, 2013 — Tonsil stone is the common name for tonsillolith or tonsillar calculi (plural), or tonsillar calculus (singular). A tonsil stone is a cluster of calcified material that becomes lodged in the crevices of the tonsils; these crevices are called tonsillar crypts. Most often occurring in the palatine tonsil, they are also known to occur in the lingual tonsils. Although small areas of calcification are generally common, true tonsil stones are actually somewhat rare.

Primarily composed of calcium, the tonsil stone may also contain ammonia, carbonate, magnesium and phosphorus. Often the sufferer may feel the tonsil stone as an object stuck in their throat. Although sometimes difficult to remove, they are generally harmless other than occasionally affecting swallowing and frequently being the cause of chronic halitosis.

Symptoms of Tonsil Stones

Most often occurring in persons with post nasal drip or chronic inflammation of the tonsils, or persons that have experienced tonsillitis frequently, often tonsil stones will produce no symptoms and the person may be affected for a period of time without knowing.

More serious cases can often produce bad breath and less frequently there is pain or discomfort when swallowing. Other symptoms are coughing “fits”, tightening feeling in the throat or closing of the throat often resulting in choking or a choking feeling, or a metallic taste in the mouth. Smaller tonsil stones are often detected accidently during x-rays or other oral exams such as during a visit to the dentist.

More serious symptoms that often accompany larger tonsil stones are:

Recurrent or persistent halitosis

Frequent sore throat

Tonsil infection

White “debris” from the stone breaking up

Ear aches

Swelling of the tonsil

Persistent bad taste in the mouth

Difficulty in swallowing, or painful swallowing

Less common are larger or giant tonsil stones. Giant tonsil stones may be mistaken for peritonsillar abscesses or tumors of the tonsil.

Treatment  of Tonsil Stones

Prevention first: cleaning the tonsil area when brushing the teeth can help prevent the formation of tonsil stones. A frequently used and effective method of removing smaller stones and preventing further development is irrigation. Basic irrigation is as simple as gargling with warm salty water or mouthwash. Water jets that are used to clean the teeth are too forceful for irrigation of the tonsils and may actually damage or rupture them, causing more harm and increasing risk of infection. Mild irrigation with a hose attachment that screws onto the faucet is acceptable as the water pressure is light and can be adjusted at the faucet.

Larger or giant tonsil stones may require the attention of an oral surgeon where the stone will be removed and followed with irrigation to clean the ducts where the stones develop. More rarely small amounts of tissue must be excised along with the stone. Persons that suffer frequent tonsil stones have the option of laser surgery to reconstruct the surface area of the tonsil thereby reducing the crevices for the stones to form.

This laser treatment is called cryptolysis and is performed under local anesthetic and with a scanned carbon dioxide laser. The laser is used to smooth and even the tonsil surface by selectively vaporizing tissue. For persistent sufferers a full tonsillectomy may be necessary to perform if all other treatments fail. A tonsillectomy is the complete removal of the tonsil. Many persons have had this procedure performed when they were young children, but today it is less common to perform a tonsillectomy unless it is necessary.


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Ali Forghani, DDS

My name is Dr Ali Reza Forghani, and I currently run the Modern Smiles Dental Practice in Rockville, Maryland.  I graduated from New York University College of Dentistry, after receiving my Bachelor of Science degree from the University of Maryland.  My aim is to provide comprehensive dental care for all of my patients, and I believe that education and the use of modern methods and technologies is the best way to achieve this.

 

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