Tonsil stones, medically known as tonsilloliths, may form if dead skin cells, food debris, or mucus gets trapped in the tonsils and calcifies (hardens). Patients with tonsil stones often experience pain while swallowing, eating, or drinking, and swelling might also be present. Tonsil stones typically cause a feeling of an obstruction at the top of the throat, and patients could notice persistent bad breath. If the stones become very large, they could lead to breathing difficulties. Since the symptoms associated with tonsil stones may sometimes be caused by a more serious condition, patients who notice stones should be examined by a healthcare provider. This is especially important if the patient is experiencing neck pain or swelling, difficulty speaking or swallowing, and an inability to tolerate citrus. A medical evaluation is also essential if bloody saliva occurs or if one tonsil is larger than the other.
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One of the simplest and most important methods of preventing tonsil stones is to stay hydrated. When individuals aren't drinking enough water, more debris can accumulate on the tonsils without being washed away. If individuals already have tonsil stones, staying hydrated is a vital part of treating them as well. Patients can gargle warm salt water to start dissolving the stones. Experts also recommend gargling with a mouthwash free of alcohol. One of the problems with alcoholic mouthwashes is they dry out the mouth. So if an individual does use a mouthwash with alcohol, they need to drink extra water to make sure bacteria doesn't grow. The drier the mouth, the greater the chances of bacterial growth on the tonsils. Some medications can cause dry mouth, so patients should make sure they're sipping water throughout the day if they're prescribed one of these. Water is the best liquid for staying hydrated, but other drinks are acceptable if water isn't an option.
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Practice Good Oral Hygiene
Another one of the most important preventative measures when it comes to tonsil stones is to practice good oral hygiene. Individuals with poor dental hygiene are more likely to develop tonsil stones. If individuals do have tonsil stones, it might be a sign there's an issue with their brushing, flossing, or mouthwash habits. Studies have shown individuals who don't engage in regular brushing and flossing are also at an increased risk of tonsil stones. This may be because more debris is trapped in the crevices of the tonsils when it isn't brushed away. It may also be because bacteria are more likely to grow on the tonsils if they're also growing in the mouth. The same types of bacteria that lead to tonsil stones are also responsible for oral infections, gum disease, and tooth decay. Bacteria on the tonsils often indicate there are also bacteria thriving in other parts of the mouth. One study shows tonsil stones are made of a material similar to the plaque on the teeth.
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Smoking can affect the development of tonsil stones. It also affects an individual's overall oral health in basically every possible regard. Smoking can increase an individual's chances of tooth loss, gum disease, tonsillitis, and various forms of mouth cancer. Though vaping doesn't have as many significant and detrimental effects as smoking, it can also be a significant contributor to tonsil stones. Both smoking and vaping wear away at an individual's immune system because their body is constantly trying to get rid of the poisonous chemicals. At the same time, cigarettes lead to inflammation throughout the body. This increases an individual's chances of developing fungal and bacterial infections in their tonsils, mouth, or anywhere else in their body. Their tonsils may also become inflamed, which can contribute to tonsil stones or cause other issues. Tonsil stones caused by smoking can lead to holes in the tonsils. In turn, these holes cause more problems with an individual's oral health, especially if they become infected. Treatment by a doctor is necessary if patients believe their tonsils are infected.
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Course Of Antibiotics
The majority of tonsil stones won't require treatment with medication, especially since antibiotics can't get rid of tonsil stones by themselves. however, tonsil stones do need treatment with antibiotics if the tonsils are infected. Antibiotics help prevent bacteria from growing and work with the immune system to destroy bacterial infections. There is a wide range of antibiotics available today. If patients are prescribed antibiotics for a tonsil infection, they must take the entire course even if they start feeling better. Failing to complete a course of antibiotics can lead to a recurrence of the infection, and it might also become antibiotic-resistant. If this is the case, patients might need to get their tonsils removed entirely. This is without considering potential complications from the infection spreading. Antibiotics do have several side effects, and they won't address whatever underlying issues are leading to the tonsil stones. For example, if poor oral hygiene is a factor, a course of antibiotics won't prevent a recurrence unless patients also change their oral hygiene habits. Viral infections can't be fought off by antibiotics.
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Vigorous Gargling With Salt Water
Vigorous gargling with salt water can help reduce the pain associated with tonsil stones, and studies suggest it could aid wound healing and reduce inflammation. Salt is also known for its ability to reduce the overall amount of bacteria in the mouth, and using a saltwater gargle could help prevent future infections. To make a saltwater solution, stir one-quarter to one-half of a teaspoon of salt into an eight-ounce cup of warm water until the salt completely dissolves. Both sea salt and table salt are suitable for this remedy. However, patients might want to consider using distilled water instead of ordinary tap water, as the chlorine in tap water could be irritating to the throat. To improve the taste of a saltwater solution, some individuals like to add honey or lemon to the mixture.
To use the saltwater solution for tonsil stones, individuals should take a large sip of the mixture, tilt their head back, and gargle for thirty seconds before spitting out the water. Repeat these steps until the eight-ounce cup is empty. Generally, gargling with salt water can be repeated every four hours. If symptoms persist after three days of using salt water gargling, the patient should see a doctor to be evaluated for a possible infection.
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If small tonsil stones are present, coughing could be effective in dislodging them. Patients with this condition will likely feel the urge to cough naturally as a result of the throat irritation triggered by the stones. While coughing, it is important to remain vigilant for potentially serious signs. For example, the patient should examine any phlegm produced with the cough. If it is bloody, yellow, or brown, this could indicate an infection that needs antibiotics, and further tests may be necessary. Patients should see their doctor if they notice a persistent or worsening cough that lasts for three weeks or longer, and a doctor's visit is also recommended for a cough that disrupts daily life by making it difficult to eat or speak. If shortness of breath is present with a cough, the patient should seek a prompt medical evaluation at an urgent care facility or the emergency room.
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Cotton Swab Removal
Tonsil stones don't need to be removed if they aren't causing any symptoms. The first line of treatment tends to be gargling at home. However, if gargling doesn't seem to be helping, one option is to engage in a cotton swab removal. A cotton swab can be used to loosen the stone, and patients can also press the swab gently on the tonsil tissue around the stone to help dislodge the stone. Combining this technique with gargling can sometimes help loosen a stone more effectively than gargling alone. The best method is to slide the swab behind the tonsil stone and then push forward, which will pull the tonsil stone further toward the mouth rather than pushing it into the throat. It's important not to push too hard with the cotton swab, since this can cause individuals to injure the back of their throat. It's also important for patients to not use their fingers or any sharp implements to attempt the removal of a tonsil stone.
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A tonsillectomy is a surgical procedure to remove the tonsils. It can be especially beneficial for patients who have recurrent tonsil stones or repeated episodes of tonsillitis. Tonsillectomies require general anesthesia, and they are typically performed at outpatient surgery centers. Patients having this procedure should not take acetylsalicylic acid for at least two weeks before the operation, and no food should be eaten after midnight on the day of the surgery. During the tonsillectomy, the surgeon uses a scalpel or a heat-emitting device to remove both tonsils. Patients can normally go home a few hours after the procedure is finished, and a friend or family member will need to drive the patient home. For adults, recovery from a tonsillectomy may take ten to fourteen days; recovery for children is usually faster.
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Laser Tonsil Cryptolysis
Laser tonsil cryptolysis is an in-office procedure ear, nose, and throat specialists can perform. The procedure requires only a local anesthetic, and most patients can return to work the following day. Laser tonsil cryptolysis is not used to remove the tonsils; it is only intended to remove the crypts where tonsil stones usually form. Most doctors recommend laser tonsil cryptolysis in cases where small stones are present at no more than three locations. If the tonsil stones are very large or if treatment of large surface areas is needed, a coblation procedure may be more appropriate. In considering laser tonsil cryptolysis, the surgeon will evaluate whether the tonsil stones can be easily seen when the patient opens their mouth, and the patient may also need to have their gag reflex tested, as those with a strong gag reflex typically need a different procedure. As with any procedure, this form of cryptolysis carries some risks. For example, the laser could burn the oral cavity or the face if the patient sneezes or moves during the procedure. The tonsils could also regrow, and patients might experience continued problems with tonsillitis or tonsil stones. However, this procedure causes considerably less pain than a tonsillectomy, and it is effective for many patients.
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Coblation Tonsil Cryptolysis
Coblation tonsil cryptolysis is similar to laser tonsil cryptolysis, and both procedures are designed to remove the areas of the tonsil in which stones normally lodge. Coblation tonsil cryptolysis can be performed with local anesthesia, and surgeons might also choose to perform it under general anesthesia for patients who have a strong gag reflex or who need treatment across the entire surface of the tonsil. Coblation uses radio waves to convert a saltwater solution into charged ions that cut through soft tissue. Unlike laser procedures, coblation does not involve any heat, so it may be more comfortable for some patients. Individuals who undergo coblation often experience a significant decrease in the number of tonsil stones they have, and the procedure can eliminate stones in some cases.