Misconceptions

• A typical tonsil stone or tonsillolith
  
  Occasionally you will discover small, whitish-yellow, bad-smelling lumps in the back of your throat. Often these lumps are mistaken for plaque because they look like irregular shaped masses of the gunk sometimes found on your teeth. These are not plaque growths but tonsilloliths, also known as tonsil-stones.
  
  

Causes

• Tonsil stones are caused by the accumulation of anaerobic bacteria in the pockets of the tonsils. Anaerobic bacteria is a type of bacteria that cannot survive in oxygenated environments. Your tonsils contain recesses called crypts. The surface of your tonsils is formed of a mucus membrane called the oral mucosa. The oral mucosa removes dead cells constantly. These dead cells are usually washed away by your saliva, but can get caught in the crypts of your tonsils. Anaerobic bacteria finds the dead cells and uses them as a food source. As time passes, these bacteria and dead cells accumulate. Your body reacts to the foreign accumulation by attacking it with white blood cells. This gives the tonsilloliths their whitish color. These lumps are not destroyed by your white blood cells, so they sit in the throat pits growing larger over time.
  
  

Symptoms

• Tonsil stones create an irritating sensation at the back of the throat. They can feel like the beginnings of a strep infection. Occasionally tonsil stones will dislodge spontaneously from the pits of your tonsils. People assume they are bits of plaque because there is little explanation for their sudden appearance in the mouth. Tonsilloliths cause bad breath because they are made of anaerobic bacteria and dead cells. In severe cases tonsil stones can cause tonsillitis.
  
  

Prevention/Solution

• People use their fingernails or a toothpick to scrape a tonsil stone out. Fingernails are usually dirty so wash your hands thoroughly. Use the head of a moist cotton swab to remove the tonsil stone. If you have a sensitive gag reflex these methods can prove unpleasant.
  
  Dental irrigation systems use jets of water to rinse hard to reach areas of the mouth, including the tonsils. Use caution when using a dental irrigation system as the water pressure can tear the tissue of your tonsils. Set the pressure to its lowest setting and increase pressure as necessary. Using a dental irrigation jet should not irritate your gag reflex as severely as a toothpick or cotton swab.
  
  The most effective method to reduce the occurrence of tonsil stones is to use oxygenated oral care products. These include mouth rinses, nasal sprays, and toothpastes that kill the odor-causing bacteria that leads to tonsilloliths. Killing these bacteria reduces and in some cases prevents further production of tonsil stones.
  
  A severe method to prevent the growth of tonsil stones is to have a tonsillectomy. Discuss other options with your ear, nose and throat doctor before having this procedure.
  
  

Warning

• Before starting any medical treatment or following any medical advice, you should first consult your doctor.