No thanks to a recurring sore throat, you’ve been miserable for a good part of the year and not for lack of trying. You’ve gotten more sleep to bolster your immune system and drunk enough water to rival Singapore’s yearly rainfall. You’ve sucked enough lozenges to know sore throats really suck. And now, you may have to give up chocolate and other festive treats, too.
Here’s the thing. While you have been doing your best to bolster your defences against sore throat, your tonsils might be the antagonists in this health drama.
That’s because sore throat could be caused by tonsil stones, especially if the irritation keeps coming back or lasts more than a month. There may be a constant bad taste in your mouth and people have been offering you breath mints.
You may also find it difficult to swallow and feel like there's something stuck at the back of your throat. When you check the back of your mouth, you might see white spots on the tonsils.
(Art: iStock/ttsz)
The white, embedded parts at the back of the mouth are not teeth but tonsil stones. (Photo: iStock/Patcharaporn Noonin)
These stones are formed in the tonsils – two round, fleshy masses found in the back of your throat. Tonsils are part of your immune system, which means they are in charge of “catching” and killing germs that try to enter your body through the mouth and nose.
Like your kidneys and gallbladder, your tonsils are also capable of growing small, hard, calcified bits that can be white or yellow in appearance.
“The tonsils contain natural pockets or tonsillar crypts that can trap various materials, such as food particles, dead cells, bacteria and mucus,” said Dr Ben Gee, the founder and principal dentist at Delight Dental.
“Over time, these trapped substances combine with minerals like calcium from saliva and harden or calcify, forming tonsil stones.”
According to Associate Professor Raymond Ngo, the head and a senior consultant at Ng Teng Fong General Hospital’s Otolaryngology - Head & Neck Surgery, tonsil stones are not common.
A tonsil stone. (Photo: iStock/Wittayayut)
“While smaller tonsil stones may go unnoticed, larger ones can cause noticeable symptoms,” said Dr Gee, referring to the signs mentioned earlier. Most people aren’t familiar with tonsil stones and that have led to surprising encounters, he said.
“For instance, one patient came in quite distressed, convinced that she had chipped a tooth after coughing up a small, hard, white fragment,” Dr Gee recounted. “It turned out to be a tonsil stone that had dislodged on its own.”
Dr Gee has also had patients report “coughing up or even swallowing small, gritty bits” that they’d mistaken for grains of rice or seeds.
“In one particularly memorable case, a patient thought they had accidentally ingested a foreign object after feeling a hard, uncomfortable ‘pop’ in their throat, only to learn it was a tonsil stone breaking loose.”
“We don’t know why some people get tonsil stones and some don’t,” said Assoc Prof Ngo.
But there may be some inclinations such as having deeper or larger tonsillar crypts, according to Dr Gee. “These crypts provide the perfect environment for debris such as food particles, mucus and bacteria to accumulate and calcify over time.”
(Photo: iStock/sweetmila)
Poor oral hygiene is another factor. If you haven’t been regularly brushing, flossing and cleaning your tongue, it can “lead to an increased buildup of bacteria and food debris in the mouth, which may settle in the tonsillar crypts”, said Dr Gee.
Other factors, he added, include a decreased saliva production, repeated bouts of tonsilitis, allergies, sinus issues and frequent colds. They contribute by either lessening the flushing out of bacteria, causing inflammation that enlarges the tonsils to trap more debris, or creating post-nasal drip where mucus can accumulate in the tonsils.
Even your diet can play a part. For instance, foods such as milk, cheese and yoghurt can contribute to the buildup of calcium-rich debris, which may calcify into stones, said Dr Gee. Meanwhile, sugary, sticky or processed foods can “fuel bacterial growth or leave behind small particles that can easily get trapped in the tonsillar crypts”.
It depends on how much the stones are bothering you; if they don’t, nothing needs to be done. Generally, “patients do not need treatment, unless they have bad breath or discomfort with chronic infection”, said Assoc Prof Ngo.
Even better news, tonsil stones can be dislodged by a doctor with a long, blunt-tip instrument. However, stones that are dislodged this way “very quickly reform”, he said. “The only way to prevent reformation is to remove the tonsils with surgery.”
He cautioned: “We do not recommend self-removal as it is difficult to do it in front of a mirror and can cause bleeding from local trauma”.
(Photo: iStock/okugawa)
But if you’re certain and confident that DIY Operation: Tonsil Stone Removal is not going to injure your mouth in any way and lead to infection, you could try using an oral water jet on the gentlest setting, recommended Dr Gee.
Or try “regularly gargling with warm salt water to help loosen the stones, reduce bacteria and soothe any irritation in the throat”. “It’s particularly useful for smaller stones or as a preventive measure,” he said.
For visible stones that are easily accessible, “you can gently nudge it out using a clean, dampened cotton swab”, suggested Dr Gee. “It’s important to do this with care and avoid applying excessive pressure as the tonsils are sensitive and can bleed or become inflamed.”
Research shows that surgically removing the tonsils (aka tonsillectomy) doesn’t result in reduced immunity. In fact, some studies show that the opposite is true with patients reporting an improved immune response. Keep in mind, though – even if you have your tonsils removed, the tissues in your throat can still become infected and sore, noted Cleveland Clinic.
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If your issue seems to be related to oral health such as persistent bad breath, poor oral hygiene or debris in the mouth, a dentist can help, said Dr Gee.
For chronic tonsil stones, recurrent throat infections, difficulty swallowing, or persistent symptoms affecting your throat or general health, see a general practitioner or ENT (ear, nose and throat) specialist instead, he said. “They can provide more advanced options, such as medical procedures to remove the stones or address underlying tonsil issues.”
But seek help early to ensure proper management, reduce discomfort and prevent complications, he said.
Continue reading...
Here’s the thing. While you have been doing your best to bolster your defences against sore throat, your tonsils might be the antagonists in this health drama.
That’s because sore throat could be caused by tonsil stones, especially if the irritation keeps coming back or lasts more than a month. There may be a constant bad taste in your mouth and people have been offering you breath mints.
You may also find it difficult to swallow and feel like there's something stuck at the back of your throat. When you check the back of your mouth, you might see white spots on the tonsils.
(Art: iStock/ttsz)
The white, embedded parts at the back of the mouth are not teeth but tonsil stones. (Photo: iStock/Patcharaporn Noonin)
WHAT ARE TONSIL STONES?
These stones are formed in the tonsils – two round, fleshy masses found in the back of your throat. Tonsils are part of your immune system, which means they are in charge of “catching” and killing germs that try to enter your body through the mouth and nose.
Like your kidneys and gallbladder, your tonsils are also capable of growing small, hard, calcified bits that can be white or yellow in appearance.
“The tonsils contain natural pockets or tonsillar crypts that can trap various materials, such as food particles, dead cells, bacteria and mucus,” said Dr Ben Gee, the founder and principal dentist at Delight Dental.
“Over time, these trapped substances combine with minerals like calcium from saliva and harden or calcify, forming tonsil stones.”
According to Associate Professor Raymond Ngo, the head and a senior consultant at Ng Teng Fong General Hospital’s Otolaryngology - Head & Neck Surgery, tonsil stones are not common.
A tonsil stone. (Photo: iStock/Wittayayut)
HOW DO I TELL I HAVE TONSIL STONES?
“While smaller tonsil stones may go unnoticed, larger ones can cause noticeable symptoms,” said Dr Gee, referring to the signs mentioned earlier. Most people aren’t familiar with tonsil stones and that have led to surprising encounters, he said.
“For instance, one patient came in quite distressed, convinced that she had chipped a tooth after coughing up a small, hard, white fragment,” Dr Gee recounted. “It turned out to be a tonsil stone that had dislodged on its own.”
Dr Gee has also had patients report “coughing up or even swallowing small, gritty bits” that they’d mistaken for grains of rice or seeds.
“In one particularly memorable case, a patient thought they had accidentally ingested a foreign object after feeling a hard, uncomfortable ‘pop’ in their throat, only to learn it was a tonsil stone breaking loose.”
WHY AM I PRONE TO TONSIL STONES?
“We don’t know why some people get tonsil stones and some don’t,” said Assoc Prof Ngo.
But there may be some inclinations such as having deeper or larger tonsillar crypts, according to Dr Gee. “These crypts provide the perfect environment for debris such as food particles, mucus and bacteria to accumulate and calcify over time.”
(Photo: iStock/sweetmila)
Poor oral hygiene is another factor. If you haven’t been regularly brushing, flossing and cleaning your tongue, it can “lead to an increased buildup of bacteria and food debris in the mouth, which may settle in the tonsillar crypts”, said Dr Gee.
Other factors, he added, include a decreased saliva production, repeated bouts of tonsilitis, allergies, sinus issues and frequent colds. They contribute by either lessening the flushing out of bacteria, causing inflammation that enlarges the tonsils to trap more debris, or creating post-nasal drip where mucus can accumulate in the tonsils.
Even your diet can play a part. For instance, foods such as milk, cheese and yoghurt can contribute to the buildup of calcium-rich debris, which may calcify into stones, said Dr Gee. Meanwhile, sugary, sticky or processed foods can “fuel bacterial growth or leave behind small particles that can easily get trapped in the tonsillar crypts”.
DO I NEED TO HAVE THE STONES REMOVED?
It depends on how much the stones are bothering you; if they don’t, nothing needs to be done. Generally, “patients do not need treatment, unless they have bad breath or discomfort with chronic infection”, said Assoc Prof Ngo.
Even better news, tonsil stones can be dislodged by a doctor with a long, blunt-tip instrument. However, stones that are dislodged this way “very quickly reform”, he said. “The only way to prevent reformation is to remove the tonsils with surgery.”
He cautioned: “We do not recommend self-removal as it is difficult to do it in front of a mirror and can cause bleeding from local trauma”.
(Photo: iStock/okugawa)
But if you’re certain and confident that DIY Operation: Tonsil Stone Removal is not going to injure your mouth in any way and lead to infection, you could try using an oral water jet on the gentlest setting, recommended Dr Gee.
Or try “regularly gargling with warm salt water to help loosen the stones, reduce bacteria and soothe any irritation in the throat”. “It’s particularly useful for smaller stones or as a preventive measure,” he said.
For visible stones that are easily accessible, “you can gently nudge it out using a clean, dampened cotton swab”, suggested Dr Gee. “It’s important to do this with care and avoid applying excessive pressure as the tonsils are sensitive and can bleed or become inflamed.”
DOES REMOVING THE TONSILS AFFECT YOUR IMMUNE SYSTEM?
Research shows that surgically removing the tonsils (aka tonsillectomy) doesn’t result in reduced immunity. In fact, some studies show that the opposite is true with patients reporting an improved immune response. Keep in mind, though – even if you have your tonsils removed, the tissues in your throat can still become infected and sore, noted Cleveland Clinic.
Collapse Expand
WHO SHOULD I SEE: A DENTIST OR GP?
If your issue seems to be related to oral health such as persistent bad breath, poor oral hygiene or debris in the mouth, a dentist can help, said Dr Gee.
For chronic tonsil stones, recurrent throat infections, difficulty swallowing, or persistent symptoms affecting your throat or general health, see a general practitioner or ENT (ear, nose and throat) specialist instead, he said. “They can provide more advanced options, such as medical procedures to remove the stones or address underlying tonsil issues.”
But seek help early to ensure proper management, reduce discomfort and prevent complications, he said.
Continue reading...