Tonsil Stones & Your Dental Health

First Things First, What Is A Tonsil Stone?

Tonsil stones are calcifications that develop on the tonsils, usually yellow or white and towards the back on the sides. They are formed by accumulated bacterial deposits, dead cells, mucus and food particles in the crevices of your tonsils. They range in size and can be as big as a grape.

Mild cases may not be detected by an individual, however, they can become a major inconvenience when you feel the need to swallow constantly or have horrible halitosis. Since these stones are irregular and are tacky, they tend to get trapped in the tonsils for a significant amount of time. Most of the time, these fall out on their own and there’s no need for professional removal, however this is not always the case.

So to answer our question: Are they dangerous?

It depends case to case, they may be a minor inconvenience for some, but for others it may pose a risk and a sign of something deeper.

A Quick Background on Tonsil Stones

Chances are that most people have had a tonsil stone to some degree. It could’ve felt like something was stuck in the back of your throat. You may have unknowingly coughed or sneezed it out. Unfortunately, not everyone can simply expel these tonsil stones with a cough or sneeze, so how does it become a chronic issue for those people?

The tonsils are the first line of defense for the immune system. They filter out pathogens from entering your body. At some point this filter becomes overwhelmed and reaches a max capacity hence the formation of these stones. However, this isn’t the only reason.

Causes of Tonsil Stones

Inadequate Dental Hygiene
Mouth breathing
Large tonsils
Hormonal changes
Too much calcium without sufficient vitamins K2 and D3
Large tonsils
Chronic tonsillitis
Deep crevices (crypts) in tonsils

The causes of tonsil stones vary from person to person, they can be caused by an imbalance in the oral microbiome, genetics, poor diet, and much more.

We know that bacterias’ favorite food is sugar, it helps them multiply exponentially. This excessive amount of bacteria may colonize in the deep crevices or crypts of your tonsils. They thrive in this anaerobic environment, as these crevices become burdened by biofilm, the tonsils resemble large, clogged pores.

A reduction in sugar and fermentable carbs are suggested and encouraged to assist in the prevention of tonsilloliths.

Sinus drainage also may contribute to the creation of tonsil stones causing bioburdens. Consider using a xylitol nasal spray like Xlear Nasal Spray to keep the sinus cavities clean and clear of bacteria.

Much like cavities, tonsilloliths can be formed by breathing through the mouth. Colonies of bacteria dry up as there isn’t saliva as a buffering agent to wash away bad bacteria and build-up. Some medications may even cause xerostomia (condition where the mouth does not produce an adequate amount of saliva).

Immunocompromised patients may develop tonsilloliths at a higher rate due to the body’s compromised ability to fight bacteria, viral infections, and inflammation. The tonsils are easily overburdened by filtering in overdrive and excess. It’s kind of like using a dirty air filter in a purifier.

DIAGNOSING TONSILLOLITHS OR TONSIL STONES

Most stones are diagnosable by your physician through a physical exam. In cases where tonsil stones are invisible, your provider may look for these symptoms: strep throat, sinus infection, and tonsillitis. Sometimes images are needed, it’s important to note that not all tonsil stones appear in x-rays. Even then, it may look similar to other types of calcifications which makes it an unreliable way to identify tonsilloliths. To truly and accurately locate these stones, your provider may prescribe imaging such as a CT scan or an MRI. This is usually only necessary if the provider suspects that there may be stones hidden inside your tonsil folds or if there is a risk of damage to your tonsils.

REMOVING TONSIL STONES

At home:

If you are feeling discomfort you may find ways to get rid of your tonsilloliths at home. These should be done with caution and for tonsil stones that are not causing you significant pain. Unsafe methods of removal include toothbrushes and tweezers.

Vigorously gargle warm salt water
Use a water flosser to GENTLY spray water and dislodge the tonsil stone
Gently nudge the stone with a cotton swab
Cough

In office:
Should home remedies prove ineffective you may need to see a healthcare professional/provider to aid you in removal of tonsil stones. Usually minor surgical procedures are done to remove large and/or painful stones.

Oftentimes a dentist, oral surgeon, or doctor may remove tonsilloliths, in extreme cases, and ENT may be needed. The dentist may use a combination of dental tools, medicated rinses, or laser therapy to remove the stones.

HOW TO PREVENT TONSIL STONES

There are many ways to prevent tonsil stones. We talked about what causes them earlier so you may be able to guess some preventative measures!

Brush your teeth regularly. Twice a day, 45 minutes after eating sugary, acidic, processed foods/drinks. Be sure to use remineralizing toothpastes such as Risewell or Boka!
Floss and tongue scrape daily
Reduce processed and foods loaded with sugar, switch to a nutrient-dense diet
Probiotics for dental and oral health may be used if you notice the presence of bleeding gums or bad breath
See your dentist regularly for professional cleanings and checkups
Avoid mouthwashes that are alcohol based or antibacterial – these will disrupt your oral microbiome
Mouth tape
Cease smoking, vaping, any use of tobacco
Do not abuse alcohol
Address any underlying conditions like tonsillitis or sinus infections.