While you may not know it, you’ve got two bodyguards in the back of your throat: your tonsils. These soft collections of tissues in the back of your throat collect and filter out unwanted bacteria and viruses in your body. But sometimes more than bacteria and viruses get caught in your tonsils — some people have extra pockets or crypts in their tonsils, which can collect food material and old cells. This condition is known as tonsil stones.
Evolution of Tonsil Stones
Tonsil stones are called “stones” because they are much harder than your average piece of food. However, they tend to start off softer. A piece of food, such as a small piece of bread, becomes stuck in your tonsil crypts. When you swallow, digestive enzymes in your saliva start to break down the softer portions of your food. The remaining portion is harder.
The food particle in your tonsil starts to collect some “friends” over time. This includes bacteria and cells that have sloughed off from the lining in your mouth. These cells contain a hardened substance known as keratin, the same material that provides hardness to your fingernails and strength to your hair. Understandably, they then harden the food material in your tonsil into a stone-like mass.
How Do I Spot a Tonsil Stone?
Tonsil stones have a different appearance and cause varying symptoms in people. You may start to notice the back of your throat feels itchy or have a feeling of fullness in the back of your throat. Tonsil stones can look like the following:
- White and round, much like a pearl
- Orange-yellow and cheese-like
- Rough, gray, uneven particles
The good news is that most tonsil stones will fall out on their own without causing much fuss. You may not even notice them until one day, you feel as if you’ve swallowed something unexpected. If you notice something in the back of your throat, you may be able to spot a tonsil stone by opening wide and saying “ahhh,” which makes the tonsils more prominent.
To Remove or Not to Remove a Tonsil Stone
If the idea of having a stone-like conglomeration of bacteria, old food and cells makes you want to remove a tonsil stone immediately, you are not alone. It can be tempting to take a swipe at a tonsil stone, attempting to remove it from your mouth altogether. However, the best approach for tonsil stone removal can be tricky to decide. You have a few options:
Wait for the stone to fall out. As long as the tonsil stone does not grow too large, you likely won’t experience any complications from it, and it will eventually pop out all on its own.
Gargle with salt water in an attempt to dislodge the tonsil stone. Mix one-fourth to one-half a teaspoon of salt in warm water, and tilt your head back so the water flows toward the back of your throat without swallowing it. Repeat the “ahhhhh” noise to activate the tonsils. A Waterpik, a machine that shoots a steady stream of water, also may help to dislodge the tonsil stone.
Brushing or scraping the tonsil stone away. This is not an advised option because the tonsils tend to have a steady supply of blood vessels to the area. One wrong or too-rough scrape, and you likely have a mess on your hands. Also, scraping near the back of your throat can activate your gag reflex, causing you to feel as if you are choking, according to Paul Donohue, MD, a physician writing in The Herald-Tribune.
Surgical removal of the tonsils or tonsil stone. In rare instances, a tonsil mass can become so large that it is infected or causes difficulty swallowing. In this instance an ear, nose and throat doctor may be recommended to remove the tonsil.
Who Gets Tonsil Stones?
Tonsil stones are much more likely to occur in adolescents. The tonsils tend to be larger in the young because they are helping to support a growing immune system. As you age, the tonsils shrink, which will make tonsil stones less likely to occur. However, tonsil stones can cause chronic tonsillitis infections, sore throat and bad breath.
While you can’t change the shape of your tonsils, you can practice good oral hygiene habits that reduce the chances you will experience future tonsil stones. Frequently gargling with salt water or warm water also can help dislodge particles.