The tonsillar caseum or tonsil stones, are hard white or yellow formations found on or within the tonsils. They are benign accumulations of bacteria and debris in the crypts of the tonsils. Although this problem can cause discomfort, it does not pose a greater risk and is generally easily treatable..
However, they can sometimes develop into large formations that cause swollen tonsils and create an unpleasant odor. When they present with fever and sore throat, they can be a manifestation of an acute bacterial infection of the tonsils, also known as tonsillitis, which can have important medical connotations..
The tonsils are gland-like structures located in the back of the throat; They are located on each side of the throat. They are part of a protection system that serves to prevent foreign objects from seeping into the lungs. They are made of tissue that contains lymphocytes, cells that prevent and fight infection.
In many cases, the tonsils become more of a problem than a help. Tonsils are believed to have evolved for an environment where humans weren't exposed to as many germs from pollution as we find today from living in areas with relatively high populations.
It is common for people with tonsil stones to not even know they have them. Tonsillar stones are not always easy to see and can range from the size of a grain of rice to the size of a large grape..
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Some people have no visible symptoms when they suffer from tonsil stones. Even when they are large, some tonsil stones are only discovered incidentally on X-rays or CT scans. Those who do have symptoms often suffer from the following conditions:
One of the main indicators of tonsil caseum is bad breath or halitosis, which accompanies a tonsil infection.
When tonsil stones and tonsillitis occur simultaneously, it can be difficult to determine if the pain in the throat is caused by the infection or the tonsil stone..
However, the presence of a tonsil stone can cause pain or discomfort in the area where it is lodged..
Typically, tonsil stones can be seen as white, yellow, or gray nodules on the tonsils..
This is not always the case; many times they are hidden in the folds of the tonsils. In these cases they can only be detected with the help of non-invasive examination techniques..
Depending on where it is located and the magnitude of the tonsil stone, it can become difficult or painful to swallow food or liquids. People with stones in their throats may also feel like they have something stuck in their throat..
Due to shared nerve pathways, the stones can cause the sensation of pain in the ear, even though the stone itself does not touch the ear.
Inflammation from the infection and the stones themselves can cause the tonsil to swell or enlarge.
The tonsils are full of crevices, tunnels, and pits called tonsil crypts, where bacteria and other materials - such as dead cells, mucus, saliva, and food - can become trapped and accumulate. Bacteria and fungi feed on this buildup and cause a distinctive odor..
When this happens the waste can concentrate in white formations that occur in the pockets. This tends to occur more often in people who have chronic inflammation of the tonsils or repeated episodes of tonsillitis..
Tonsil stones are usually more common in teens and in larger tonsils. Those with poor dental hygiene can also get tonsil stones. Common causes of tonsillar caseum are:
- Poor dental hygiene.
- Large tonsils.
- Chronic sinus problems.
- Chronic tonsillitis (inflamed tonsils).
When tonsillar caseum occurs suddenly, it can be a manifestation of tonsillitis. Tonsillitis usually tends to be caused by viruses (70% of cases) such as influenza or rhinovirus.
However, when it manifests with caseum it is usually of bacterial origin, especially by action of the Streptococcus pyogenes, also known as "meat-eating bacteria", because it has a toxin capable of destroying the skin (although it is not the case in this case).
The problem with tonsillitis when it is caused by this bacterium is that it can be complicated late with heart diseases (such as rheumatic fever) and kidney diseases (nephritis), which significantly increase the mortality of the patient..
The ideal treatment for a tonsil stone usually depends on its size and its potential to cause discomfort or damage..
Gargling with salt water (1 teaspoon of salt in 8 ounces of warm water) a few times a day can help ease the discomfort of tonsillitis, which often accompanies tonsil stones..
Some people choose to dislodge tonsil stones at home with the use of picks or swabs..
Sometimes tonsil stones are so deeply embedded that they cannot be removed at home. In this case, a tonsillectomy may be justified..
Tonsillectomy is a definitive treatment for tonsil stones, as without tonsils the stones cannot form. It is generally recommended to try all conservative measures before considering a tonsillectomy..
A tonsillectomy is safe, but it can cause a sore throat for several days after surgery. Like all surgeries, tonsillectomy carries some risks. These include bleeding, infection, breathing difficulties related to swelling and, very rarely, life-threatening reactions to anesthesia..
In some cases antibiotics can be used to control tonsil stones. They can be used to reduce the counts of bacteria that play a crucial role in the development and growth of tonsil stones..
Preventing the formation of tonsil caseum is not complicated, it is enough to have good dental hygiene. It is suggested to brush your teeth and tongue after meals, at bedtime and first thing in the morning..
However, people who tend to suffer from chronic tonsillitis are much more likely to develop tonsil stones, with surgical removal of the tonsils being the only surefire way to prevent them. Also recommended:
- Give up smoking.
- Gargling with salt water.
- Drink lots of water to stay hydrated.
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