Children's ENT Throat & Voice

How to Remove Tonsil Stones

February 3, 2020
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If you are experiencing tonsil stones, it is essential to address this condition proactively. This guide offers comprehensive strategies on how to stop or remove tonsil stones, both through self-managed approaches at home and with professional medical intervention. You will gain insights into identifying the presence of tonsil stones, understanding their development, assessing the need for tonsil removal, as well as the details of tonsillectomy, thereby enabling you to make a well-informed decision regarding your treatment options.

What are Tonsil Stones?

Tonsil stones, also known as tonsilloliths, are small, calcified particles that form in the crevices of the tonsils (two oval-shaped glands located at the back of your throat (left tonsil and right tonsil (Figure 1)). These formations consist of material such as dead cells, bacteria, and food particles that have become trapped and subsequently calcified. Tonsil stones can sometimes cause discomfort or emit a foul odour despite being generally harmless.

 

Uvula and Tonsils

How Do I Know if I Have Tonsil Stones?

Several distinctive symptoms can help confirm your suspicions if you suspect you have tonsil stones. These symptoms might not all appear simultaneously, and their severity can vary:

  • Persistent Halitosis (Bad Breath): Often the most noticeable symptom, bad breath results from the bacteria harboured within the stones.
  • Foreign Body Sensation: A frequent feeling that something is stuck at the back of your throat.
  • Swallowing Difficulties: Tonsil stones may cause discomfort or a blockage sensation when swallowing.
  • Throat Discomfort: Persistent or recurring sore throat can indicate irritation from the stones.
  • Radiating Ear Pain: Pain in the tonsils may extend to the ears due to interconnected nerve pathways.
  • Coughing: Reflexive coughing attempts to clear the throat of stones.
  • Off-Tasting Mouth: An unpleasant or metallic taste in the mouth can occur if tonsil stones are present.

Causes of Tonsil Stones

There are several causes and risk factors associated with tonsil stones. Here’s the breakdown:

  • Trapped Debris: Food particles, dead cells, and bacteria can get trapped in the tonsil crypts (tiny pockets on the surface) and harden into stones.
  • Frequent Tonsil Infections: Repeated infections can cause scarring within the tonsils, leading to deeper crypts and a higher chance of debris becoming trapped.
  • Enlarged Tonsillar Crypts: Naturally larger crypts provide more space for debris to accumulate and form stones.
  • Dehydration: Reduced saliva flow due to dehydration can contribute to a drier mouth and throat, making it easier for debris to stick and form stones.
  • Age Factor: While tonsil stones can occur at any age, they are more prevalent in teenagers and young adults due to higher rates of tonsillitis during these years.

How to Get Tonsil Stones Out?

There are multiple strategies on how to get rid of tonsil stones, such as gentle home remedies and, in severe cases, professional surgical intervention. Let’s have a look at them so you’ll understand why getting tonsils removed might be the appropriate course of action.

How to Get Rid of Tonsil Stones Using Home Remedies

You may not need to do anything if tonsil stones don’t bother you. In fact, tonsil stones often fall out on their own eventually, and the underlying cause goes away. However, if you are wondering how you can remove these stones at home when they cause uncomfortable symptoms, you can try these home remedies to get rid of them:

  • Gargle with Warm Saltwater: Dissolve 1/2 teaspoon of table salt in a warm glass of water and gargle vigorously for 30 seconds, a few times a day. The salt helps loosen the stones and reduce inflammation.
  • Cough it Out: Sometimes, a good cough can be all you need to dislodge a tonsil stone. Try a series of forceful coughs, aiming to clear your throat completely, but don’t do it for too long else you might end up hurting your throat.
  • Water Flossing: A low-pressure water irrigator, also known as a water flosser, can be a helpful tool. Aim the stream at the back of your throat near the tonsil stone to try and flush it out. Be gentle and avoid using high pressure.
  • Gentle Cotton Swab: If you can see the tonsil stone clearly, be very careful and try using a cotton swab dipped in warm water to nudge it out gently. Avoid pushing too hard, as this can irritate your tonsils.
  • Stay Hydrated: Drinking plenty of fluids throughout the day helps keep your mouth and throat moist, which can make it harder for debris to accumulate and form stones.

Important Note: Home or natural remedies are for mild cases of tonsil stones. If you experience persistent or severe symptoms, like large stones, frequent recurrence, difficulty swallowing, or fever, you should consult an ENT specialist.

Tonsillectomy

Tonsillectomy is a surgical procedure to remove the entire tonsils from the back of the throat. This procedure is typically performed when the tonsils become chronically infected, enlarged or cause other severe symptoms such as difficulty breathing or swallowing.

The operation is done through the mouth under general anaesthesia (patient asleep), and there will be no external visible cuts in the neck region. Tonsillectomy is one of the most common surgeries performed in children. However, some adults may also benefit from it.

Why Get Tonsils Removed?

If you do not have problems with your tonsils, they should be left alone. However, if the tonsils are problematic such as the conditions listed below, they should be removed.

  1. Recurrent (Frequent) Tonsillitis (Figure 2a&B): Tonsillitis is an infection of the tonsils. Patients with tonsillitis usually experience bad sore throat, painful swallowing and fever, but be sure to check with your doctor as some people may confuse viral pharyngitis with tonsillitis. During an active infection, the tonsils are swollen, inflamed and may have patches of pus. Your doctor will usually need to treat the tonsillitis with a course of oral antibiotics, pain relievers as well as gargle and lozenges. If you experience frequent or severe tonsil infection, your doctor may recommend a tonsillectomy.

Tonsil vs. Tonsillitis

Figure 2a – A comparison between normal and infected tonsils

Infected Tonsil

Figure 2b – White patches on a red and swollen tonsil, indicating a tonsil infection

  1. Snoring and Breathing Problems: If your tonsils are big, they may block the upper airway, leading to breathing difficulties and snoring. It can also be a cause of obstructive sleep apnoea (OSA), a condition where a patient stops breathing for a short period during sleep.
  1. Suspected Cancer: If you have a growth on the tonsil or an abnormally enlarged tonsil (one tonsil much bigger than the other), you should probably get your tonsils removed and get tested for cancer.
  1. Other Problems With the Tonsils: In some instances, the tonsils may be removed when there is an embedded foreign body (e.g., fish bone completely buried in the tonsil) or to provide access for surgery in the mouth for other reasons.

Benefits of Tonsil Removal

The benefits of tonsil removal can be plenty, especially if you are dealing with persistent or large tonsil stones that contribute to discomfort and frequent infections. Here are three key benefits of undergoing tonsil removal surgery in Singapore:

  • Reduced Frequency of Throat Infections: Removing the tonsils can decrease the occurrence of frequent sore throats and tonsil infections, improving your health and reducing the need for continuous medical treatments.
  • Elimination of Tonsil Stones: Tonsillectomy removes the environment where tonsil stones form, thus eliminating the risk of future tonsil stone formation and the associated symptoms like bad breath and discomfort.
  • Improved Sleep Quality: For people suffering from sleep disturbances such as snoring or obstructive sleep apnea related to enlarged tonsils, tonsil removal can help improve airflow, leading to better sleep quality and overall well-being.

Frequently Asked Questions about Why You Should Get Your Tonsils Removed

Does the removal of tonsils weaken my immune system?

The removal of tonsils will not make you more susceptible to infections, as tonsils play a small role in your immune system (though individual responses may vary). The lymphatic system, bone marrow, spleen and thymus are the key organs in your immune system. There are many studies that have shown that tonsillectomy is a safe procedure with no significant negative effects on the immune system.

What are the possible risks and complications from tonsillectomy?

Tonsillectomy is generally a common and safe surgical procedure. However, as with all surgical procedures, there are some risks involved. The most common risk is bleeding (less than 5% chance). Most cases of bleeding after a tonsillectomy can be stopped in the clinic. In rare occasions, the bleeding may have to be stopped in the operating theatre setting. Rarer complications of tonsillectomy include infection, injuries to the lip, teeth, gums and tongue (during retraction of the mouth and tongue) as well as tongue numbness and altered or decreased taste (usually temporary).

What is the recovery like after tonsillectomy?

Recovery after tonsillectomy involves a period where the surgical wound — the area where the tonsils used to be — is left exposed, as no stitches are placed to close it. This allows the area to heal naturally over time. Hence, when you look at the back of your throat, you will see two large white patches on the left and right side. Do not be alarmed as this is the normal appearance of a post-tonsillectomy wound. There will be pain during this period, but your pain should be kept under control with painkillers, gargles and lozenges. The white patch (which looks like large ulcers – Figure 3) will heal on its own, and it usually takes approximately 3-4 weeks for the wound to close completely.

Tonsils Removal

Figure 3 – The appearance of the throat a few days after removal of the tonsils. The white patches (indicated by blue arrows) are the surgical wounds (where the tonsils used to lie on). This appearance is temporary and the wound usually heals completely over 3-4 weeks.

Are there any restrictions after tonsillectomy?

You can resume most of your activities of daily living after tonsillectomy. However, to ensure that your recovery is smooth, you should take the following precautions:

  • Food — Certain foods will make your recovery more unpleasant. Spicy food, acidic food and alcohol can cause more pain in the surgical wound. Hence, to reap the most benefits of tonsil removal, you should avoid these foods until your surgical wound heals in about 3-4 weeks.
  • Exercise — It is advisable not to perform any exercise for at least 2 weeks after the surgery. As the surgical wound is raw during this period, there is a risk of bleeding from increased blood circulation to the head and neck region from exercise. Likewise, alcohol consumption may have the same effect and should be avoided.

 

 

Tonsils Jokes

Best wishes,

Dr Gan Eng Cern

ENT Specialist Singapore

    When Should You See an ENT Specialist in Singapore?

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    Dr Gan Eng Cern

    Dr Gan Eng Cern is a distinguished ENT doctor with fellowship training. In addition to his clinical practice as an ear, nose and throat specialist in Singapore, Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.

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