Tonsil Stones: The Myth And The Science

Mythology abounds. Much of our science today has dispelled the myths that most primal societies thrived on. However, the pervasiveness of traditions, including health beliefs, tells of the need to continue to educate and inform.

Our physical bodies are one of the first things we reflect on in our quest to understand our world. As a result, we construct diverse explanations for what happens in our bodies. There’s evidence to show that some of the made-up beliefs aggravate morbidity and mortality.

One issue that has been of great concern to a good number of people is the occurrence of tonsil stones. In my experience, a question about this came up in every oral health presentation I have done in the last few months. The audience for these talks was people of diverse socio-demographic backgrounds. The issue is widespread and a great bother to many of the people that are affected. One fact that comes through is that a key reason for people’s anxiety with tonsil stones is this condition’s association with halitosis (bad breath).

Unsurprisingly, there are some ideas regarding tonsil stones that people hold on to that are not scientific. The importance of this realization is that it is the empirical understanding of health issues that creates a path towards healing: biomedical and psychosocial.

Tonsils are structures located at the back of the throat, bilaterally, normally. They form part of the immune system. This is the system that helps the body defend against harmful microbes and other foreign agents. Their position at the back of the throat enables them to sieve foreign pathogens. They are a haven for cells that mount immune responses against harmful microbes.

Tonsil stones are hardened or calcified substances that form in the recesses of the tonsils. They are made up of food debris, bacteria, and minerals. Within the anatomical structure of the tonsils are crypts (holes). These crypts are more pronounced in persons with relatively larger tonsils. Food debris can get lodged in the crypts, and other materials will accumulate around them, becoming hard over time. Clinically, tonsil stones can be seen as grayish or yellowish substances within the structure of the tonsils. One can even see tonsil stones upon opening wide and looking at the back of the throat in a plane mirror. They can get dislodged sometimes.

Whilst they are not strictly harmful, tonsil stones are associated with halitosis. They also present with a feeling of something stuck in the throat and frequent tonsillitis (inflammation of the tonsils), which usually comes with pain. Conversely, inflammation of the tonsils can also predispose the tonsils to tonsil stones. This is because during tonsillitis, the tonsils swell up. Upon resolution of the tonsillitis, the tonsils revert to “normal size,” and holes form on them. The stones can then form in these holes.

The myths surrounding tonsil stones mostly concern the cause, indication, consequences, and management. Good oral hygiene is extremely important in preventing tonsil stones; poor oral hygiene, which comes with more food debris packed in the mouth, can contribute to them. However, it does not necessarily mean that anyone with tonsils has poor oral hygiene. Indeed, there are people who are very meticulous with their oral hygiene and are still prone to tonsil stones. It is, however, better for them to occur despite good oral hygiene.

Also, contrary to the belief of many people that tonsil stones are an indication of a systemic disease, it’s not true. A reference to the science of the predisposing factors contradicts this belief.

Furthermore, tonsil stones may be dealt with using a water flosser. The gentle pressure can irrigate the tonsils adequately to dislodge the stones. One does not need to insert sharp instruments at the back of the throat in an attempt to dislodge the stones. Moreover, surgery is not the only way to manage tonsil stones, as some people believe. Saltwater gargles also help to dislodge the stones.

A surgical procedure called tonsillectomy, which involves surgical removal of part or all of the tonsils, can be done only when there is recurrent infection of the throat, disruption of normal breathing during sleep due to large tonsils, or accumulation of an abscess (a swelling filled with pus) around the tonsils.

Tonsil stones are quite pervasive. The major concern surrounds the halitosis that they lead to, and the feeling of a lump in the throat. Whilst they are not necessarily harmful, people are very much concerned about the condition, even affecting their self-image. Maintain good oral hygiene as much as it lies in your power. Use a water flosser or do saltwater gargling to assist with dislodging. Where it is indicated, the tonsils can be surgically removed mostly by a trained Ear, Nose and Throat specialist without impinging on the effectiveness of the immune system.