Talk:Tonsil stones

Tonsillolith or Tonsil Stone

Small white or tan foul smelling balls found in tonsils. These form in many pockets of which are called crypts located in the tonsil on ether side of the tonsils. The most probably make up are bacteria and white blood cells, the inner lining of the tonsils. The patient typically notices something like a stuck piece of food or something hard within the back of their mouth. If that is the case then the stone is probably protruding from a crypt. Typically these will self extract and will be digested by the patient. To ease the irritation you can take a flashlight and a cotton tipped stick and "pop" out the tonsillolith by forcing from the side like popping a pimple. Some may be behind areas not easily accessable depending how your parents designed your tonsil. You can design a paperclip bend banded to a pen so it can enter the crypts or around corners. Over time, you will be able to control the gag reflex. Please be gentle and if there is bleeding, stop immediatly and try another time.

Another option is to have a tonsillectomy which is a complete removal of the tonsils. This will solve the problem completely. I would only considered this if it were a very serious issue, damaging your well being. Otherwise, it can just be a daily routine like brushing your teeth.

This information comes from hours of studying the internet and personal experience. Remember, we are not dying from tonsilloliths, we are suffering with it.

Tonsilolliths are NOT food I have talked with many ENTs and they all say it is the inner lining of the tonsil that is sluffed off, it gets stuck in the crypts and when it has become big enough it pushes its way out.— Preceding unsigned comment added by Hughpine89 (talk • contribs) 21:53, 13 June 2007 (UTC)

Hughpine89 - re edit to above, this is the talk page to discuss the article, not the article itself.David Ruben ^Talk 21:06, 13 June 2007 (UTC)

Possible alternative treatment

In order to get rid of or at least decrease the production of the Tonsilloliths

it is important to do a NASAL WASH with saltwater each time before you brush your teeth ( and tongue !).

To make the saltwater solution, mix one-half teaspoon unionized salt in an 8-ounce glass of warm water. Unionized salt is used because iodized salt may be irritating when used over a long period of time.

Sniff the liquid up your nose, one nostril at a time and allow the fluid to run out of your mouth

Then brush your teeth and tongue with toothpaste as usual.

After a few days the Tonsilloliths will start to come loose and a few days later their production will become less and less.

Many doctors tell their patients to gargle with salt water in order to get rid of the Tonsilloliths. But gargling is simply not enough. You have to do the Nasal Wash with the saltwater aswell. At least once or twice a day.

I wouldn't suggest snorting salt water- Whatever the reason.

See neti pot — Omegatron 01:47, 1 November 2006 (UTC)

Dental Water Jet

I just aquired an Interplak dental water jet from W**mart to try out the forced flush method. You must buy the adjustable one, like Interplak model WJ6RW, the other ones are to powerful and will injure your tonsils bad. With the water jet turned almost to its lowest, it is pretty gentle. Mix in a salty water solution or mouthwash or clean water (make sure when you are done you run 1 tank to rinse the system with warm regular water). You should get a rubber tipped tip or use the regular tip. If you are not use to swabbing your tonsils with a cotton tipped stick, you may get a gag reflex, so turn the water even lower and bear with it. The trick is to find the crypts and almost put the tip inside them. An explosion of tonsil stones will be flushed out of your most trouble-some crypts. I guess with the salty water solution you can try the nose flush like the above friend said.

Good luck, and remember...we are not dying from tonsilloliths, we are living with them.

Update: I have been using it everyday just before bed for a few weeks now since the first initial flush(quite the purge). Well almost everyday, I went away for a weekend, and when I came back I found one tiny bugger. Other than that, I havent seen one yet. Yes its a pain to do it everyday, but you are going to have to do it anyway when you get that annoying itch and stinky breath; I have no itch anymore and NO STINKY breath. The reason I purchased it was cause I was fed up with cotton swabs and gagging trying to get the real tricky ones. I also had a chronic low level sore throat for almost 2 weeks before this (btw chronic means to last long). My throat feels better now when I wake up (even though I was on meds, this helped I know). A lot of research I did concludes that tonsilloliths can contribute to chronic low level sore throats. Try this salt water jet before cutting out your tonsils.

• I'd like to add my support for the oral irrigator as treatment (initial usage) and as prevention (with daily use). I think the key to preventing tonsilloliths is mechanically cleaning out the tonsils everyday as you would clean your teeth.

I bought a waterpik and like this person I found that the pulsating jet of water is very efficient at cleaning out the tonsils. I can see the efficacy of this water action by what is flushed out into the sink: tiny bits of food, discoloured vicosities and other debris. I know this material is coming out of my tonsils and not from my teeth or the surface of my tongue because I flush my tonsils AFTER flossing, brushing and irrigating my teeth. After months of use, gradually becoming accustomed to the gag reflex and desensitized to the water jet hitting the soft tonsils, I find that I can irrigate my tonsils quite comfortably. By doing this extra step every night, about 30 seconds for each tonsil, I haven't had a tonsil stone in over a year.

Further update: After I quit drinking milk all together, I have found a massive reduction in the amount of stones. I clean them about 1.5 times a month (averaged out), mostly I just catch that disgusting scent of the stones and I know its time to flush. —Preceding unsigned comment added by 68.60.40.51 (talk) 03:27, 14 September 2007 (UTC)

Baking soda

This person living with tonsil stones has found gargling for a full minute with a half water/half baking soda solution very helpful in getting rid of the pesky little monsters. Make sure to gargle 'vigourously' and try to let the water get as far back toward your tonsils as you can. This works especially well on stubborn stones that stay in place for several days, but I imagine it also helps prevent the formation of new stones. Be patient, though: often a set-in stone will need a day or two after gargling to fall out. Good luck!

Images and outside links

Here is an excelent image of a tonsillolith. It is korean, and I am not sure how the copy right rules work, but I feel it would be good if somebody could include it (or other images) in the main article.

Here is what I feel is the best image:
http://portal.page1.co.kr/content_images/weekly_0603_m.gif

Here is the parent page:
http://health.chol.com/weekreport/weekreport_v.aspx?srno=104

Also, this site indicates that a tonsillolith either does, or can become calcified:
http://www.ijri.org/articles/archives/20011101/images03.htm

Alternate treatment 2

I clean my own tonsils with an extended toothpick BEFORE they calcify into stones. During this time they are actually fairly soft, like tooth plaque. I can very well prevent the accumulated material from building up to levels mentioned in this article. I am not sure whether to recommend a process such as this though. One must have a VERY steady hand to prevent injury, to expose the tonsils in the mouth requires one to not breath at all, and excessive pressure on the tonsils with such devices may cause nausea.

Alternate treatment 3

Some people may find it possible to bend their tongue around enough to touch their tonsils. I can get a massaging action going that eventually dislodges the tonsillolith. I now do this sporadically out of habit (when I am concentrating intensely, for example), which prevents the tonsillolith from forming to a significant size in the first place (just try not to show your ugly face while your doing it). Curiously though, tonsilloliths only ever seem to form on my right tonsil...

Enigma 0Z 21:07, 19 July 2007 (UTC) writes:

Are you sure you're not me? I have the same ability... and they always form on my right tonsil! But it seems for me that it takes a couple of days working at it before I can really get the stone out.

Just adding my own observations to the pool:

1. I can move both of my tonsils around quite a bit, but I can move my right more 2. I usually don't get any in my left tonsil (either that or they're just too big to remove) 3. I usually get them in my right tonsil 4. It seems that when I do get one in my left, it requires more effort to remove.

I'm probably going to see an ENT soon about these, so if I get any new information, I'll post it up.

Alternate Treatment 4

Regarding the origin of stones, I have a few interesting observations. I usually try to get rid of them before they calcify into anything large as discussed here, using an extending toothpick as described above. Observation 1: my mother, sister, and I all experience stones, and none of my close friends (that i feel comfortable discussing this with) do. This poses the question, is it genetic? Observation 2: The stones always seem to 'appear' in the deeper crypts, as though they are forming inside the tonsils. I check and wash/cleanse every day, and somehow the little buggers re-appear out of the blue. My diet changes often (i'm in college...) so I haven't noticed a correlation between certain foods and their production. Observation 3: My left tonsil seems to produce twice as many...and I only ever find 'big ones' on the left. Research shows much of this occurance, with people experiencing stones usually on just the one side. I'm not sure what this may mean....any comments?

perhaps this is caused by an increased presence/absence of saliva during sleep, due to sleeping on a particular side of the body?

I also have asked a few close friends and family about them, but the only other person who gets them is my dad, which supports the genetics theory. But we also both had a lot of throat infections in the past (I had a lot of strep throat as a kid, he got tonsillitis almost every year until he turned 65). I get more on the left too, but I can tell from digging around back there getting them out that my left tonsil crypt is a lot bigger than the right one, which is probably why there are more there.

Dietary Considerations

As part of a weight loss regime I cut grains out of my diet and my tonsil stones stopped entirely. Now the only grain I eat is brown rice and I can go as long as I want without a tonsil stone but as soon as I cave in and have some pasta, bread, cookies, etc. a new stone forms within days. If you think about flour of any type it's the perfect substance to form into a paste that can not only get into a tiny crevice but also stay there and attract other substances to stick to it which is how these horrible stank social-life ruining things come to be. I believe the reason brown rice doesn't contribute to stones is because of it still having the bran intact like a thin shell over the grain. This shell keeps the grain relatively intact as I chew and swallow and so it does not find its way into a crack in the surface of my tonsils. I believe that white rice would break down quickly upon exposure to saliva and turn into a paste just like flour does. I have not experimented yet but I think probably eating corn meal (Fritos, cornbread, tortillas, etc.) also would lead to the development of a tonsil stone in those of us who have the tendency (the tendency being crevices in our tonsils). It's pretty hard to avoid processed grains but if you want to be free of tonsil stones it's certainly worth a try. Flour, whole grain or not, is not good for you anyway no matter what the USDA tries to tell you.Etsybad 23:49, 8 March 2007 (UTC)

Merge proposal

The following discussion is closed. Please do not modify it. Subsequent comments should be made in a new section.

The result was merge Cryptic tonsillitis into this article. -- David Ruben ^Talk 12:59, 15 May 2007 (UTC)

I propose merging/deleting what little additional information is currently in Cryptic tonsillitis to this tonsillolith article. The term "Cryptic tonsillitis" has just 4 hits at PubMed and none at Diseases Database (see search), it is therefore not a term that is generally recognised nor used. Any specific details on the inflammation & infection of teh tonsils should then be under tonsillitis article. David Ruben ^Talk 12:06, 2 May 2007 (UTC)

As per WP:Merge#Proposing a merger that where "silence (at least 10 days), proceed with the merger". I have proceeded to merge. I found nothing in Cryptic tonsillitis not already in this article and so have switched it to be a redirect. David Ruben ^Talk 12:59, 15 May 2007 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Discussion of the addition of advice

Further instructions on how to clean and remove tonsil stones is something I would like to see added to Wikipedia. I wrote the following which I thought with some additional work people would at least find helpful. These instructions were deemed non neutral and inappropriate by an editor and dropped. I see these instructions as being little different from the page on tooth brushing. I don't have any sources other than tips and bits of information I found here and there on the net. Frankly, there does not seem to be much information available. How do you clean tonsils? This is one way. Instead of simply deleting perhaps other readers and the editor who found this "wholey inappropriate" could help make this information better, and eventually it could be included in the main article. I have tried to make it more NPOV. I don't know where to verify it other than my own experience. Help. This is well meant advice, I wish knew how to do this years ago, and it belongs in the public domain.

Before this is dropped again I would like to at least see a straw poll on whether to include it or not.

Practical Advice

How to clean your tonsils & what equipment you need.

Equipment

What	Purpose
Miners style head mounted flashlight	You need your hands free and it is pretty dark inside your mouth.
Medium sized hand mirror	To see the back of your mouth
Adjustable pressure water irrigator (water pik)	For cleaning your tonsils

Procedure

• Ask a family member for a before and after opinion so you know if this procedure actually helps you.
• Cleaning your tonsils is messy, so set up in the bathroom over the sink.
  
• Put the mirror on top of your faucet and adjust it to about 45 degrees or so. I prop the mirror up with various bits of junk hanging around the bathroom.
  
• Put the headlamp onto your head, turn it on, and adjust it so you can bend over and illuminate your tonsils by bouncing the beam off the mirror. Once you have things adjusted properly you should be able to easily see your tonsils in the mirrror and still have your hands free to operate the water irrigator. It is really hard to hold an ordinary flashlight and operate a waterpik so the headlamp is a must.
  
• Get your water irrigator going. Important: turn it down to the lowest pressure or it may hurt
  
• Gently spray water over your tonsils. Clean out any crevices or holes. If you have tonsil stones, lots of them may come out at this point.
  
• If it hurts or starts bleeding, maybe you should see a doctor. Be really gentle. A certain amount of gagging is typical. Just stop, catch your breath, dry out your mouth by swallowing. It will get easier.
  
• You may have crevices in lower parts of your tonsils hiding behind your tongue. Hold your tongue down with your toothbrush so you can access the bottom of the tonsil.
  
• You should also clean out behind the flap at the sides of your mouth. See close up of mouth diagram, the structure labeled Glassopalatine arch Point the irrigator tip both behind the flap and up and down.
  
• Clean your equipment
  
• Check with your family member to assess results
  

70.73.152.247 05:36, 21 May 2007 (UTC)

But who states that one needs to "clean tonsils" ? Wikipedia is not a how-to guide, nor does it offer medical advice nor instruction to the readers. Information that is to be included must be WP:Notable and WP:Cite from WP:Reliable sources to WP:Verify.

"tips and bits of information I found here and there on the net" is not from reliable sources and thus can not be included.

"other than my own experience" falls foul of WP:No original research.

I'm sure you mean well, but the information above, as it stands, does not belong in the article. David Ruben ^Talk 23:07, 29 May 2007 (UTC)

UK sources?

This page is truly excellent! I'm really looking forward to having a go at this and sorting out this problem. Has anybody got a recommendation for where to get hold of a suitable waterpik type device in the UK?

Also, when performing the proceedure described above, do you recommend shining the light off the bathroom mirror into one's mouth, and looking in the smaller mirror? Or the other way around?

Many thanks. —The preceding unsigned comment was added by 82.211.95.178 (talk) 13:17, August 21, 2007 (UTC)

Colors

any info out there on different colors? either broccoli stains it or i need to make an appointment. 68.78.26.171 15:34, 29 May 2007 (UTC)

Connections with other conditions?

Does anyone know if there are any links between this and other conditions such as allergies, skin disorders (acne), swollen glands, white tongue, etc? — Preceding unsigned comment added by 203.17.45.119 (talk • contribs) 17:09, 6 June 2007 (UTC)

note risk of injury

Hi, I picked my tonsils with a small ear-stick, and after a few months, unfortunately, injured my tonsil. since then - my tonsil bleeds almost each time I have a Tonsillolith ! So I would advice on adding, in the suggestion part of the article - to be VERY careful when picking the tonsils...

Talgalili 21:52, 6 July 2007 (UTC)

Relieve the foreign-object feeling

I noticed that drinking hot drinks (especially coffee) can make the foreign-object-in-my-throat feeling go away almost instantly for a long period of time. My guess is that heat causes the tonsil to become less sensitive to stimuli--193.188.115.248 08:15, 4 September 2007 (UTC)