Tonsil stones Q&A
With the easing of the Corona 19 quarantine policy, the number of people who care regarding bad breath has increased significantly. Bad breath can be significantly alleviated by making lifestyle changes. However, if bad breath does not go away even though you brush your teeth thoroughly and do not have cavities or gum disease, you need to suspect that you have tonsil stones. Tonsil stones are yellowish grains the size of rice grains that are formed when food debris and bacteria clump together in the pores of the tonsils (tonsillar crypts). Although it does not cause serious problems to the human body, it can cause discomfort to others and interfere with interpersonal relationships due to its foul breath. With the help of Professor Park Ki-nam of the Department of Otorhinolaryngology at Soonchunhyang University Bucheon Hospital and Professor Woo-ri Park of the Department of Otorhinolaryngology at Gachon University Gil Hospital, we summarized representative questions regarding tonsil stones in a Q&A format.
Yellowish grains of food/bacteria
Not a serious illness but causes discomfort
Thorough brushing is essential, gargling is helpful
Q : – In what cases do tonsil stones occur?
“There are many causes of tonsil stones. Chronic tonsillitis is a typical example. Frequent tonsillitis can enlarge the tonsillar fossa, and food residue can get stuck in it and form tonsil stones. Poor oral hygiene, such as not brushing your teeth properly, can also facilitate the growth of bacteria, which can lead to tonsil stones. The same goes for dry mouth. Also, tonsil stones are more likely to occur in people with congenitally developed tonsillar crypts.”
Q : – Can you suspect tonsil stones simply by smelling your breath?
“In addition to bad breath, a foreign body sensation is accompanied, and in severe cases, a sore throat is felt. Stones that cause foreign body sensation are usually 1 mm in size, but there are cases where they have grown to 1.4 cm. Stones can be seen when you open your mouth wide, and they may come out of your mouth when coughing or brushing your teeth. Unlike stones in the body, tonsil stones are not as hard as stones. It is characterized by the fact that food and bacteria are clumped together sloppily, so they crumble easily when touched. In addition, it stays in the mouth for a long time and mixes with rotten food, giving off a bad odor. Of course, it is difficult to conclude that just because you feel a foreign body in your throat, it is unconditionally due to tonsil stones. This is because the same symptoms can occur when suffering from reflux laryngitis and sinusitis (sinusitis). It is necessary to receive more careful treatment through endoscopy at the hospital.”
Q: -Is there any problem with tonsil stones?
“Yes. Unless bad breath and foreign body sensation caused by tonsil stones interfere with daily life, I do not intentionally remove them or undergo surgery. If the symptoms are serious, such as being annoying every time you swallow saliva and making it difficult to communicate with others because of bad breath, you can visit an otolaryngologist to remove stones with an inhaler. However, even following getting rid of tonsil stones in this way, it is not long before they occur once more. In this case, it is worth considering a tonsillectomy to remove the tonsil itself. Since the tonsils are an organ that performs immune functions, some patients are concerned that there will be problems with the immune system following surgery, but there is no need to worry too much. This is because other tissues that replace that function are scattered throughout our body.”
Q: -I am also curious regarding the time required for tonsillectomy and the recovery period.
“Tonsillectomy takes regarding 20 to 30 minutes under general or local anesthesia. During the operation, you have to keep your mouth open, and the gag reflex may occur when the medical staff presses the tongue to properly examine the tonsil, so most of the surgery is performed under general anesthesia. It takes up to 2 weeks to recover following surgery. You should not eat hot or spicy food at this time. Eat cold porridge for 7 to 8 days, then eat soft foods such as jajangmyeon or udon, and then switch to a regular diet. Avoid crispy foods like chicken or nachos. If you don’t do it right, it can irritate the area where the surgery was wounded and cause bleeding.”
Q : -There are people who want to get rid of tonsil stones without medical help. Is it okay?
“There are people who want to remove tonsil stones at home because they are afraid of going to the hospital regularly or because they are afraid of surgery. This is usually done by looking in a mirror and using a cotton swab, tweezers, or inhaler to remove the embedded stone. Attempts are also made to break up stones by pouring water into a syringe and then spraying it. However, it is best to refrain from trying to remove tonsil stones yourself. This is because it can touch the tonsil tissue and cause bleeding or inflammation. There is also a risk of mishaps that touch the stone and push it further inside. Moreover, tonsil stones are not all that we can see. It is rare that only one occurs, and there are many cases where several grains are hidden even inside the invisible. In other words, it is meaningless to remove only the conspicuous part when the mouth is open.”
Q : -What do I need to know to prevent and alleviate symptoms?
“To prevent tonsil stones, you must pay special attention to oral hygiene to prevent the growth of bacteria in the mouth. After eating, brush your teeth carefully so that no food residue is left behind, and even gargle with salt water or physiological saline solution sold at pharmacies. It is also important to drink enough water to avoid dry mouth. It is better to consume it periodically rather than inhaling large amounts at once. Smoking and drinking alcohol can also dry out your mouth, so avoid them as much as possible.”
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